Undressing DReSS as p-i mediated disease.
Publisher DOI
PubMed ID
41102078
Abstract
Drug Reaction with Eosinophilia and Systemic Symptoms (DReSS) is a severe T cell-mediated hypersensitivity reaction. T cells in DReSS are stimulated via the p-i mechanism (pharmacological interaction with immune receptors), where the drug shows an off-target binding to immune receptors (TCR and/or HLA) leading to an unorthodox activation of T cells. P-i stimulations are particularly strong in DReSS, as the causative drugs are typically administered at high doses for prolonged durations (>7 days) and bind with relatively high affinity to a specific HLA allele and/or TCR. This mechanism results in delayed yet profound immune activation, progressing through four distinct phases. The p-i concept provides a unifying explanation for many puzzling aspects of DReSS and has significant implications for diagnosis, management, and prevention. Recognizing drug concentration, therapy duration, and HLA affinity as key determinants of strong p-i-mediated immune activation can improve risk assessment, early diagnosis, and intervention strategies for DReSS.
Date Issued
2026-04
Publication Type
Article
Subject(s)
Subjects
DReSS
•
Drug affinity
•
Drug dose
•
Drug hypersensitivity
•
p-i concept
Language(s)
en
Author(s)
Peyer, Tim | |
Muller, Yannick | |
Harr, Thomas | |
Martin, Katja |
Additional Credits
Journal
Allergology International
Publisher
Elsevier
ISSN
1440-1592
1323-8930
Access(Rights)
open.access