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Acute and Chronic Sinusitis - Fauquier ENT
Autoantibodies that develop are selectively directed against the particular cytochrome that metabolized the parent drug. The hapten hypothesis proposes that the drug metabolite can act as a hapten and can modify the self of the individual by covalently binding to proteins. The danger hypothesis proposes that the immune system only responds to a foreign antigen if the antigen is associated with a danger signal, such as cell stress or cell death.Most clinically overt adverse hepatic events associated with drugs are unpredictable, and they have intermediate (1 to 8 weeks) or long latency (up to 12 months) characteristic of reactions.Immune-mediated drug-induced liver nearly always disappears or becomes quiescent when the drug is removed.Exemples methyldopa
nitrofurantoinReferences Liu ZX, Kaplowitz N.
Chapter 6 cites two examples in which in-vitro data make it possible to reduce the uncertainties in risk assessment associated with exposure to ozone and ultraviolet radiation.
Adaptive immune system - Wikipedia
Very little is understood about the mechanism of IDRs and their unpredictable nature makes them very difficult to study. There is a large amount of circumstantial evidence that most are and are caused by chemically of the drugs involved rather than to the drug itself. The two major mechanistic hypotheses for these reactions are the and the . The hapten hypothesis is that a drug, or more likely a reactive metabolite of a drug, covalently binds to protein making it "foreign" and in some patients this leads to an immune response. The danger hypothesis is that for something to induce an immune response it has to cause cell damage or cell stress, otherwise it will either be ignored by the immune system or induce tolerance. These two hypotheses are not mutually exclusive.
Lecture Notes in Immunology: Function of the Human
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