Food and Drug Reactions and AnaphylaxisCharacterization of drug-specific T cells in lamotrigine hypersensitivity☆,☆☆
Section snippets
Donor characteristics
PBMCs were obtained from the peripheral blood of 4 LTG-hypersensitive patients (Table I) . All patients were free of immunosuppressive therapy for at least 24 months before blood donation. Controls were patients administered LTG for a long term without adverse effects (n = 4) and unexposed individuals (n = 4). Two LTG-exposed controls were on LTG therapy; 2 had not been exposed to LTG for greater than 12 months. Approval for the study was obtained from the local ethics committee, and informed
In vitro stimulation of blood mononuclear cells by LTG
PBMCs from 3 of 4 LTG-hypersensitive patients proliferated after in vitro stimulation with LTG (1-100 μg mL−1; Fig 1, a ). No proliferation was seen with PBMCs from hypersensitive patient 4 or the 2 control groups (Fig 1, b ). PBMCs from the patients and controls also
Discussion
Anticonvulsant hypersensitivity syndrome, which can be severe and cause deaths, is characterized clinically by skin rash (of variable severity), fever, arthralgia, lymph-adenopathy, and eosinophilia.1 The demonstration of drug-specific clonal proliferation of lymphocytes from hypersensitive patients14, 15, 16, 17, 21, 28 is indicative of the requirement of immune system activation in the development of the clinical symptoms. In this study, we have shown the presence of LTG-specific
Acknowledgements
We thank the Departments of Immunology and Tropical Medicine (University of Liverpool) for the use of equipment. We also thank all blood donors.
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2021, Journal of Immunological MethodsCitation Excerpt :It is quite important, especially in polymedicated patients, because it could help to discriminate suspicious culprit drugs from tolerant/non-culprit drugs and enhance the reliability of the LTT. Nevertheless, some drugs seem not to significantly provoke T cell responses as demonstrated by a study of carbamazepine and lamotrigine hypersensitivity, which showed specificities of 100% (Naisbitt et al., 2003a; Naisbitt et al., 2003b). Also the specificity of LTT for β-lactam hypersensitivity was evaluated as 98% (Luque et al., 2001).
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Supported by the Wellcome Trust. D.J.N. is a Wellcome Trust Research Career Development Fellow.
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Reprint requests: Dean J. Naisbitt, PhD, Department of Pharmacology and Therapeutics, Sherrington Building, Ashton Street, The University of Liverpool, PO Box 147, Liverpool, L69 3GE, England.