RT Journal Article
T1 Controversies in drug allergy: In vitro testing.
A1 Mayorga, Cristobalina
A1 Ebo, Didier G
A1 Lang, David M
A1 Pichler, Werner J
A1 Sabato, Vito
A1 Park, Miguel A
A1 Makowska, Joanna
A1 Atanaskovic-Markovic, Marina
A1 Bonadonna, Patrizia
A1 Jares, Edgardo
K1 Drug hypersensitivity
K1 IgE
K1 T-cells
K1 Anaphylaxis
K1 Cytokine
K1 Diagnostic
K1 In vitro tests
K1 p-i concept
K1 Proliferation
K1 Severe cutaneous reactions
AB Despite their low frequency, drug hypersensitivity reactions (DHRs) can be serious and result in lifelong sequelae. The diagnosis is critical to avert future reactions and should identify the culprit drug or drugs and safe alternatives. However, making the diagnosis can be complex and challenging. Reliable in vitro tests can offer the potential to improve a diagnosis of DHR and influence medical decision making. Importantly, in vitro testing is frequently not performed as a test in isolation but rather as a component of a diagnostic algorithm along with additional tests. There are several in vitro approaches for the different endotypes of DHRs. However, only few are available for routine diagnosis, and many are restricted to research laboratories. In vitro tests exhibit varying sensitivity and specificity depending on the drug involved and the clinical phenotype. In vitro tests can complement skin tests, especially in patients with negative or equivocal skin test responses inconsistent with the clinical presentation and in severe reactions in which drug provocation tests are contraindicated. The main unmet need for many in vitro tests for the diagnosis of DHRs is validation in larger studies with standardized controls that could harmonize diagnostic management between the United States, European Union, and other regions of the world.
PB Elsevier
YR 2018
FD 2018-09-28
LK http://hdl.handle.net/10668/13343
UL http://hdl.handle.net/10668/13343
LA en
NO Mayorga C, Ebo DG, Lang DM, Pichler WJ, Sabato V, Park MA, et al. Controversies in drug allergy: In vitro testing. J Allergy Clin Immunol. 2019 Jan;143(1):56-65
DS RISalud
RD Apr 12, 2025