Fig 2. Viral enhancement of p-i acting drugs
Drugs bind to proteins (non-covalently, reversibly, low affinity),
including immune receptor proteins. Such low-affinity binding is mostly
clinically irrelevant, as it is insufficient to elicit T cell
stimulation. However, during viral infections, immune receptors are
expressed in much higher density, the chances for increased low affine
interactions increases and the p-i binding may become functionally
relevant. T cells are activated by the drug, as long as the
virus-induced immune stimulation lasts. When the virus-induced immune
activation is over, the patient no longer shows any drug reactivity.