Diagnostic Tools and Biomarkers for Severe Drug Eruptions

Abstract

In accordance with the development of human technology, various medications have been speedily developed in the current decade. While they have beneficial impact on various diseases, these medications accidentally cause adverse reactions, especially drug eruption. This delayed hypersensitivity reaction in the skin sometimes causes a life-threatening adverse reaction, namely Stevens-Johnson syndrome and toxic epidermal necrolysis. Therefore, how to identify these clinical courses in early time points is a critical issue. To improve this problem, various biomarkers have been found for these severe cutaneous adverse reactions through recent research. Granulysin, Fas ligands, perforin, and granzyme B are recognized as useful biomarkers to evaluate the early onset of Stevens-Johnson syndrome and toxic epidermal necrolysis, and other biomarkers, such as miRNAs, high mobility group box 1 protein (HMGB1), and S100A2, which are also helpful to identify the severe cutaneous adverse reactions. Because these tools have been currently well developed, updates of the knowledge in this field are necessary for clinicians. In this review, we focused on the detailed biomarkers and diagnostic tools for drug eruption and we also discussed the actual usefulness of these biomarkers in the clinical aspects based on the pathogenesis of drug eruption.

Síndrome De Stevens-Johnson - Revisão De Literatura

“…Porém, se nos deparamos com os casos clínicos com suspeita diagnóstica SSJ/NET e há limitação para avaliação de ligantes Fas solúveis e granulisina, especialmente devido à amostragem tardia, outros biomarcadores, como bicarbonato sérico, endocan e IL-15, podem ser úteis para a detecção da síndrome e a previsão do futuro curso clínico desses pacientes. Como ferramenta de estimativa de prognóstico para esses pacientes, o SCORTEN é a ferramenta indicada (YOSHIOKA et al, 2021).…”

“…A avaliação ocorre no dia da admissão para tratamento (dia 1) e no dia 3 (dia da avaliação com a melhor correlação com prognóstico de mortalidade) (BRANDT, et al, 2021). Os exames e testes supracitados combinados serão úteis para determinar a abordagem terapêutica para a erupção medicamentosa (YOSHIOKA et al, 2021).…”

Drug hypersensitivity, in vitro tools, biomarkers, and burden with COVID‐19 vaccines

“…7 However, recent developments (Figure 2B ) have analyzed the role of other biomarkers in diagnosis, prognosis, or prediction on HSR, and have evaluated the effect of therapeutic approaches. 33 , 34 …”

“…The most important diagnostic biomarkers are the detection of sIgE in serum, the over‐expression of certain molecules on the cell surface during BAT (mainly CD63 and CD203c) and proliferation or mediator release in other cell‐based tests (Figure 2). 7 However, recent developments (Figure 2B) have analyzed the role of other biomarkers in diagnosis, prognosis, or prediction on HSR, and have evaluated the effect of therapeutic approaches 33,34 …”

Drug eruptions: an emergency room approach

“…Se cree que el mecanismo por el cual se genera el daño es una reacción inmunitaria específica que desencadena la apoptosis masiva de queratinocitos, mediada por la expresión de FasL, granulisina y anexina A1 en la interacción con linfocitos T citotóxicos, linfocitos NK y monocitos. Algunos de estos mediadores podrían servir como posibles biomarcadores para la detección temprana de este síndrome (56)(57)(58)(59)(60)(61)(62) .…”