Immunogenetics of drug-induced skin blistering disorders. Part I: Perspective.
The overall immunopathogenesis relevant to a large series of disorders caused by a drug or its associated hyperimmune condition is discussed based upon the examination of the genetics of severe drug-induced bullous skin problems (sporadic idiosyncratic adverse events, including Stevens-Johnson syndrome and toxic epidermal necrolysis). An overarching pharmacogenetic schema is proposed. Immune cognition and early-effector processes are focused upon and a challenging synthesis around systems evolution is explained by a variety of projective analogies. Etiology, human leukocyte antigen-B, immune stability, dysregulation, pharmacomimicry, viruses and an aggressive ethnically differentiated 'karmic' response are discussed.
School of Biological Sciences, The University of Reading, Whiteknights, Reading, RG6 6AH, UK. c.e.bowman@reading.ac.uk
Clive
C
Bowman
Olivier
O
Delrieu
D001768:Blister / Q000209:etiology / Q000235:genetics* / Q000276:immunology; D004342:Drug Hypersensitivity / Q000209:etiology / Q000235:genetics* / Q000276:immunology; D064420:Drug-Related Side Effects and Adverse Reactions; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D004364:Pharmaceutical Preparations / Q000378:metabolism; D010597:Pharmacogenetics; D013262:Stevens-Johnson Syndrome / Q000235:genetics / Q000276:immunology
D006680:HLA Antigens; D004364:Pharmaceutical Preparations