Allergic Reaction to Meds? - EBV

[Marco]

This is a rough translation from an article in French. Apologies, but I'm sure you'll get the drift.

Philippe Musette and colleagues (Inserm Unit 905 "Pathophysiology and biotherapy of autoimmune and inflammatory diseases", Rouen) have shown that drug-induced allergic reactions (related to drug use) are actually caused by immune reactions against viruses. Clearly, in some sensitive individuals, the medication causes the reactivation of EBV (Epstein Barr Virus), a herpes family virus, normally in a state known as "sleeping". The virus multiplies and causes an immune response that causes rashes and visceral disorders. The detailed results, based on monitoring of 40 patients, were published in the journal Science Translational Medicine.

Researchers followed 40 patients with DRESS (Drug reaction with eosinophilia for systemic symptoms) that is to say a reaction to the drug causing increased concentration in lymphocytes and eosinophils, allergic symptoms cutaneous and visceral - liver, lung and renal in response to different drugs belonging mainly to the family of antibiotics and anticonvulsants. Philippe Musette and his team analyzed viral replication in these 40 people. In the vast majority of them (76%), the researchers observed the increased number of EBV in the blood.

Observations made of the immune cells of these patients (especially CD8 + T lymphocytes) show that most of the patients' immune response is directed against the viral particles. The body does not react against the drug, previously considered responsible for triggering allergic symptoms, but struggles against invasion and viral reactivation induced by the drug.

The drugs tested could therefore trigger the activation of dormant Epstein-Barr virus in patients, by a mechanism not yet understood, but under investigation, say Philippe Musette and his team.

The researchers also show that the three drugs tested in this process result in patients' DRESS "but not in controls. This also presupposes that there are factors still to be defined that make people more or less vulnerable to a medication allergy reaction.

These results may challenge the generally accepted view on the mechanisms of drug allergy. Future treatment of cutaneous manifestations may require, in addition to stopping the drug involved, anti-viral therapy.

This is probably one of the first studies demonstrating the role of EBV (Epstein Barr virus) in drug allergic reaction.

Original abtract here :

http://stm.sciencemag.org/content/2/46/46ra62.abstract

 

[maryb]

This makes so much sense with regards to what happened to me earlier on this year. I had a 10 day course of Xifaxan beg Jan and with 2 days of finishing became ill, suffered a huge allergic reaction and back to square 1 with food intolerances etc.Tested positive for EBV active infection several times over the past 4 years. What happened just makes so much sense now thanks for posting.

 

[natasa778]

Thanks for that Marco. Other herpesviruses have been suspected/reported in the past, this one is on HHV6 - I 'think' I remember seeing reports of possible involvement of others

http://www.ncbi.nlm.nih.gov/pubmed/12865768

The reactivation of human herpesvirus 6 in drug-induced hypersensitivity syndrome is not a coincidental phenomenon. Human herpesvirus 6 reactivation plays an important role in the pathogenesis of drug-induced hypersensitivity syndrome, especially in the latter half of the clinical symptoms. Reactivated human herpesvirus 6 sometimes leads to the severe complications of drug-induced hypersensitivity syndrome, such as encephalitis and type 1 diabetes mellitus. In conclusion, drug-induced hypersensitivity syndrome is a complex disease composed of drug allergy and human herpesvirus 6.

http://www.ncbi.nlm.nih.gov/pubmed/20205923

 

[natasa778]

aaah here

Drug-induced hypersensitivity syndrome (DIHS) is a severe multi-organ system reaction caused by specific drugs. Many reports have revealed that human herpesvirus 6 (HHV-6) reactivation contributes to the development of DIHS. In addition, recent articles have shown that reactivation of other herpesviruses such as human herpesvirus 7 (HHV-7), Epstein-Barr virus (EBV), cytomegalovirus (CMV) might be also implicated in the development of DIHS. These observations suggest that not only HHV-6 but also other herpesvirses might reactivate from the latency and play an important role in the appearance of clinical manifestations of DIHS. Several patients with DIHS were treated with intravenous immunoglobulin (IVIG) in addition to systemic corticosteroids. The results have been encouraging although virus reactivation could not be suppressed. Although the pathomechanism of IVIG treatment in patients with DIHS remains unknown, the therapeutic effects of IVIG could be dependent, in part, on functional capabilities of anti-virus IgG contained in IVIG.

http://www.ncbi.nlm.nih.gov/pubmed/15767030