Publication: The role of in vitro detection of drug-specific mediator-releasing cells to diagnose different phenotypes of severe cutaneous adverse reactions
Issued Date
2021-11-01
Resource Type
ISSN
20927363
20927355
20927355
Other identifier(s)
2-s2.0-85119414361
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Mahidol University
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SCOPUS
Bibliographic Citation
Allergy, Asthma and Immunology Research. Vol.13, No.6 (2021), 896-907
Suggested Citation
Jettanong Klaewsongkram, Supranee Buranapraditkun, Pattarawat Thantiworasit, Pawinee Rerknimitr, Papapit Tuchinda, Leena Chularojanamontri, Ticha Rerkpattanapipat, Kumutnart Chanprapaph, Wareeporn Disphanurat, Panlop Chakkavittumrong, Napatra Tovanabutra, Chutika Srisuttiyakorn, Yuttana Srinoulprasert, Chonlaphat Sukasem, Yuda Chongpison The role of in vitro detection of drug-specific mediator-releasing cells to diagnose different phenotypes of severe cutaneous adverse reactions. Allergy, Asthma and Immunology Research. Vol.13, No.6 (2021), 896-907. doi:10.4168/AAIR.2021.13.6.896 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/77197
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Title
The role of in vitro detection of drug-specific mediator-releasing cells to diagnose different phenotypes of severe cutaneous adverse reactions
Author(s)
Jettanong Klaewsongkram
Supranee Buranapraditkun
Pattarawat Thantiworasit
Pawinee Rerknimitr
Papapit Tuchinda
Leena Chularojanamontri
Ticha Rerkpattanapipat
Kumutnart Chanprapaph
Wareeporn Disphanurat
Panlop Chakkavittumrong
Napatra Tovanabutra
Chutika Srisuttiyakorn
Yuttana Srinoulprasert
Chonlaphat Sukasem
Yuda Chongpison
Supranee Buranapraditkun
Pattarawat Thantiworasit
Pawinee Rerknimitr
Papapit Tuchinda
Leena Chularojanamontri
Ticha Rerkpattanapipat
Kumutnart Chanprapaph
Wareeporn Disphanurat
Panlop Chakkavittumrong
Napatra Tovanabutra
Chutika Srisuttiyakorn
Yuttana Srinoulprasert
Chonlaphat Sukasem
Yuda Chongpison
Other Contributor(s)
Ramathibodi Hospital
Siriraj Hospital
Chulalongkorn University
King Chulalongkorn Memorial Hospital
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Faculty of Medicine, Chulalongkorn University
Chiang Mai University
Siriraj Hospital
Chulalongkorn University
King Chulalongkorn Memorial Hospital
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Faculty of Medicine, Chulalongkorn University
Chiang Mai University
Abstract
Propose: The purpose of this study was to investigate panels of enzyme-linked immunospot assays (ELISpot) to detect drug-specific mediator releasing cells for confirming culprit drugs in severe cutaneous adverse reactions (SCARs). Methods: Frequencies of drug-induced interleukin-22 (IL-22)-, interferon-gamma (IFN-γ)-, and granzyme-B (GrB)-releasing cells were measured by incubating peripheral blood mononuclear cells (PBMCs) from SCAR patients with the culprit drugs. Potential immunoadjuvants were supplemented to enhance drug-induced mediator responses. Results: Twenty-seven patients, including 9 acute generalized exanthematous pustulosis (AGEP), 10 drug reactions with eosinophilia and systemic symptoms, and 8 Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) were recruited. The average frequencies of drug-induced IL-22-, IFN-γ-, and GrB-releasing cells were 35.5±16.3, 33.0±7.1, and 164.8±43.1 cells/million PBMCs, respectively. The sensitivity of combined IFN-γ/IL-22/GrB ELISpot was higher than that of IFN-γ ELISpot alone for culprit drug detection in all SCAR subjects (77.8% vs 51.9%, P < 0.01). The measurement of drug-induced IL-22- and IFN-γ releasing cells confirmed the culprit drugs in 77.8% of AGEP. The measurement of drug-induced IFN-γ- and GrB-releasing cells confirmed the culprit drugs in 62.5% of SJS/TEN. Alpha-galactosylceramide supplementation significantly increased the frequencies of drug-induced IFN-γ releasing cells. Conclusion: The measurement of drug-induced IFN-γ-releasing cells is the key for identifying culprit drugs. The additional measurement of drug-induced IL-22-releasing cells enhances ELISpot sensitivity to identify drug-induced AGEP, while the measurement of drug-induced GrB-releasing cells could have a role in SJS/TEN. ELISpot sensitivity might be improved by supplementary alpha-galactosylceramide.