Dendrimeric Antigens for Drug Allergy Diagnosis: A New Approach for Basophil Activation Tests

Fernandez

Montañez

et al. 2019

Self Cite

Drug hypersensitivity reactions (DHRs) are nowadays the third cause of allergy after rhinitis and asthma with a significant increase in prevalence in both adults and paediatric population with new drugs included as culprit. For this, DHRs represent not only a health problem but also a significant financial burden for affected individuals and health systems. Mislabelling DHRs is showing to be a relevant problem for both, false label of drug allergic and false label of nonallergic. All this reinforces the need to improve accurate diagnostic approaches that allow an appropriate management.Moreover, there is a need for training both, nonallergist stakeholders and patients to improve the reaction identification and therefore decrease the mislabelling. The use of allergy cards has shown to be relevant to avoid the induction of DHRs due to the prescription of wrong medication.Recent developments over the last 2 years and highlights about risk factors, diagnostic approaches, mechanisms involved as well as prevention actions, and management have been reviewed. In these papers, it has been outlined the need for correct diagnosis and de-labelling of patients previously false-reported as allergic, which will improve the management and treatment of patients with DHRs. K E Y W O R D Sallergy diagnosis, allergy treatment, basic mechanisms, drug allergy, epidemiology | 2369

Section: Diagnosismentioning

confidence: 99%

Section: Irs In Vitro Testsmentioning

confidence: 99%

Recent developments and highlights in drug hypersensitivity

Fernandez

Montañez

et al. 2019

Self Cite

“…60 In another study, the ability of penicilloyl DeAns to stimulate basophils was demonstrated in patients with betalactam allergy (Figure 2D bottom), with basophil response being associated with the size of the nanoconjugates and density of drugs. 61 Therefore, nanostructures in BAT provide the possibility of both increasing the hapten density, because of their multivalent capacity, and presenting the appropriate size for having an optimal sIgE bridging on the basophil surface. These two factors are essential to improve the sensitivity of this cellular test.…”

Section: Use Of Nanostructures In Detection Of Sige In Cellular Testmentioning

confidence: 99%

Role of nanostructures in allergy: Diagnostics, treatments and safety

Pérez‐Inestrosa

Rojo

et al. 2021

Self Cite

Nanotechnology is science, engineering and technology conducted at the nanoscale, which is about 1-100 nm. It has led to the development of nanomaterials, which behave very differently from materials with larger scales and can have a wide range of applications in biomedicine. The physical and chemical properties of materials of such small compounds depend mainly on the size, shape, composition and functionalization of the system. Nanoparticles, carbon nanotubes, liposomes, polymers, dendrimers and nanogels, among others, can be nanoengineeried for controlling all parameters, including their functionalization with ligands, which provide the desired interaction with the immunological system, that is dendritic cell receptors to activate and/or modulate the response, as well as specific IgE, or effector cell receptors.However, undesired issues related to toxicity and hypersensitivity responses can also happen and would need evaluation. There are wide panels of accessible structures, and controlling their physico-chemical properties would permit obtaining safer and more efficient compounds for clinical applications goals, either in diagnosis or treatment. The application of dendrimeric antigens, nanoallergens and nanoparticles in allergy diagnosis is very promising since it can improve sensitivity by increasing specific IgE binding, mimicking carrier proteins or enhancing signal detection. Additionally, in the case of immunotherapy, glycodendrimers, liposomes, polymers and nanoparticles have shown interest, behaving as platforms of allergenic structures, adjuvants or protectors of allergen from degradation or having a depot capacity. Taken together, the application of nanotechnology to allergy shows promising facts facing important goals related to the improvement of diagnosis as well as specific immunotherapy.

“…A novel study showed that nanostructures with higher diameter and number of determinants induced higher basophil activation in allergic patients. 80 Selective relaxant-binding agents, such as Sugammadex, form high affinity complexes with steroidal NMBAs, particularly rocuronium, generating the complex S-R-Cx. The use of BAT has confirmed in a clinical case the existence of IgE that recognizes the complex regardless of the individual steroidal NMBA.…”

Section: Drug-sige Determinationmentioning

confidence: 99%

“…Additionally, the use of nanostructures bound to BLs has proved the relevance of the carrier molecule and the drug distribution for immunological recognition. A novel study showed that nanostructures with higher diameter and number of determinants induced higher basophil activation in allergic patients 80 …”

Section: In Vitro Testsmentioning

confidence: 99%

Advances and novel developments in drug hypersensitivity diagnosis

Ariza

Bogas

et al. 2020

Self Cite

The diagnosis of drug hypersensitivity reactions (DHRs) has important implications for both patients and health system. 1 Mainly because an allergy label, whether true or not, implies the avoidance of medications that may be essential, the performance of unnecessary desensitization procedures, or the use of alternative medications. All these alternatives can lead to a less effective treatment, more potential adverse effects, and costs for health systems. 2 Moreover, in the case of antibiotics, it results in bacterial resistance. 3 Considering that there are no specific tests to distinguish between a viral infection and DHRs in the acute phase, a diagnostic work-up should be performed to remove a false label of hypersensitivity. 4 DHRs diagnosis is complex, time consuming, needs to be done by trained staff, and it is not standardized for many drugs. It is mainly based on skin testing (ST) and drug provocation tests (DPTs),