Cross-reactivity with drugs at the T cell level

PURPOSE OF REVIEW: Cross-reactivity with drugs is an important clinical problem in drug hypersensitivity. Once a patient is labeled 'drug-allergic' all drugs of the same class are withheld and future therapeutic interventions are limited. Here we review cross-reactivity with drugs at the T cell level. RECENT FINDINGS: Analysis of T cell recognition of various classes of drugs (beta-lactam antibiotics, sulfonamides, local anesthetics) using T cell clones suggests that at the T cell level the whole structure, in particular the core and to a lesser degree side chains, are recognized. SUMMARY: It is necessary to differentiate cross-reactivity mediated by T cells and antibodies as only the latter seem to recognize side chains exclusively.