Thus, only rare individuals are predisposed to develop SJS in response to a particular drug on the bases of their expression of specific T-cell receptor types. While the evidence supporting this T-cell receptor selectivity is limited, one study identified the preferential presence of the TCR-V-b and complementarity-determining region 3 in T-cell receptors found on the T cells in the blisters of patients with allopurinol-induced DRESS syndrome. This finding is compatible with the notion that specific types of T cell receptors are involved in the development of specific drug-induced SCARs. ADME
Variations in ADME, i.e. an individuals efficiency in absorbing, tissue-distributing, metabolizing, or excreting a drug, have been found to occur in various severe cutaneous adverse reactions (SCARS) as well as other types of adverse drug reactions. These variations influence the levels and duration of a drug or its metabolite in tissues and thereby impact the drugs or metabolites ability to evoke these reactions. For example, CYP2C9 is an important drug-metabolizing cytochrome P450; it metabolizes and thereby inactivates phenytoin. Taiwanese, Japanese, and Malaysian individuals expressing the CYP2C9*3 variant of CYP2C9, which has reduced metabolic activity compared to the wild type (i.e. CYP2c9*1) cytochrome, have increased blood levels of phenytoin and a high incidence of SJS (as well as SJS/TEN and TEN) when taking the drug. In addition to abnormalities in drug-metabolizing enzymes, dysfunctions of the kidney, liver, or GI tract which increase a SCARs-inducing drug or metabolite levels are suggested to promote SCARs responses.
Orographic lift can cause an significant increase in the intensity of the convection of a tropical cyclone when its eye moves over a mountain, breaking the capped boundary layer that had been restraining it. Jet streams can both enhance and inhibit tropical cyclone intensity by influencing the storms outflow as well as vertical wind shear. Formation
Tropical cyclones tend to develop during the summer, but have been noted in nearly every month in most tropical cyclone basins. Tropical cyclones on either side of the Equator generally have their origins in the Intertropical Convergence Zone, where winds blow from either the northeast or southeast. Within this broad area of low-pressure, air is heated over the warm tropical ocean and rises in discrete parcels, which causes thundery showers to form. These showers dissipate quite quickly; however, they can group together into large clusters of thunderstorms. This creates a flow of warm, moist, rapidly rising air, which starts to rotate cyclonically as it interacts with the rotation of the earth.Several factors are required for these thunderstorms to develop further, including sea surface temperatures of around 27 °C (81 °F) and low vertical wind shear surrounding the system, atmospheric instability, high humidity in the lower to middle levels of the troposphere, enough Coriolis force to develop a low-pressure center, a pre-existing low-level focus or disturbance,
There is a limit on tropical cyclone intensity which is strongly related to the water temperatures along its path. and upper-level divergence. An average of 86 tropical cyclones of tropical storm intensity form annually worldwide.