Pharmacogenomic Advances in the Prediction and Prevention of Cutaneous Idiosyncratic Drug Reactions

Clin Pharmacol Ther. 2017 Jul;102(1):86-97. doi: 10.1002/cpt.683. Epub 2017 Jun 3.

Abstract

Cutaneous idiosyncratic drug reactions (CIDRs) are usually unpredictable, ranging from mild maculopapular exanthema (MPE) to severe cutaneous adverse drug reactions (SCARs) such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Increasing evidence suggests that HLA alleles are strongly associated with drug-induced-CIDRs. The pathomechanisms for CIDRs include genetic polymorphisms affecting complex immune-specific HLA/drug antigen/T-cell receptor interactions and drug metabolism. Pharmacogenomic tests to prevent CIDRs have been widely implemented in clinical practice in recent years.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Genetic Testing / methods*
  • HLA Antigens / genetics*
  • Humans
  • Immunity, Cellular
  • Pharmacogenetics
  • Pharmacogenomic Variants*
  • Predictive Value of Tests
  • Stevens-Johnson Syndrome* / genetics
  • Stevens-Johnson Syndrome* / immunology
  • Stevens-Johnson Syndrome* / prevention & control

Substances

  • HLA Antigens