Diagnostic value of specific T cell reactivity to drugs in 95 cases of drug induced liver injury

• DOI: 10.1136/gut.41.4.534
• Publication Date: 2010-06-30T16:46:12Z
• Authors: V A J Maria; R M M Victorino
• Keywords: Adult; Male; 0301 basic medicine; Prostaglandin Antagonists; T-Lymphocytes; Indomethacin; Statistics as Topic; Middle Aged; Statistics, Nonparametric; Culture Media; 3. Good health; Drug Hypersensitivity; 03 medical and health sciences; Evaluation Studies as Topic; Chemical and Drug Induced Liver Injury, Chronic; Humans; Female; Cell Division; Cells, Cultured

Background —Diagnosis of drug induced liver injury is usually based on a temporal relation between intake and clinical picture as well the exclusion alternative causes. More precise diagnosis has been attempted by using in vitro specific T cell reactivity to drugs but test never reached general acceptability because frequent negative results which could be explained, part, prostaglandin producing suppressor cells (PPSC). Aim —To analyse diagnostic value modified where lymphocyte responses are detected presence inhibitor. Patients —Ninety five patients with injury, 106 healthy controls, 35 individuals recent exposure same without adverse effects, 15 disease unrelated drugs. Methods —Peripheral blood mononuclear (PBMC) were cultured alone Responses assessed 3 H-thymidine incorporation lymphocytes. Results expressed counts per minute stimulation indexes (SI). —When PBMC stimulated alone, sensitisation (SI>2) was 26% cases. This noticeably increased (56%) when inhibitor added cultures. No found controls. In possible sensitivity several drugs, only one drug. The severity lesions, aminotransferase concentrations duration, lower evidence PPSC. Conclusions —This new approach useful for particularly exposed more than drug; furthermore, putative PPSC associated less severe forms hepatitis.