T-cell assays for the investigation of drug hypersensitivity

Teo, Ying and Ardern-Jones, Michael R. (2022) T-cell assays for the investigation of drug hypersensitivity. In, Cutaneous Drug Hypersensitivity: Clinical Features, Mechanisms, Diagnosis, and Management. Springer International Publishing AG, pp. 79-90. (doi:10.1007/978-3-030-82743-4_9).

Record type: Book Section

Abstract

Attribution of drug culpability in delayed drug reactions can be challenging, particularly when multiple medications are involved. Various in vitro T-cell tests have been utilized in research settings as part of diagnostic algorithms and have the potential to provide a safe method of testing without provoking hazardous reactions. Routine testing is currently limited by variable sensitivity. However, improved understanding of the underlying mechanisms and assay optimization in larger cohorts aligned to the drug and reaction phenotype will further improve the role of T-cell assays as a reliable means of determining the causative drug. Sensitivity and specificity of the lymphocyte proliferation assay (LTT), ELISpot, and ELISA are determined by drug and phenotype factors, and a detailed understanding of the laboratory process is required to ensure the test results are interpreted correctly for clinical use in the diagnosis of T-cell-mediated drug hypersensitivity reactions.

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