Skin Resident Memory T Cells May Play Critical Role in Delayed-Type Drug Hypersensitivity Reactions

Front Immunol. 2021 Aug 23:12:654190. doi: 10.3389/fimmu.2021.654190. eCollection 2021.

Abstract

Delayed-type drug hypersensitivity reactions (dtDHR) are immune-mediated reactions with skin and visceral manifestations ranging from mild to severe. Clinical care is negatively impacted by a limited understanding of disease pathogenesis. Though T cells are believed to orchestrate disease, the type of T cell and the location and mechanism of T cell activation remain unknown. Resident memory T cells (TRM) are a unique T cell population potentially well situated to act as key mediators in disease pathogenesis, but significant obstacles to defining, identifying, and testing TRM in dtDHR preclude definitive conclusions at this time. Deeper mechanistic interrogation to address these unanswered questions is necessary, as involvement of TRM in disease has significant implications for prediction, diagnosis, and treatment of disease.

Keywords: Stevens-Johnson syndrome; adverse drug reactions; delayed-type drug hypersensitivity reactions; drug reaction with eosinophil and systemic symptoms; fixed drug eruption; maculopapular exanthem; tissue-resident memory T cells; toxic epidermal necrolysis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Disease Susceptibility
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / etiology*
  • Drug Hypersensitivity / metabolism
  • Humans
  • Hypersensitivity, Delayed / diagnosis*
  • Hypersensitivity, Delayed / etiology*
  • Hypersensitivity, Delayed / metabolism
  • Immunologic Memory*
  • Lymphocyte Activation
  • Skin / drug effects
  • Skin / immunology*
  • Skin / metabolism
  • T-Lymphocyte Subsets / immunology
  • T-Lymphocyte Subsets / metabolism
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism