AUTHOR=Chen Chun-Bing , Hung Wei-Kai , Wang Chuang-Wei , Lee Chih-Chun , Hung Shuen-Iu , Chung Wen-Hung 

TITLE=Advances in understanding of the pathogenesis and therapeutic implications of drug reaction with eosinophilia and systemic symptoms: an updated review

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1187937

DOI=10.3389/fmed.2023.1187937

ISSN=2296-858X

ABSTRACT=A drug reaction with eosinophilia and systemic symptoms, or drug-induced hypersensitivity syndrome (DRESS/DIHS), is one type of severe cutaneous adverse reaction (SCAR). It is characterized by fever, widespread skin lesions, a protracted clinical course, internal organ involvement, and possibly long-term autoimmune sequelae. The presence of high-risk human leukocyte antigen (HLA) alleles, a hypersensitivity reaction after culprit drug ingestion, and human herpesvirus reactivation may all contribute to its complex clinical manifestations. Some recent studies focusing on the roles of involved cytokines and chemokines and T cells co-signaling pathways in DRESS and DIHS were conducted. In addition, some predictors of disease severity and prognosis were also reported. In this review, we provided an update on the current understanding of the pathogenesis, potential biomarkers, and relevant therapeutic rationales of DRESS and DIHS.