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Drug Desensitization: General Concepts Management of HRs in patients without treatment alternatives is based on the DD procedure, able to induce a temporary hyporesponsive state by incremental escalation of sub-optimal doses of the offending drug, until reaching required dosage ( Desensitization is conceptually dedicated to patients in which an IgE-mediated mechanism is demonstrated by positive skin testing or serum IgE for culprit drug, however, patients who suffered immediate reactions to taxanes and other chemotherapies in which the IgE mechanisms cannot be demonstrated have also been successfully desensitized ( Two types of DD protocols are available: rapid drug desensitization which addresses type I reactions with mast cells/basophils/IgE involvement, and slow drug desensitization which addresses delayed type IV reactions with T-cell involvement (Waldram et al., 2018), insulin ( Mechanisms Involved In Drug Desensitization: Mast Cells Regardless of whether the reaction is the consequence of an IgE- or non IgE-mediated mechanism, MC are key effector cells in the majority of immediate drug reactions, and the desensitization procedure is associated with the inhibition of MC degranulation and cytokine production

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