Fig 3. Virus release due to massive p-i activation (DRESS)
A high affine p-i activation can lead to strong T cell activation, T cell expansion, and the acute symptoms of DRESS such as cytotoxicity in various organs. Such p-i activated T cells can also contain herpes virus peptide-specific T cells (reactive towards HHV6, CMV, EBV), which usually control the replication of the virus in the tissue via IFN-γ release. Through p-i activation, such T cells switch from a controller (IFNγ) to a cytotoxic phenotype. When they encounter herpes peptide-expressing cells, they attack them, the prefabricated viruses are released, and viraemia of various herpes viruses occurs.