Clinic for Rheumatology, University of Bern, Bern, Switzerland.
werner.pichler@insel.ch
PURPOSE OF REVIEW: Presentation of different mechanism of drug-induced
autoimmunity and highlighting of new developments. RECENT FINDINGS: Drugs can
induce autoimmune diseases by their pharmacological properties. Injection of
certain drugs into the thymus can alter positive selection in the thymus and
elicit autoimmune reactions. Peripheral tolerance can be broken by increasing
the expression of LFA-1 adhesion molecule on T cells. This can be related to the
inhibition of intracellular kinases. Alternatively, a drug specific immune
response might elicit autoimmunity by cross-reactivity: the drug reactive T
cells might be cross-reactive with certain peptide antigens and possibly
autoantigens. SUMMARY: Drug-specific immune responses are well described. They
have a great tendency to be cross-reactive with peptide antigens. This
'immunological' cause of autoimmunity elicited by drugs may occur more
frequently than thought. It connects the field of drug hypersensitivity with
drug-induced autoimmunity.
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