Drug hypersensitivity in the fast lane: What clinicians should know about phenotypes, endotypes, and biomarkers

Ann Allergy Asthma Immunol. 2020 Jun;124(6):566-572. doi: 10.1016/j.anai.2020.04.005. Epub 2020 Apr 15.

Abstract

Objective: To review novel concepts in drug hypersensitivity and the management of immediate hypersensitivity reactions.

Data sources: English language literature on MEDLINE and Embase surrounding drug hypersensitivity and desensitization.

Study selections: References were selected based on relevance, date of publication, and originality.

Results: There are numerous citations looking at categorizing drug reactions, pathogenesis, biomarkers, and desensitization. Current understanding supports the use of a phenotype-endotype-biomarker model for categorizing immediate hypersensitivity reactions. Drug desensitization is a powerful therapeutic strategy that enables temporary induction of tolerance to medications that triggered immediate reactions.

Conclusion: Immediate hypersensitivity reactions are diverse in presentation and pathogenesis. Drug desensitization is an effective intervention with sufficient evidence to support its more widespread availability.

Publication types

  • Review

MeSH terms

  • Basophils
  • Biomarkers*
  • Desensitization, Immunologic
  • Disease Management
  • Disease Susceptibility
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / epidemiology
  • Drug Hypersensitivity / etiology*
  • Drug Hypersensitivity / therapy
  • Genetic Predisposition to Disease
  • Health Care Costs
  • Humans
  • Hypersensitivity, Immediate / diagnosis
  • Hypersensitivity, Immediate / etiology
  • Immunoglobulin E
  • Phenotype*
  • Severity of Illness Index
  • Skin Tests

Substances

  • Biomarkers
  • Immunoglobulin E