The Genetics of Drug Hypersensitivity Reactions
Cornejo-García JA1,2, Jurado-Escobar R1, Doña I2, Perkins JR1, Agúndez JA3, García-Martín E3, Viguera E4, Blanca-López N5, Canto G5, Blanca M2
1Research Laboratory, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain
2Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain
3Department of Pharmacology, University of Extremadura, Caceres, Spain
4Genetics Unit, Department of Cell Biology, Genetics and Physiology, Faculty of Sciences, Malaga University, Malaga, Spain
5Allergy Service, Infanta Leonor University Hospital, Madrid, Spain
J Investig Allergol Clin Immunol 2016; Vol 26(4)
Drug hypersensitivity reactions (DHRs) are a major problem for healthcare systems, regulatory agencies, and the pharmaceutical industry. DHRs are induced by various mechanisms and encompass a heterogeneous set of potentially life-threatening clinical entities. In addition to environmental effects, individual factors play a key role in this intricate puzzle. However, despite commendable efforts in recent years to identify individual predisposing factors, our knowledge of the genetic basis of these reactions remains incomplete. In this manuscript, we summarize current research on the genetics of DHRs, focusing on specific immune-mediated reactions (immediate and nonimmediate) and on pharmacologically mediated reactions (cross-intolerance to nonsteroidal anti-inflammatory drugs). We also provide some thoughts on potential technological approaches that would help us to decipher the molecular mechanisms underlying DHRs. We believe this manuscript will be of interest not only for allergists and basic researchers in the field, but also for clinicians from various areas of expertise who manage these reactions in their clinical practice.
Key words: Drug hypersensitivity, Immediate and nonimmediate reactions, Cross-intolerance, Single-nucleotide polymorphisms, Genome-wide association study.