Pathophysiology

doi: 10.25005/2074-0581-2018-20-2-3-207-211
DETECTION OF DRUG ALLERGY ON ANTITUBERCULOSIS DRUGS USING LEUKOCYTES LYSIS SENSIBILIZATION REACTION AND TOTAL IMMUNOGLOBULIN E

E.V. Dudenko, S. Sydykova

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.

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References
  1. Mirakian R, Ewan PW. BSACI guidelines for management of drug allergy. Clinical Experimental Allergy. 2008;39(1):43-61.
  2. 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.
  3. 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.
  4. Rive CM, Bourke J, Phillips EJ. Testing for drug hypersensitivity syndromes. Clinical Biochemistry Review. 2013;34:15-38.
  5. 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.
  6. 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.
  7. 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.
  8. Demko IV. Lekarstvennaya allergiya [Drug allergy]. Sibirskoe meditsinskoe obozrenie. 2013;4:83-7.
  9. Shabikeeva SB, Altymysheva AT, Kalyuzhnyy SI, Toktogulova NA, Sooronbaev TM. Lekarstvennaya allergiya [Drug allergy]. Vestnik KRSU. 2014;14(12):126-9.
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. Khaitov RM, Ilyina NI. (red.) Allergologiya i immunologiya: Natsional’noe rukovodstvo [Allergology and Immunology: National guideline]. Moscow, RF: GEOTAR-Media; 2009: 656 p.

Author information:


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

Conflicts 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

E-mail: dudenko.e@list.ru

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