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  Indian J Med Microbiol
 

Figure 1: Role and pathogenesis of viral reactivation in DRESS: In the presence of genetic and certain environmental factors, culprit drug induces immune dysregulation, causing a reduction in the proinflammatory monocytes, driving the expansion of Treg cells in association with a proportional decrease in the Th17 cells and B-lymphocytes. This specific immune deficiency state induces HHV reactivation. Later, as the immune reconstitution occurs, an increase in the Th17 cells drives autoi mmunit y in the later course of DRESS. FoxP3 = Master regulator of T regulatory lymphocytes, DRESS = Drug reaction with eosinophilia and systemic symptoms, HHV = Human herpesvirus, RoRγt = Master regulator of Th17 lymphocytes, T-bet = Master regulator of Th1 lymphocyte

Figure 1: Role and pathogenesis of viral reactivation in DRESS: In the presence of genetic and certain environmental factors, culprit drug induces immune dysregulation, causing a reduction in the proinflammatory monocytes, driving the expansion of Treg cells in association with a proportional decrease in the Th17 cells and B-lymphocytes. This specific immune deficiency state induces HHV reactivation. Later, as the immune reconstitution occurs, an increase in the Th17 cells drives autoi mmunit y in the later course of DRESS. FoxP3 = Master regulator of T regulatory lymphocytes, DRESS = Drug reaction with eosinophilia and systemic symptoms, HHV = Human herpesvirus, RoRγt = Master regulator of Th17 lymphocytes, T-bet = Master regulator of Th1 lymphocyte