Exploring cytokine outputs for ex vivo diagnostics in drug reaction with eosinophilia and systemic symptoms (DRESS)

Ana M. Copaescu; Effie Mouhtouris; Fiona James; Michelle S.Y. Goh; Elizabeth J. Phillips; Jason A. Trubiano; for Australasian Registry of Severe Cutaneous Adverse Reactions (AUS-SCAR)

doi:10.1016/j.waojou.2024.101002

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Exploring cytokine outputs for ex vivo diagnostics in drug reaction with eosinophilia and systemic symptoms (DRESS)

Journal article

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Exploring cytokine outputs for ex vivo diagnostics in drug reaction with eosinophilia and systemic symptoms (DRESS)

Ana M. Copaescu, Effie Mouhtouris, Fiona James, Michelle S.Y. Goh, Elizabeth J. Phillips, Jason A. Trubiano and for Australasian Registry of Severe Cutaneous Adverse Reactions (AUS-SCAR)

The World Allergy Organization journal, Vol.17(12), 101002

2024

DOI: https://doi.org/10.1016/j.waojou.2024.101002

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Abstract

Antibiotic hypersensitivity

Drug reaction with eosinophilia and systemic symptoms

Enzyme-linked immunoSpot

Interferon-gamma

T-Lymphocytes

Background In an exploratory study to assess the potential to individualize T-cell diagnostics in antibiotic-associated severe T-cell mediated hypersensitivity, we focused on drug reaction with eosinophilia and systemic symptoms (DRESS) and the related cytokine outputs IL-4 and IL-5. Methods Patients with well-phenotyped RegiSCAR ≥4 DRESS, positive intradermal skin testing, and a previous negative IFN-γ Enzyme-Linked ImmunoSpot (ELISpot) assay were prospectively recruited. We specifically performed an ELISpot assay with IL-4 and IL-5 cytokine outputs. As comparative controls, these cytokine outputs were performed simultaneously in patients with a positive ex vivo IFN-γ release ELISpot result. Results Four antibiotic-associated DRESS cases were included. The IL-4 and IL-5 output ELISpot assay demonstrated various results among these patients, with at least 1 cytokine present in all the cases. As for the 2 controls with known positive IFN-γ release, compared to the IFN-γ secretion, the cytokine output using IL-4 and IL-5 showed an increased positivity. Conclusion In patients where the early response has suggested a TH2 response such as DRESS, IL-4 and IL-5 cytokine outputs could present an investigational advantage, including when IFN-γ is negative. In the future, larger prospective studies are required to understand the role of varied cytokine outputs in T-cell-mediated hypersensitivities.

Details

Title: Exploring cytokine outputs for ex vivo diagnostics in drug reaction with eosinophilia and systemic symptoms (DRESS)
Authors/Creators: Ana M. Copaescu - Austin Hospital
Effie Mouhtouris - Austin Health
Fiona James - Austin Health
Michelle S.Y. Goh - Austin Health
Elizabeth J. Phillips - Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
Jason A. Trubiano - Centre for Antibiotic Allergy and Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
for Australasian Registry of Severe Cutaneous Adverse Reactions (AUS-SCAR)
Publication Details: The World Allergy Organization journal, Vol.17(12), 101002
Publisher: Elsevier Inc. on behalf of World Allergy Organization.
Identifiers: 991005723864007891
Murdoch Affiliation: Institute for Immunology and Infectious Diseases
Language: English
Resource Type: Journal article

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