Drug-induced lupus

被引:119
作者
Rubin, RL [1 ]
机构
[1] Univ New Mexico, Sch Med, Dept Mol Genet & Microbiol, Albuquerque, NM 87131 USA
关键词
autoimmunity; systemic jupus erythematosus; T cells; thymus function; oxidative drug metabolism;
D O I
10.1016/j.tox.2004.12.025
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Autoantibodies and, less commonly, systemic rheumatic symptoms are associated with treatment with numerous medications and other types of ingested compounds. Distinct syndromes can be distinguished, based on clinical and laboratory features, as well as exposure history. Drug-induced lupus has been reported as a side-effect of long-term therapy with over 40 medications. Its clinical and laboratory features are similar to systemic lupus erythematosus, except that patients fully recover after the offending medication is discontinued. This syndrome differs from typical drug hypersensitivity reactions in that drug-specific T-cells or antibodies are not involved in induction of autoimmunity, it usually requires many months to years of drug exposure, is drug dose-dependent and generally does not result in immune sensitization to the drug. Circumstantial evidence strongly suggests that oxidative metabolites of the parent compound trigger autoimmunity. Several mechanisms for induction of autoimmunity will be discussed, including bystander activation of autoreactive lymphocytes due to drug-specific immunity or to non-specific activation of lymphocytes, direct cytotoxicity with release of autoantigens and disruption of central T-cell tolerance. The latter hypothesis will be supported by a mouse model in which a reactive metabolite of procainamide introduced into the thymus results in lupus-like autoantibody induction. These findings, as well as evidence for thymic function in drug-induced lupus patients, support the concept that abnormalities during T-cell selection in the thymus initiate autoimmunity. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:135 / 147
页数:13
相关论文
共 50 条
[41]   Drug-induced agranulocytosis during treatment with infliximab in enteropathic spondyloarthropathy [J].
Favalli, EG ;
Varenna, M ;
Sinigaglia, L .
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 2005, 23 (02) :247-250
[42]   Idiosyncratic Drug-Induced Liver Injury: Mechanistic and Clinical Challenges [J].
Jee, Alison ;
Sernoskie, Samantha Christine ;
Uetrecht, Jack .
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 2021, 22 (06) :1-26
[43]   Pathophysiological Differences and Differential Diagnosis of Autoimmune and Drug-Induced Hepatitis [J].
Zeni, Nicola ;
Cristofani, Alessandro ;
Piano, Salvatore Silvio ;
Bolognesi, Massimo ;
Romano, Antonietta .
LIVERS, 2025, 5 (02)
[44]   AUTOIMMUNITY AGAINST PLATELETS - [[IDIOPATHIC]] AND DRUG-INDUCED IMMUNE THROMBOCYTOPENIA [J].
KIEFEL, V ;
MUELLERECKHARDT, C .
PATHOLOGIE BIOLOGIE, 1994, 42 (08) :795-796
[45]   Genetic and Genomic Approaches to the Study of Drug-Induced Liver Injury [J].
Daly, Ann K. .
LIVER INTERNATIONAL, 2025, 45 (01)
[46]   Drug-Induced Liver Injury Associated With Emerging Cancer Therapies [J].
Chodup, Piotr ;
Samodelov, Sophia L. ;
Visentin, Michele ;
Kullak-Ublick, Gerd A. .
LIVER INTERNATIONAL, 2025, 45 (02)
[47]   Thyrotropin receptor antibodies and a genetic hint in antithyroid drug-induced adverse drug reactions [J].
Chang, Lin-Chau ;
Chang, Chien-Ching ;
Chen, Pei-Lung ;
Wang, Shun-Huo ;
Chen, Yi-Hsuan ;
Tsai, Yung-Hsin ;
Shih, Shyang-Rong ;
Chiu, Wei-Yih ;
Fann, Cathy Shen-Jang ;
Yang, Wei-Shiung ;
Chang, Tien-Chun .
EXPERT OPINION ON DRUG SAFETY, 2018, 17 (08) :775-784
[48]   Characterization of drug-specific lymphocyte responses in a patient with drug-induced liver injury [J].
El-Ghaiesh, Sabah ;
Sanderson, Joseph P. ;
Farrell, John ;
Lavergne, Sidonie N. ;
Syn, Wing-Kin ;
Pirmohamed, Munir ;
Park, B. Kevin ;
Naisbitt, Dean J. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2011, 128 (03) :680-U368
[49]   Genetics of drug-induced liver injury: Current knowledge and future prospects [J].
Daly, Ann K. .
CTS-CLINICAL AND TRANSLATIONAL SCIENCE, 2023, 16 (01) :37-42
[50]   Lichen planus and lichenoid drug-induced eruption: a histological and immunohistochemical study [J].
Lage, Denise ;
Juliano, Priscila Bianchini ;
Metze, Konradin ;
de Souza, Elemir Macedo ;
Cintra, Maria Leticia .
INTERNATIONAL JOURNAL OF DERMATOLOGY, 2012, 51 (10) :1199-1205