药物过敏发病机制及体内外检测

Pathogenesis,in Vivo and in Vitro Test of Drug Allergy

药物过敏是指免疫介导的药物超敏反应,其机制为IgE介导或非IgE介导。小分子药物主要通过药物原形或代谢产物与载体蛋白结合激活免疫应答,或药物直接与T细胞抗原受体结合激活CD4+T细胞、CD8+T细胞等途径引起体内免疫应答。药物被免疫系统识别后可引发I～IV型超敏反应。目前药物过敏的检测主要包括皮肤试验、实验室检查及药物激发试验。

＂Drug allergy＂ refers to immunological mechanism-mediated drug hypersensitivity reactions,which may be either IgE-mediated（immediate） or non-IgE mediated（delayed） hypersensitivity reactions.Small molecular drug can induce immune response by binding to carrier protein as prototype or metabolism product,and even can directly bind to T cell antigen receptor to activate CD4＋ T cells or CD8＋ T cells.Drug can induce type Ⅰ to Ⅳ hypersensitivity reactions after recognized by immune system.The main detection methods of drug allergy include in vivo skin tests,in vitro laboratory tests and drug provocation tests.