Activation of inflammasomes by agents causing idiosyncratic skin reactions: a possible biomarker

Chemically reactive drugs and drugs that form reactive metabolites often cause idiosyncratic drug reactions (IDRs); however, not all such drugs are associated with IDRs. Most IDRs appear to be immune mediated; therefore, the ability of a drug to induce an immune response may be the determinant of which drugs will cause IDRs. Inflammasome activation plays an important role in the initiation of an immune response. In this study, we studied two pairs of similar chemically reactive drugs, telaprevir/boceprevir and dimethyl fumarate/ethacrynic acid. In both pairs, the drug associated with skin reactions activated inflammasomes in THP-1 cells, and the drug not associated with skin reactions did not.