Drug-Induced Adverse Reactions

Some patients suffer severe, life-threatening immune reactions to medications that are well-tolerated by most people, and understanding why has become one of pharmacology's more urgent puzzles. Research in this area centers on how the immune system — particularly T cells activated by specific variants of the HLA gene — can mistake a drug or its metabolite for a foreign threat, triggering conditions like Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, and DRESS Syndrome, in which the skin and internal organs sustain rapid, sometimes fatal damage. Discoveries linking HLA-B*5701 to abacavir hypersensitivity and HLA-B*1502 to carbamazepine-induced reactions have shown that genetic screening before prescribing can prevent some of these outcomes, turning a once-unpredictable risk into a manageable one. Active questions remain around why the same HLA variant confers risk in some populations but not others, how to extend predictive screening to a broader range of drugs and reactions, and what additional immunological mechanisms govern the timing and severity of delayed hypersensitivity responses.

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Keywords

HLA-B*5701Stevens-Johnson SyndromeToxic Epidermal NecrolysisDrug HypersensitivityAbacavirCarbamazepine