Drug-induced pseudoallergy reaction through mas-related G-protein-coupled receptor X2: A narrative review

Pseudoallergy is a hypersensitivity condition not triggered by immunoglobulin E (IgE). These conditions can cause various health problems with symptoms identical to IgE-mediated allergic. The symptoms range from mild such as hives, to severe symptoms, such as anaphylactoid. Several drugs are known to activate mast cells directly through the mas-related G protein-coupled receptor X2 (MRGPRX2). MRGPRX2 is a receptor expressed on mast cells and responsible for their activation without being mediated by IgE. This review focuses on the types and methods of drugs that can induce pseudoallergy through MRGPRX2. The literature was collected with keywords in the form of “pseudo allergy” OR “pseudoallergy” AND “drug” AND “induce” NOT “Herb.” From this search, it is known that several drugs belonging to the class of antidepressants, antipsychotics, opioids, muscle relaxants, preservatives, antibiotics, radiograph media, cough suppressants, immune response modifiers, retinoids, and Bradykinin B2 receptor antagonist drugs can induce pseudoallergic reactions through MRGPRX2. In addition, the structure of the drug compound can affect its interaction with MRGPRX2 and the emergence of pseudoallergic reactions. © 2023, Faculty of Pharmaceutical Sciences, Chulalongkorn University. All rights reserved.