Using CD40 Ligand Expression to Detect Antigen-specific T Cells in Patients with Drug Eruptions

Higuchi, Tetsuya; Satoh, Takahiro; Yokozeki, Hiroo

doi:10.2340/00015555-1617

Cited by 4 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, the potential of using CD40L to detect activated drug-specific T cells in DTH to antibiotics and anti-epileptics has been demonstrated in case control studies of small sample sizes, but its overall accuracy and application in SCARs remain to be further explored. For instance, among 14 patients clinically diagnosed with drug eruptions, only 8 of their causative drug-activated PBMCs were tested positive for CD40L (61,62).…”

Section: Cd40 and Cd40lmentioning

confidence: 99%

The Roles of Immunoregulatory Networks in Severe Drug Hypersensitivity

Hsu

et al. 2021

Front. Immunol.

View full text Add to dashboard Cite

The immunomodulatory effects of regulatory T cells (Tregs) and co-signaling receptors have gained much attention, as they help balance immunogenic and immunotolerant responses that may be disrupted in autoimmune and infectious diseases. Drug hypersensitivity has a myriad of manifestations, which ranges from the mild maculopapular exanthema to the severe Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DRESS/DIHS). While studies have identified high-risk human leukocyte antigen (HLA) allotypes, the presence of the HLA allotype at risk is not sufficient to elicit drug hypersensitivity. Recent studies have suggested that insufficient regulation by Tregs may play a role in severe hypersensitivity reactions. Furthermore, immune checkpoint inhibitors, such as anti-CTLA-4 or anti-PD-1, in cancer treatment also induce hypersensitivity reactions including SJS/TEN and DRESS/DIHS. Taken together, mechanisms involving both Tregs as well as coinhibitory and costimulatory receptors may be crucial in the pathogenesis of drug hypersensitivity. In this review, we summarize the currently implicated roles of co-signaling receptors and Tregs in delayed-type drug hypersensitivity in the hope of identifying potential pharmacologic targets.

show abstract

Section: Cd40 and Cd40lmentioning

confidence: 99%

The Roles of Immunoregulatory Networks in Severe Drug Hypersensitivity

Hsu

et al. 2021

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…CD154 is a member of the TNF‐superfamily and is expressed by CD8 +ve cytotoxic T cells, which can also be involved in NIDHRs, for example a maculopapular exanthema to β‐lactams. With respect to the application of a CD154‐based lymphocyte activation test (LAT) in NIDHRs, we located a single series of 14 patients . This study provided encouraging data about the potential of a CD154‐LAT in NIDHRs, but no cases with NIDHR to aminopenicillins were enrolled.…”

Section: Figurementioning

confidence: 99%

CD154 (CD40L): A novel aid to document nonimmediate hypersensitivity to amoxicillin or amoxicillin clavulanic acid

Gasse

Ebo

Mertens

et al. 2020

Clin Experimental Allergy

View full text Add to dashboard Cite

“…A CD154 assay to identify drug-specific hypersensitivity also was performed, and it successfully detected the cause of drug hypersensitivity. 4 We are performing further analyses of the clinical usefulness of the CD154 assay. We expect that the combined use of LTTs and CD154 assays will enable us to differentiate between drug hypersensitivity and pathogen hypersensitivity with high accuracy.…”

Section: Replymentioning

confidence: 99%

“…Our results suggest that amoxicillin sensitization was detectable only transiently during the acute phase in some patients with skin eruptions after H pylori eradication therapy. As with amoxicillin-induced exanthema in patients with infectious mononucleosis, 4 positive LTT responses to amoxicillin during the acute phase of skin eruptions after H pylori eradication therapy might be caused by not only persistent true sensitization but also transient reversible hypersensitivity to the drug. Degraded H pylori, H pylorispecific T cells, and/or recirculation of mucosal T cells into the blood could be responsible for the transient breakdown of immune tolerance to or ignorance of the drug.…”

mentioning

confidence: 99%