In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug Reactions

Background. Cutaneous drug reactions are common but diagnostically challenging due to phenotypic heterogeneity and simultaneous exposure to multiple drugs. These limitations prompted the development of diagnostic tests. Aims. To evaluate the performance of an in vitro assay measuring interferon-gamm...

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Main Authors: Ilan Goldberg, Meital Hanson, Gabriel Chodick, Idit Shirazi, Sarah Brenner
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Clinical and Developmental Immunology
Online Access:http://dx.doi.org/10.1155/2012/687532
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author Ilan Goldberg
Meital Hanson
Gabriel Chodick
Idit Shirazi
Sarah Brenner
author_facet Ilan Goldberg
Meital Hanson
Gabriel Chodick
Idit Shirazi
Sarah Brenner
author_sort Ilan Goldberg
collection DOAJ
description Background. Cutaneous drug reactions are common but diagnostically challenging due to phenotypic heterogeneity and simultaneous exposure to multiple drugs. These limitations prompted the development of diagnostic tests. Aims. To evaluate the performance of an in vitro assay measuring interferon-gamma release from patients’ lymphocytes in the presence of causative drugs for the diagnosis of drug reactions. Methods. Mononuclear cells derived from patients were incubated with and without suspected drugs, and increment of interferon-gamma levels was measured by ELISA. We performed a telephonic survey to evaluate the effect of stopping the drugs incriminated by the assay on cutaneous manifestations. Results. We assessed 272 patients who used 1035 medications. When assessed against the questionnaire data collected at least 6 months after stopping the causative drug, sensitivity was found to be 83.61% and specificity 92.67%. Likelihood ratio for a positive test is 11.40 and for a negative test 0.18. Positive predictive value is 75.37% and negative predictive value is 95.47%. The test was found to perform significantly better in females and in older patients. Conclusions. Interferon-gamma release test is a useful adjunct tool in the diagnosis of cutaneous drug reactions.
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spelling doaj-art-de52d4cf003544c2970126d0dbd3780e2025-08-20T02:21:21ZengWileyClinical and Developmental Immunology1740-25221740-25302012-01-01201210.1155/2012/687532687532In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug ReactionsIlan Goldberg0Meital Hanson1Gabriel Chodick2Idit Shirazi3Sarah Brenner4Department of Dermatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 64239, IsraelDepartment of Dermatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 64239, IsraelSchool of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Dermatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 64239, IsraelDepartment of Dermatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 64239, IsraelBackground. Cutaneous drug reactions are common but diagnostically challenging due to phenotypic heterogeneity and simultaneous exposure to multiple drugs. These limitations prompted the development of diagnostic tests. Aims. To evaluate the performance of an in vitro assay measuring interferon-gamma release from patients’ lymphocytes in the presence of causative drugs for the diagnosis of drug reactions. Methods. Mononuclear cells derived from patients were incubated with and without suspected drugs, and increment of interferon-gamma levels was measured by ELISA. We performed a telephonic survey to evaluate the effect of stopping the drugs incriminated by the assay on cutaneous manifestations. Results. We assessed 272 patients who used 1035 medications. When assessed against the questionnaire data collected at least 6 months after stopping the causative drug, sensitivity was found to be 83.61% and specificity 92.67%. Likelihood ratio for a positive test is 11.40 and for a negative test 0.18. Positive predictive value is 75.37% and negative predictive value is 95.47%. The test was found to perform significantly better in females and in older patients. Conclusions. Interferon-gamma release test is a useful adjunct tool in the diagnosis of cutaneous drug reactions.http://dx.doi.org/10.1155/2012/687532
spellingShingle Ilan Goldberg
Meital Hanson
Gabriel Chodick
Idit Shirazi
Sarah Brenner
In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug Reactions
Clinical and Developmental Immunology
title In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug Reactions
title_full In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug Reactions
title_fullStr In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug Reactions
title_full_unstemmed In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug Reactions
title_short In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug Reactions
title_sort in vitro release of interferon gamma from peripheral blood lymphocytes in cutaneous adverse drug reactions
url http://dx.doi.org/10.1155/2012/687532
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