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      In vitro release of interferon-gamma and macrophage migration inhibition factor in drug-induced urticaria and angioedema.

      Acta dermato-venereologica

      Adolescent, Adult, Aged, Aged, 80 and over, Angioedema, chemically induced, metabolism, Animals, Cell Migration Inhibition, Child, Child, Preschool, Drug-Related Side Effects and Adverse Reactions, Female, Guinea Pigs, Humans, Interferon-gamma, drug effects, secretion, Lymphocytes, cytology, Macrophage Migration-Inhibitory Factors, Macrophages, Male, Middle Aged, Urticaria

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          Abstract

          T-cells are involved in the pathogenesis of cutaneous drug reactions. T-cell phenotype and cytokine release pattern in rivo and in vitro might correlate with the type of immune response involved in cutaneous drug reactions. In vitro release of interferon-gamma and macrophage migration inhibition factor (MIF) from peripheral blood lymphocytes, following in vitro challenge with the suspected unmodified drugs, was studied in 12 patients with drug-induced urticaria and/or angioedema and in two group-matched controls. The occurrence of positive interferon-gamma and MIF responses was significantly higher in patients with drug-induced urticaria and/or angioedema than in controls. The sensitivity and specificity of the interferon-gamma test (50% and 92%, respectively) were similar to that of the MIF test (58% and 96%, respectively). Percentage agreement between both tests was 80.9 (kappa = 0.76). In vitro release of interferon-gamma and MIF in drug-induced urticaria and/or angioedema suggests a drug-specific immune response, and may implicate the drug as a possible inducer of the reaction.

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