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Predominance of IL-5-secreting drug-specific T cells in subgroups of patients with drug-induced delayed-type hypersensitivity reaction
Clinical and Translational Allergy volume 4, Article number: P35 (2014)
Drug hypersensitivity reactions (DHRs) can be classified into IgE-induced, immediate type and T-cell mediated, delayed-type reactions. While the former are considered as Th2-driven immune responses characterized by IL-5-secretion, the later are regarded as mainly provoked by IFN-gamma-producing Th1 cells. However, it has been suggested that delayed-type DHRs could also be elicited by IL-5 or a mixed T cell cytokine pattern.
We sought to characterize drug-specific T cell subpopulations in patients with delayed-type DHRs to beta-lactam antibiotics by enzyme-linked immunospot (ELISPOT) assay, a sensitive technique to detect antigen-specific cytokine-producing cells. Peripheral blood was drawn from eight patients who had experienced maculopapular exanthema as a clinical manifestation of a DHR against beta-lactam antibiotics (penicillin, amoxicillin or cefuroxim), which was confirmed by skin patch-test. The occurrence and frequencies of drug-specific IL-5-, IFN-gamma- and IL-10-producing T cells were analyzed by ELISPOT assay and compared to ten healthy controls without history of delayed-type DHRs.
Results and conclusion
As expected, ELISPOT analysis of peripheral blood mononuclear cells (PBMC) revealed increases in drug-specific IFN-gamma-producing T cells. However, in a subgroup of patients with delayed-type DHRs, augmented numbers of drug-specific IL-5-secreting T cells were observed, regardless which drug was taken. Of note, IL-10 positive T cells were not decreased in drug-allergic patients when compared with healthy controls. Our results show that DHRs are characterized by distinct patterns of cytokine-secreting lymphocytes which resemble either Th1, Th2 or a mixed type of Th cells. Thus, determining both IFN-gamma- and IL-5-positive (but not IL-10-producing) cells by ELISPOT assay increases the sensitivity in detecting drug-specific T cells. This may help diagnosing drug-allergy in patients with suspected DHRs negative by other conventional allergy tests.
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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Pfützner, W., Intrup, C. & Möbs, C. Predominance of IL-5-secreting drug-specific T cells in subgroups of patients with drug-induced delayed-type hypersensitivity reaction. Clin Transl Allergy 4 (Suppl 3), P35 (2014). https://doi.org/10.1186/2045-7022-4-S3-P35
- Peripheral Blood Mononuclear Cell
- Hypersensitivity Reaction
- ELISPOT Assay
- Drug Hypersensitivity