Immunogenetics of drug-induced skin blistering disorders. Part I: Perspective. (April 2009)

• Record Type: Journal Article
• Authors: Bowman, Clive; Delrieu, Olivier
• Is Part Of: Pharmacogenomics. Volume 10:Number 4(2009)
• Page Start: 601
• Page End: 621
• Publication Date: 2009-04
• Subjects: erythema multiforme -- human leukocyte antigen -- hypersensitivity -- Lyell syndrome -- MHC -- maculopapular erythema -- pharmacogenetics -- rash -- Steven––Johnsons syndrome -- toxic epidermal necrolysis; Pharmacogenomics -- Periodicals; 615.1
• DOI: 10.2217/pgs.09.11
• Languages: English
• ISSNs: 1462-2416

Abstract

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.