Genetic aspects of immune-mediated adverse drug effects

Peter J Bugelski

doi:10.1038/nrd1605

Genetic aspects of immune-mediated adverse drug effects

Nat Rev Drug Discov. 2005 Jan;4(1):59-69. doi: 10.1038/nrd1605.

Author

Peter J Bugelski¹

Affiliation

¹ Director of Experimental Pathology, Department of Toxicology and Investigational Pharmacology, Centocor Inc., 200 Great Valley Parkway, Malvern, Pennsylvania 19355, USA. pbugelsk@cntus.jnj.com

PMID: 15688073
DOI: 10.1038/nrd1605

Abstract

Adverse drug effects (ADEs) are of great importance in medicine and account for up to 5% of all hospital admissions. ADEs can arise from several mechanisms and a wide range of drugs can cause immune-mediated ADEs (IMADEs). For a drug to elicit an IMADE, it must be both immunogenic (that is, able to sensitize the immune system) and antigenic (that is, able to evoke a response from a sensitized immune system). Unlike protein therapeutics, small-molecule drugs (or xenobiotics) are usually neither immunogenic nor antigenic. IMADEs are therefore the result of complex interactions between drug-metabolizing enzymes, immune sensitization and immune effectors. The genetic aspects of this interplay are discussed in this review.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Adverse Drug Reaction Reporting Systems / statistics & numerical data*
Clinical Trials, Phase II as Topic
Clinical Trials, Phase III as Topic
Humans
Immune System / drug effects
Immune System / physiology*
Immune System / physiopathology
Immunogenetics*
Models, Immunological