Toxic epidermal necrolysis and antifolate drugs in cancer chemotherapy.
Fiche publication
Date publication
novembre 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HUMBERT Philippe
Tous les auteurs :
Pierard-Franchimont C, Lesuisse M, Humbert P, Delvenne P, Pierard GE
Lien Pubmed
Résumé
Folates are one-carbon donors essential for synthesizing purines, pyrimidines, serine, and methionine. They correspond to anionic hydrophilic molecules essential for DNA synthesis in mammalian cells. The latter cells lack the capacity to synthesize folates. In some patients, high dosages of antifolate drugs (eg: methotrexate, pemetrexed) used in cancer chemotherapy alter the keratinocytes, endothelial cells and Factor XIIIa+ dermal dendrocytes in a range of various severities. Such conditions clinically designed under the heading antifolate cytotoxic skin reaction (ACSR) occasionally resemble the toxic epidermal necrolysis (TEN) / Stevens-Johnson syndrome (SJS) spectrum. Whether or not the TEN/SJS presentation of ACSR is a regular condition similar to that induced by other drugs or a variant condition supported by a unique pathomechanism is unsettled.
Référence
Curr Drug Saf. 2012 Nov 1;7(5):357-60.