Mas-Related G Protein-Coupled Receptor-X2 and Its Role in Non-immunoglobulin E-Mediated Drug Hypersensitivity

Immunol Allergy Clin North Am. 2022 May;42(2):269-284. doi: 10.1016/j.iac.2021.12.003. Epub 2022 Mar 31.

Abstract

A diverse group of Food and Drug Administration-approved cationic drugs including antibiotics, neuromuscular blocking drugs, opioids, antidepressants, and radiocontrast media activate mast cells and cause hypersensitivity reactions by both an immunoglobulin E IgE-dependent and independent manner. The recent discovery that these drugs activate mast cells via the G protein-coupled receptor known as Mas-related GPCR-X2 (MRGPRX2) has represented a paradigm shift of how drug hypersensitivity reactions are viewed. This article provides an overview of the current status of the role of MRGPRX2 on non-IgE-mediated drug hypersensitivity. Potential risk factors and evaluation for suspected MRGPRX2-mediated drug reactions are also discussed.

Keywords: Anaphylaxis; Drug hypersensitivity; MRGPRX2; Mast cells.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Drug Hypersensitivity* / diagnosis
  • Humans
  • Immunoglobulin E*
  • Nerve Tissue Proteins
  • Receptors, G-Protein-Coupled
  • Receptors, Neuropeptide / genetics
  • United States

Substances

  • MRGPRX2 protein, human
  • Nerve Tissue Proteins
  • Receptors, G-Protein-Coupled
  • Receptors, Neuropeptide
  • Immunoglobulin E