Laboratory diagnosis of drug allergy. Part 2. Methodology for determining the activation of cells to drugs allergens

Abstract

Increase of allergy in the population, associated with a significant increase in the amount of medication prescribed to patients, as well as the immune reactivity changes, which leads to increased complications of therapy, including allergic reactions to medications. Skin tests to diagnose immediate type allergy drug can not always be used. There are many contraindications to carry them out. The reliability of these tests is relatively low due to the fact that the cause of allergic reaction is often not the initial drug and its metabolites. Therefore, skin tests with laboratory tests are usually used for diagnostic of drug allergy. Confirmatory tests with drugs, such as the definition of specific serum IgE, only available for certain drugs. The sensitivity of these tests is not 100 %, so in some cases there is a need in provocation tests. New diagnostic agents such as basophil activation test, cellular antigen stimulation test and its flow cytometric version (FLOW-CAST) with high reliability can determine the presence of immediate hypersensitivity, the presence or absence of specific IgE, according to the type of neurotransmitter to medical and other allergens, as well as availability pseudoallergic mechanism of clinical manifestations, diagnosis of aspirin-induced asthma and similar conditions. At the same time, the lymphocyte transformation test reveals the delayed type allergies to medicines sensitization of T-lymphocytes. Performing the test by determining of CD69 upregulation, as the T-lymphocyte activation marker, significantly reduces the response time and thereby accelerate results of the study. Thus, the use of in vitro methods for determination of drug allergens triggered cell activation will increase the effectiveness of diagnostic tests, improve the accuracy of diagnosis of drug allergy, thereby reducing the need in provocation tests.