Immunological mechanisms of idiosyncratic drug-Induced adverse reactions

There are two major unresolved questions regarding the immunological mechanisms of idiosyncratic drug-induced adverse reactions. The first is that they occur in only a very small number of exposed individuals—as seen in conditions such as drug-induced liver injury and Stevens–Johnson syndrome—yet, because they can be fatal when they do occur, they pose a significant clinical problem. The second is that the site or organ where the reaction occurs varies from person to person, even for the same drug. Although the drug circulates systemically throughout the body, the reaction is often highly localized to a specific tissue or organ. In this Research Topic, we would like to examine the current state of research addressing these two questions, with a specific focus on the immune mechanisms underlying idiosyncratic drug-induced adverse reactions.Resolving these questions is expected to lead to a better understanding of how immune responses contribute to idiosyncratic drug-induced adverse reactions. Identifying immunological factors—including genetic and metabolic determinants that influence immune activation and individual susceptibility—would support a shift from population-level drug safety toward patient-specific risk prediction and personalized prescribing. Clarifying why immune-mediated reactions localize to particular organs would help explain the link between drug metabolism, immune activation, and tissue-specific vulnerability. Together, this knowledge could inform screening strategies to identify high-risk patients before treatment, guide the design of safer drug candidates, and strengthen post-marketing pharmacovigilance.This Research Topic concerns the immunological aspects of idiosyncratic drug-induced adverse reactions. Submissions should address immune mechanisms or immune-mediated determinants of adverse drug reactions, rather than idiosyncratic drug-induced adverse reactions more broadly. We are seeking researchers capable of contributing manuscripts on topics including, but not limited to:• HLA polymorphisms and their role in individual susceptibility• The breakdown of immune tolerance following drug exposure• The mechanisms by which drugs and covalently bound drug-protein adducts trigger immune activation• Immunological mechanisms underlying site-specific (organ-localized) reactions• Inflammasome activation and its links to lifestyle-related diseases such as atherosclerosis• The impact of the gut microbiota on the risk of idiosyncratic drug-induced liver injury (iDILI)Original research, reviews, and perspective articles are all welcome. Topic editors: Ryuji Kato, Jack Uetrecht Source: https://www.frontiersin.org/research-topics/85971/immunological-mechanisms-of-idiosyncratic-drug-induced-adverse-reactions