PMID- 36343890
OWN - NLM
STAT- MEDLINE
DCOM- 20230207
LR  - 20230214
IS  - 1534-4436 (Electronic)
IS  - 1081-1206 (Linking)
VI  - 130
IP  - 2
DP  - 2023 Feb
TI  - Interleukin-6 and cytokine release syndrome: A new understanding in drug 
      hypersensitivity reactions.
PG  - 178-184
LID - S1081-1206(22)01905-6 [pii]
LID - 10.1016/j.anai.2022.10.025 [doi]
AB  - Immediate drug hypersensitivity reactions (DHRs) are historically thought to be 
      because of immunoglobulin E (IgE) cross-linking, causing mast cell degranulation 
      and release of mediators like tryptase and histamine. With the increasing use of 
      monoclonal antibodies, it has become apparent that some patients present atypical 
      features during immediate DHRs, including occurrence in initial exposure, a lack 
      of urticaria and angioedema, and the presence of fever, chills, rigors and 
      musculoskeletal pain as the predominant symptoms. This observation led to the 
      recognition of a novel phenotype of immediate DHRs called cytokine release 
      syndrome (CRS). Other types of immediate DHRs include infusion-related reactions 
      (which present similarly to CRS), and mixed reactions (which share overlapping 
      features of both type 1 reactions and CRS). Desensitization to culprit drugs can 
      be a lifesaving option in patients who develop immediate DHRs to first-line 
      treatment. Whereas robust data are supporting the safety and efficacy of drug 
      desensitization, breakthrough reactions can still occur and CRS seems to be a 
      more common cause than type 1 reactions. Tryptase has been the only available 
      biomarker for immediate DHRs and is associated with type 1 reactions. Emerging 
      evidence consistently found the association between increased serum interleukin 6 
      level and DHR-related CRS, suggesting that interleukin 6 can be a novel 
      biomarker, in addition to tryptase, to distinguish various types of DHRs. In the 
      era of precision medicine, phenotyping and endotyping hypersensitivity reactions 
      to chemotherapy and monoclonal antibodies using validated biomarkers should be 
      part of routine drug allergy care.
CI  - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Lee, Erika Yue
AU  - Lee EY
AD  - Department of Medicine, Institute of Health Policy, Management and Evaluation, 
      Eliot Phillipson Clinician-Scientist Training Program, University of Toronto, 
      Toronto, Ontario, Canada; Division of Allergy and Immunology, St. Michael's 
      Hospital, Toronto, Ontario, Canada. Electronic address: 
      erika.lee@mail.utoronto.ca.
FAU - Jakubovic, Baruch D
AU  - Jakubovic BD
AD  - Department of Medicine, Humber River Hospital, Toronto, Ontario, Canada; 
      Department of Medicine, Queen's University, Kingston, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20221105
PL  - United States
TA  - Ann Allergy Asthma Immunol
JT  - Annals of allergy, asthma & immunology : official publication of the American 
      College of Allergy, Asthma, & Immunology
JID - 9503580
RN  - 0 (Interleukin-6)
RN  - EC 3.4.21.59 (Tryptases)
RN  - 0 (Biomarkers)
RN  - 0 (Antibodies, Monoclonal)
SB  - IM
MH  - Humans
MH  - Interleukin-6
MH  - Tryptases
MH  - Cytokine Release Syndrome
MH  - *Hypersensitivity, Immediate/diagnosis
MH  - *Drug Hypersensitivity
MH  - Biomarkers
MH  - Antibodies, Monoclonal
EDAT- 2022/11/08 06:00
MHDA- 2023/02/08 06:00
CRDT- 2022/11/07 19:27
PHST- 2022/08/08 00:00 [received]
PHST- 2022/08/25 00:00 [revised]
PHST- 2022/10/31 00:00 [accepted]
PHST- 2022/11/08 06:00 [pubmed]
PHST- 2023/02/08 06:00 [medline]
PHST- 2022/11/07 19:27 [entrez]
AID - S1081-1206(22)01905-6 [pii]
AID - 10.1016/j.anai.2022.10.025 [doi]
PST - ppublish
SO  - Ann Allergy Asthma Immunol. 2023 Feb;130(2):178-184. doi: 
      10.1016/j.anai.2022.10.025. Epub 2022 Nov 5.