Abstract
Objective: To Increase the knowledge on Drugs Hypersensitivity Reactions (DHRs); activation, development of reliable diagnostic tests for better: selection of studies, diagnosis, identification of risk groups, prevention, cross-reactions, severs skin drug reactions and alternative therapeutics.
Methods: Review longitudinal and transversal studies about: immune mechanisms, hypersensitivity responses, parameters of methods and diagnostic consistency.
Results: The basophils are the most accessible cells for the study (peripheral blood 0.5%-1%); when they get activated release histamine as a response to allergens; the most used tests are the BAT (IgE- dependent); FcεRI-mediated signaling, the binding to the antigen (bivalent dimers); depends on the concentration (bell curve - ideal form); and more complex antigens present non-ideal dose-response curves (several forms). There are 4 types of evaluating BAT: 1) Secretion of granules 2) Membrane expression of activation markers: CD63, CD69, and CD203c by cytometry 3) the old technique of modified degranulation of basophils (MDB) and 4) Modified Leukocyte Migration Inhibitor Factor (MLIF). Currently there is an increase in the prevalence of DHRs: 7% in older adults, 18% in children (15% -24%) and 5%-15% in hospitalizations. The main cause of allergy are antibiotics: penicillin and β-lactams (50%); more frequently in women (40-60 years).
Conclusions: The BAT and alternative complementary tests with dilutions confirm the diagnosis and suggest the degree of sensitivity of the patient, predicting the response to treatment and reducing the risks in patients with reactions to drugs. These tests are simple, inexpensive and give great support in the diagnosis of drug reactions with coverage of several types of hypersensitivity.
Keywords
Hypersensitivity, Allergy, Adverse reactions to drugs, Antibiotics, NSAID, Anesthetic, BAT, DHRs