DETECTION OF DRUG ALLERGY ON ANTITUBERCULOSIS DRUGS USING LEUKOCYTES LYSIS SENSIBILIZATION REACTION AND TOTAL IMMUNOGLOBULIN E
Laboratory of Immunology and Molecular Biology, National Center for Phthisiology, Bishkek, Kyrgyz Republic
Objective: Detecting the presence of drug allergy (DA) for anti-TB preparations on the basis of the studying of the immune mechanisms of DA in tuberculosis.
Methods: Performed identification of the first and fourth types of DA for anti-tuberculosis drugs in 163 tuberculosis (TB) patients. Tuberculosis of the lungs (TBL) was diagnosed in 109 (66.9%) patients, of which 43 (39.4%) had multiple drug resistance (MDR) of Mycobacterium tuberculosis and 66 (60.6%) – drug sensitivity (DS). Extrapulmonary tuberculosis (EPLT) was detected in 54 (33.1%) of the 163 patients examined. We used a leukocyte lysis sensibilization reaction (LLSR) and quantified the concentration of total immunoglobulin of E class (IgE) by immunoferment analysis (IFA). The material of the study served as the samples of peripheral blood.
Results: Positive LLSR+ for one or more drugs was detected in 103 (63.2%) of the 163 patients with TB, weakly positive LLSR± in one or more drugs – in 43 (26.4%) and negative LLSR- for all studied drugs – in 17 (10.4%) patients with TB. The highest relative number of LLSR+ showed an examination in DA of MDR TBL patients (30 of 43 patients, or 69.8%). The greatest relative number of questionable (or weakly positive) results of LLSR was found in patients with EPLT (17 of 54 patients, or 31.5%). The highest relative number of negative results of the LLSR- was for the time being the examination in DA of patients with DS TBL (9 of 66, or 13.6%). In patients with DS and MDR TBL, the total IgE level was 140.6±52.3 and 147.0±70.1 IU/ml, respectively. The highest level of IgE (172.0±68.1 IU/ml) was detected in patients with EPLT.
Conclusion: Leukocytes reactions to incubation with anti-tuberculosis drugs (the fourth type of DA) was detected in 146 (89.6%) of patients with TB from 163 patients (LLSR+ and LLSR±), and the absence of this leukocyte reaction for all the drugs studied – in 17 (10.4%) of patients with TB from 163 surveyed with suspicion of DA (LLSR-). The highest level of IgE (172.0±68.1 IU/ml) was detected in patients with EPLT.
Keywords: Tuberculosis, drug allergy, anti-tuberculosis drugs, leukocytes.
- Mirakian R, Ewan PW. BSACI guidelines for management of drug allergy. Clinical Experimental Allergy. 2008;39(1):43-61.
- Eliseeva TI, Balabolkin II. Allergicheskie reaktsii na lekarstvennye sredstva: sovremennye predstavleniya [Drug allergic reactions: current views (review)]. Sovremennye tekhnologii v meditsine. 2016;8(1):159-71.
- Tyukavkina SYu, Khurseeva GG. Reaktsii giperchuvstvitel’nosti: mekhanizmy razvitiya, klinicheskie proyavleniya, printsipy diagnostiki (lektsiya) [Hypersensitivity reactions: development mechanisms, clinical manifestations, principles of diagnosis (lecture)]. Klinicheskaya laboratornaya diagnostika. 2014;5:27-36.
- Rive CM, Bourke J, Phillips EJ. Testing for drug hypersensitivity syndromes. Clinical Biochemistry Review. 2013;34:15-38.
- Maslova L. Diagnostika i lechenie allergicheskikh reaktsiy [Diagnosis and treatment of allergic reactions]. Nauka i innovatsii [Online re-source]. 2014 [access date: 2018 July 9]: access mode: http://innosfera.org/2014/06/aMegric.
- Novikov PD, Novikov DK, Titova ND. Diagnostika allergii i giper chuvstvitel’nosti: vedushchee znachenie kletochnykh metodov [Diagnosis of the allergy and hypersensitivity: leading value of cell-like methods]. Immunopatologiya, allergologiya, infektologiya. 2016;4:25-9.
- Palomares O, Martin-Fontecha, Lauener MR. Regulatory T cells and immune regulation of allergic diseases: roles of IL-10 and TGF-β. Genes and Immunity. 2014;15:511-20. Available from: http: //www.nature.com/ gene/journal/v15/n8/full/gene 201445a.html.
- Demko IV. Lekarstvennaya allergiya [Drug allergy]. Sibirskoe meditsinskoe obozrenie. 2013;4:83-7.
- Shabikeeva SB, Altymysheva AT, Kalyuzhnyy SI, Toktogulova NA, Sooronbaev TM. Lekarstvennaya allergiya [Drug allergy]. Vestnik KRSU. 2014;14(12):126-9.
- Pukhlik BM, Pobedennaya GP, Matveeva EV. Lekarstvennaya allergiya kak proyavlene pobochnoy reaktsii na lekarstvennye sredstva: sovremennoe sostoyanie problemy [Drug allergy as a manifestation of an adverse reaction to drugs: current state of the problem]. Klinicheskaya immunologiya. Allergologiya. Infektologiya. 2012;9:54-9.
- Cliff JM, Kaufmann SH, McShane. The human immune response to tuberculosis and its treatment: a view from the blood. Immunological Reviews. 2015;264(1):88-102. Available from: www.onlinelibrary.wiley. com/doi/10.1111/imr.12269/full.
- Thong B, Chia F, Tan S. A retrospective study on sequential desensitizationrechallenge for antituberculosis drug allergy. Asia Pacific Allergy. 2014;4(3):156-63. Available from: www.ncbi.nlm.nih.gov/pmc/articles/PMC4116042.
- Drynov GI, Ushakova DV, Slastushenskaya IE. Mesto sovremennoy laboratornoy diagnostiki v prakticheskoy allergologii [Place of modern laboratory diagnostics in practical allergology]. Laboratornaya sluzhba. 2014;2:42-7.
- Karpuk IU. Diagnostika allergii na mestnye anestetiki v reaktsii antigenindutsirovannogo povrezhdeniya leykotsitov [Diagnosis of allergy to local anesthetics in the response of antigeninduced leukocytes damage]. Vestnik VGMU. 2010;9(1):1-8.
- Khaitov RM, Ilyina NI. (red.) Allergologiya i immunologiya: Natsional’noe rukovodstvo [Allergology and Immunology: National guideline]. Moscow, RF: GEOTAR-Media; 2009: 656 p.
Dudenko Elena Vyacheslavovna,
Researcher, Laboratory of Immunology and Molecular Biology, National Center for Phthisiology
Sydykova Saltanat, Researcher,
Laboratory of Immunology and Molecular Biology, National Center for Phthisiology
Conflict of interest: No conflict
Address for correspondence:
Dudenko Elena Vyacheslavovna
Researcher of the Laboratory of Immunology and Molecular Biology, National Center for Phthisiology
720020, Kyrgyz Republic, Bishkek city, Akhunbaev str., 90a
Tel.: (+996) 554 044011
Materials on the topic:
- DYNAMICS OF DRUG RESISTANCE IN M. TUBERCULOSIS DURING THE NEW CORONAVIRUS INFECTION PANDEMIC IN DUSHANBE: THE NEED FOR URGENT MEASURES
- IMPLEMENTATION STUDY IN PREVENTION AND CONTROL OF DRUG-RESISTANT TUBERCULOSIS DURING THE COVID-19 PANDEMIC IN DUSHANBE
- PREVALENCE OF MYCOBACTERIUM TUBERCULOSIS AMONG CHILDREN AT THE RESERVOIRS OF INFECTION IN THE REPUBLIC OF TAJIKISTAN
- ANTITUBERCULOSIS DRUG ALLERGY IN PATIENTS WITH MULTIDRUG-RESISTANT TUBERCULOSIS
- STIGMA AND DISCRIMINATION ASSOCIATED WITH TUBERCULOSIS
- IMPROVEMENT RESULTS OF DIAGNOSIS AND TREATMENT OF ABDOMINAL TUBERCULOSIS
- ABDOMINAL TUBERCULOSIS: RETURN TO SURGERY
- DYNAMICS OF THE INDICATORS OF LUNG DESTRUCTION AND HORMONAL BACKGROUND AS A PREDICTIVE MARKER OF THE EFFECTIVENESS OF MULTIDRUG RESISTANT TUBERCULOSIS TREATMENT
- ULTRASOUND DIAGNOSTICS OF ABDOMINAL TUBERCULOSIS IN THE CONDITIONS OF THE OUTPATIENT-DIAGNOSTIC DEPARTMENT
- EFFICACY OF TUBERCULOSIS CASES DETECTION AMONG THE POPULATION OF DUSHANBE IN THE REPUBLIC OF TAJIKISTAN