PMID- 35123386
OWN - NLM
STAT- MEDLINE
DCOM- 20220421
LR  - 20220421
IS  - 2005-6648 (Electronic)
IS  - 1226-3303 (Print)
IS  - 1226-3303 (Linking)
VI  - 37
IP  - 2
DP  - 2022 Feb
TI  - Desensitization for the prevention of drug hypersensitivity reactions.
PG  - 261-270
LID - 10.3904/kjim.2021.438 [doi]
AB  - Drug desensitization is the temporary induction of tolerance to a sensitized drug 
      by administering slow increments of the drug, starting from a very small amount 
      to a full therapeutic dose. It can be used as a therapeutic strategy for patients 
      with drug hypersensitivity when no comparable alternatives are available. 
      Desensitization has been recommended for immunoglobulin E (IgE)-mediated 
      immediate hypersensitivity; however, its indications have recently been expanded 
      to include non-IgE-mediated, non-immunological, or delayed T cell-mediated 
      reactions. Currently, the mechanism of desensitization is not fully understood. 
      However, the attenuation of various intracellular signals in target cells is an 
      area of active research, such as high-affinity IgE receptor (FcepsilonRI) 
      internalization, anti-drug IgG4 blocking antibody, altered signaling pathways in 
      mast cells and basophils, and reduced Ca2+ influx. Agents commonly requiring 
      desensitization include antineoplastic agents, antibiotics, antituberculous 
      agents, and aspirin/nonsteroidal antiinflammatory drugs. Various desensitization 
      protocols (rapid or slow, multi-bag or one-bag, with different target doses) have 
      been proposed for each drug. An appropriate protocol should be selected with the 
      appropriate concentration, dosage, dosing interval, and route of administration. 
      In addition, the protocol should be adjusted with consideration of the severity 
      of the initial reaction, the characteristics of the drug itself, as well as the 
      frequency, pattern, and degree of breakthrough reactions.
FAU - Kang, Sung-Yoon
AU  - Kang SY
AD  - Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, 
      Korea.
FAU - Seo, Jeongmin
AU  - Seo J
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Kang, Hye-Ryun
AU  - Kang HR
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
AD  - Institute of Allergy and Clinical Immunology, Seoul National University Medical 
      Research Center, Seoul National University College of Medicine, Seoul, Korea.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220228
PL  - Korea (South)
TA  - Korean J Intern Med
JT  - The Korean journal of internal medicine
JID - 8712418
RN  - 0 (Antineoplastic Agents)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - *Antineoplastic Agents/therapeutic use
MH  - Desensitization, Immunologic/methods
MH  - *Drug Hypersensitivity/diagnosis/etiology/prevention & control
MH  - Humans
MH  - Immunoglobulin E/metabolism
MH  - Mast Cells/metabolism
PMC - PMC8925949
OTO - NOTNLM
OT  - Anti-bacterial agents
OT  - Anti-inflammatory agents, non-steroidal
OT  - Antineoplastic agents
OT  - Desensitization, immunologic
OT  - Drug hypersensitivity
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2022/02/07 06:00
MHDA- 2022/04/22 06:00
PMCR- 2022/03/01
CRDT- 2022/02/06 19:48
PHST- 2021/09/24 00:00 [received]
PHST- 2021/11/19 00:00 [accepted]
PHST- 2022/02/07 06:00 [pubmed]
PHST- 2022/04/22 06:00 [medline]
PHST- 2022/02/06 19:48 [entrez]
PHST- 2022/03/01 00:00 [pmc-release]
AID - kjim.2021.438 [pii]
AID - kjim-2021-438 [pii]
AID - 10.3904/kjim.2021.438 [doi]
PST - ppublish
SO  - Korean J Intern Med. 2022 Feb;37(2):261-270. doi: 10.3904/kjim.2021.438. Epub 
      2022 Feb 28.