Applications of Immunopharmacogenomics: Predicting, Preventing, and Understanding Immune-Mediated Adverse Drug Reactions

Author:

Karnes Jason H.123,Miller Matthew A.1,White Katie D.4,Konvinse Katherine C.56,Pavlos Rebecca K.78,Redwood Alec J.8,Peter Jonathan G.910,Lehloenya Rannakoe9,Mallal Simon A.458,Phillips Elizabeth J.458

Affiliation:

1. Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona 85721, USA

2. Sarver Heart Center, University of Arizona College of Medicine, Tucson, Arizona 85724, USA

3. Division of Pharmacogenomics, Center for Applied Genetics and Genomic Medicine (TCAG2M), Tucson, Arizona 85721, USA

4. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA;

5. Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA

6. Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA

7. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Subiaco, Western Australia 6008, Australia

8. Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia 6150, Australia

9. Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town 7925, South Africa

10. Division of Dermatology, Department of Medicine, University of Cape Town, Cape Town 7925, South Africa

Abstract

Adverse drug reactions (ADRs) are a significant health care burden. Immune-mediated adverse drug reactions (IM-ADRs) are responsible for one-fifth of ADRs but contribute a disproportionately high amount of that burden due to their severity. Variation in human leukocyte antigen ( HLA) genes has emerged as a potential preprescription screening strategy for the prevention of previously unpredictable IM-ADRs. Immunopharmacogenomics combines the disciplines of immunogenomics and pharmacogenomics and focuses on the effects of immune-specific variation on drug disposition and IM-ADRs. In this review, we present the latest evidence for HLA associations with IM-ADRs, ongoing research into biological mechanisms of IM-ADRs, and the translation of clinical actionable biomarkers for IM-ADRs, with a focus on T cell–mediated ADRs.

Publisher

Annual Reviews

Subject

Pharmacology,Toxicology

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