{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:50:32Z","timestamp":1788234632110,"version":"build-2803163510"},"reference-count":86,"publisher":"Korean Association of Internal Medicine","issue":"2","license":[{"start":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T00:00:00Z","timestamp":1646006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["kjim.org"],"crossmark-restriction":true},"short-container-title":["Korean J Intern Med"],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:p>Drug desensitization is the temporary induction of tolerance to a sensitized drug by administering slow increments of the drug, starting from a very small amount to a full therapeutic dose. It can be used as a therapeutic strategy for patients with drug hypersensitivity when no comparable alternatives are available. Desensitization has been recommended for immunoglobulin E (IgE)-mediated immediate hypersensitivity; however, its indications have recently been expanded to include non-IgE-mediated, non-immunological, or delayed T cell-mediated reactions. Currently, the mechanism of desensitization is not fully understood. However, the attenuation of various intracellular signals in target cells is an area of active research, such as high-affinity IgE receptor (Fc\u03b5RI) internalization, anti-drug IgG4 blocking antibody, altered signaling pathways in mast cells and basophils, and reduced Ca2+ influx. Agents commonly requiring desensitization include antineoplastic agents, antibiotics, antituberculous agents, and aspirin\/nonsteroidal antiinflammatory drugs. Various desensitization protocols (rapid or slow, multi-bag or one-bag, with different target doses) have been proposed for each drug. An appropriate protocol should be selected with the appropriate concentration, dosage, dosing interval, and route of administration. In addition, the protocol should be adjusted with consideration of the severity of the initial reaction, the characteristics of the drug itself, as well as the frequency, pattern, and degree of breakthrough reactions.<\/jats:p>","DOI":"10.3904\/kjim.2021.438","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:45:44Z","timestamp":1644194744000},"page":"261-270","update-policy":"https:\/\/doi.org\/10.3904\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Desensitization for the prevention of drug hypersensitivity reactions"],"prefix":"10.3904","volume":"37","author":[{"given":"Sung-Yoon","family":"Kang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeongmin","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2317-4201","authenticated-orcid":true,"given":"Hye-Ryun","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2270","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12350"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s40259-013-0066-x"},{"key":"ref3","first-page":"373","volume-title":"Anaphylaxis and idiosyncrasy. 1992","author":"Widal","year":"1993"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1947.72880350012008"},{"key":"ref5","first-page":"444","volume-title":"Sensitivity to penicillin: anaphylaxis and desensitisation","author":"O\u2019Donovan","year":"1946"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.12.040"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1172\/jci87492"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/eji.201040810"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1021\/cb500134t"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1995.tb00033.x"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2009.06.026"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.05.004"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.89.22.10733"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(83)90083-0"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.09.039"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.09.012"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2004.08.037"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20040382"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/s0952-7915(02)00400-4"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/s0161-5890(02)00079-2"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.274.9.5791"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.01067"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.590991"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1159\/000078583"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.02.004"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1111\/all.14311"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2019.60.2.119"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2018.01.006"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2018.12.017"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-021-01014-x"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1200\/jco.1999.17.4.1141"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1200\/jco.1990.8.7.1263"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2000.18.1.102"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.4168\/aard.2013.1.4.295"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-012-0909-9"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2004.08.002"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2005.06.028"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.07.003"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.280.6228.1353"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.02.044"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2004.11.043"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.12.019"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.10.014"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-018-3662-0"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.4168\/aard.2020.8.3.135"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.4168\/aard.2019.7.2.109"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2010.02441.x"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(87)90371-x"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1056\/nejm198505093121905"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/39.4.556"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1007\/bf00180000"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.03.037"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1d022"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199510000-00017"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.08.018"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(87)90365-4"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2013.05.005"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1016\/s0091-6749(96)70218-x"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1990.00390210145031"},{"key":"ref60","first-page":"402","volume-title":"Vancomycin anaphylaxis and successful desensitization","author":"Anne","year":"1994"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-100-1-157_1"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2016.08.006"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1016\/s1081-1206(10)60063-4"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1016\/s0091-6749(97)70111-8"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2015.02.008"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr2772w"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000000320"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1097\/mcg.0b013e3182586f29"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.4168\/aard.2018.6.1.68"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.3904\/kjm.2012.82.3.269"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2010.2.2.77"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.49.3590"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.4168\/aard.2015.3.4.297"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.03.054"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1378\/chest.98.6.1518"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.5415\/apallergy.2014.4.3.156"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2020.61.1.4"},{"key":"ref78","first-page":"297","volume-title":"First complete description of the aspirin idiosyncrasy-asthma-nasal polyposis syndrome (plus urticaria): 1922 (with a note on aspirin desensitization). By F. Widal, P. Abrami, J. Lermoyez","author":"Widal","year":"1987"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.10.032"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1111\/all.13599"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2006.06.019"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1097\/aci.0000000000000189"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.1136\/thx.48.12.1189"},{"key":"ref84","doi-asserted-by":"publisher","DOI":"10.1097\/aci.0000000000000374"},{"key":"ref85","first-page":"129","volume-title":"Aspirin induced tolerance in aspirin-asthma detected by a new challenge test","author":"Bianco","year":"1977"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(76)90059-2"}],"container-title":["The Korean Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/kjim.org\/upload\/kjim-2021-438.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2021.438","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/upload\/kjim-2021-438.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T02:28:19Z","timestamp":1646879299000},"score":1,"resource":{"primary":{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2021.438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":86,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,3]]}},"URL":"https:\/\/doi.org\/10.3904\/kjim.2021.438","relation":{},"ISSN":["1226-3303","2005-6648"],"issn-type":[{"value":"1226-3303","type":"print"},{"value":"2005-6648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,1]]},"assertion":[{"value":"2021-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-28","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}