title: A recent update of pharmacogenomics in drug-induced severe skin reactions.
abstract: In some adverse drug reactions (ADRs), genetic predisposition plays a significant role in pathogenesis, and the skin is the most frequently reported target. These severe cutaneous ADRs include bullous fixed drug eruptions (FDE), acute generalized exanthematous pustulosis (AGEP), drug-induced hypersensitivity syndrome (HSS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). The putative contribution of individual effector cells in drug hypersensitivity is briefly mentioned. To trigger these drug hypersensitivities, certain class I HLA alleles (e.g., HLA-A and HLA-B alleles) and certain class II HLA alleles (e.g., HLA-DR alleles) have been recently found to be the genetic determinants. One of the best characterized examples mentioned in this article is HLA-B*1502 to determine the incidence of carbamazepine-induced SJS. How drugs are processed and presented by these HLA alleles to activate immune responses has been explained by several hypotheses. Further implication of pharmagenomic findings to prevent drug-induced severe skin reactions can be achieved by pre-screening putative risk HLA alleles before using drugs.
authors: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
authors: Chun-Yu
authors: CY
authors: Wei
authors: Tai-Ming
authors: TM
authors: Ko
authors: Chen-Yang
authors: CY
authors: Shen
authors: Yuan-Tsong
authors: YT
authors: Chen
mesh_terms: D056150:Acute Generalized Exanthematous Pustulosis / Q000139:chemically induced / Q000235:genetics / Q000378:metabolism / Q000517:prevention & control; D003875:Drug Eruptions / Q000235:genetics* / Q000276:immunology / Q000378:metabolism* / Q000517:prevention & control; D006680:HLA Antigens / Q000235:genetics* / Q000378:metabolism*; D006801:Humans; D015603:Keratinocytes / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D010597:Pharmacogenetics / Q000379:methods*; D011110:Polymorphism, Genetic; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced / Q000235:genetics / Q000276:immunology / Q000378:metabolism / Q000517:prevention & control
chemical_list: D006680:HLA Antigens