Advances in Prognostic Biomarkers and Targeted Immunomodulation in Severe Cutaneous Adverse Reactions

Résumé fourni par la source

Severe Cutaneous Adverse Reactions (SCARs), which belongs to delayed-type hypersensitivity reactions, comprises predominantly T cell-mediated drug reactions with often devastating consequences. The defining entities within SCARs include Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) (SJS/TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) (also known as drug-induced hypersensitivity syndrome, DIHS), and acute generalized exanthematous pustulosis (AGEP). All of these phenotypes are considered life-threatening. Studies over the past two decades have vastly enhanced our understanding of the clinical factors and immunobiological processes underlying these tragic events, with important implications for the prognostications and management. This review covers current treatment strategy, the clinical risk factors, scoring systems and biomarkers associated with mortality, disease severity and complications in SCARs. The major risk factors and causes of death in SJS/TEN and DRESS were discussed. In addition to biological agents (Anti-TNF-α, Anti IL-4, and Anti-IL-5), latest researches demonstrate the clinical efficacy of Janus kinase inhibitors (JAKi) in treating patients with recalcitrant/ prolonged DRESS and severe SJS/TEN. Moreover, there has been tremendous progress in the discovery of novel prognostic biomarkers, such as APOA4, RIP3, and HMGB1 in SJS/TEN as well as CXCL10, CCL1, sOX40, and sST2 in DRESS. These advancements demonstrate potential for early disease detection and a more targeted therapeutic approach in the future.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.