Elizabeth J. Phillips, M.D.

Professor

elizabeth.j.phillips@vanderbilt.edu
Faculty Appointments
Professor of Medicine John A. Oates Chair in Clinical ResearchProfessor of Pathology, Microbiology and ImmunologyProfessor of Pharmacology
Education
M.D., University of Alberta, Alberta, CanadaB.Sc., University of Alberta, Alberta, Canada
Research Description
The Phillips lab has a research and clinical program in drug Hypersensitivity that specifically focuses on the tissue specificity, genetic basis and immunopathogenesis of severe T-cell mediated adverse drug reactions such as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis and drug reaction with eosiniophiia and systemic symptoms. Her lab studies the development of genetic, molecular and cellular signals to predict and prevent these severe life-threatening adverse drug reactions using novel single cell technologies and mass cytometry . Her impact has been national and international and she has forged collaborations with groups in Australia, Africa and Southeast Asia to guide in the implementation of scientific programs to study the expansive and genetically diverse drug hypersensitivity syndromes. This research program is paired with an outpatient clinical drug allergy service which occurs weekly at VASAP (2611 West End Ave).
Clinical Description
Dr. Phillips is a specialist in Infectious Diseases, Clinical Pharmacology, Drug Safety and immunologically mediated adverse drug reactions and has over 25 years of expertise in this area. She runs a specialized drug hypersensitivity clinic that assesses patients with suspected immunologically mediated adverse drug reactions and occurs once weekly at the VASAP site (2611 West End). The clinic provides specialized testing, management and advice to patients and their families including drug skin and patch testing, desensitization and genetic testing.
Research Keywords
HLA, T-cell immunology, immunogenomics, single cell, pharmacogenomics, drug hypersensitivity, SJS/TEN, Adverse drug reactions
Clinical Research Keywords
Drug allergy, hypersensitivity, SJS/TEN, DRESS, de-labeling, skin testing, ELISpot, flow cytometry, pharmacogenomics, pharmacogenetics, HLA, PheWAS, whole genome.
Publications
Garon SL, Pavlos RK, White KD, Brown NJ, Stone CA, Phillips EJ. Pharmacogenomics of off-target adverse drug reactions. Br J Clin Pharmacol [print-electronic]. 2017 Sep; 83(9): 1896-911. PMID: 28345177, PMCID: PMC5555876, DOI: 10.1111/bcp.13294, ISSN: 1365-2125.

Karnes JH, Shaffer CM, Cronin R, Bastarache L, Gaudieri S, James I, Pavlos R, Steiner H, Mosley JD, Mallal S, Denny JC, Phillips EJ, Roden DM. Influence of human leukocyte antigen (HLA) alleles and killer cell immunoglobulin-like receptors (KIR) types on heparin-induced thrombocytopenia (HIT). Pharmacotherapy [print-electronic]. 2017 Jul 7/8/2017; PMID: 28688202, DOI: 10.1002/phar.1983, ISSN: 1875-9114.

Trubiano JA, Adkinson NF, Phillips EJ. Penicillin Allergy Is Not Necessarily Forever. JAMA. 2017 Jul 7/4/2017; 318(1): 82-3. PMID: 28672303, PII: 2635615, DOI: 10.1001/jama.2017.6510, ISSN: 1538-3598.

Tseng A, Hughes CA, Wu J, Seet J, Phillips EJ. Cobicistat Versus Ritonavir: Similar Pharmacokinetic Enhancers But Some Important Differences. Ann Pharmacother [print-electronic]. 2017 Jun 6/1/2017; 1060028017717018. PMID: 28627229, DOI: 10.1177/1060028017717018, ISSN: 1542-6270.

Trubiano JA, Thursky KA, Stewardson AJ, Urbancic K, Worth LJ, Jackson C, Stevenson W, Sutherland M, Slavin MA, Grayson ML, Phillips EJ. Impact of an Integrated Antibiotic Allergy Testing Program on Antimicrobial Stewardship: A Multicenter Evaluation. Clin. Infect. Dis [print-electronic]. 2017 May 5/18/2017; PMID: 28520865, PII: 3832923, DOI: 10.1093/cid/cix244, ISSN: 1537-6591.

Karnes JH, Bastarache L, Shaffer CM, Gaudieri S, Xu Y, Glazer AM, Mosley JD, Zhao S, Raychaudhuri S, Mallal S, Ye Z, Mayer JG, Brilliant MH, Hebbring SJ, Roden DM, Phillips EJ, Denny JC. Phenome-wide scanning identifies multiple diseases and disease severity phenotypes associated with HLA variants. Sci Transl Med. 2017 May 5/10/2017; 9(389): PMID: 28490672, PII: 9/389/eaai8708, DOI: 10.1126/scitranslmed.aai8708, ISSN: 1946-6242.

Stone CA, Hemler JA, Commins SP, Schuyler AJ, Phillips EJ, Peebles RS, Fahrenholz JM. Anaphylaxis after zoster vaccine: Implicating alpha-gal allergy as a possible mechanism. J. Allergy Clin. Immunol [print-electronic]. 2017 May; 139(5): 1710-1713.e2. PMID: 27986511, PMCID: PMC5420485, PII: S0091-6749(16)31455-5, DOI: 10.1016/j.jaci.2016.10.037, ISSN: 1097-6825.

Peter JG, Lehloenya R, Dlamini S, Risma K, White KD, Konvinse KC, Phillips EJ. Severe Delayed Cutaneous and Systemic Reactions to Drugs: A Global Perspective on the Science and Art of Current Practice. J Allergy Clin Immunol Pract. 2017 May; 5(3): 547-63. PMID: 28483310, PMCID: PMC5424615, PII: S2213-2198(17)30046-6, DOI: 10.1016/j.jaip.2017.01.025, ISSN: 2213-2201.

Adler NR, Aung AK, Ergen EN, Trubiano J, Goh MS, Phillips EJ. Recent advances in the understanding of severe cutaneous adverse reactions. Br. J. Dermatol [print-electronic]. 2017 Mar 3/3/2017; PMID: 28256714, DOI: 10.1111/bjd.15423, ISSN: 1365-2133.

Karnes JH, Shaffer CM, Bastarache L, Gaudieri S, Glazer AM, Steiner HE, Mosley JD, Mallal S, Denny JC, Phillips EJ, Roden DM. Comparison of HLA allelic imputation programs. PLoS ONE. 2017; 12(2): e0172444. PMID: 28207879, PMCID: PMC5312875, PII: PONE-D-16-48785, DOI: 10.1371/journal.pone.0172444, ISSN: 1932-6203.

Konvinse KC, Phillips EJ, White KD, Trubiano JA. Old dog begging for new tricks: current practices and future directions in the diagnosis of delayed antimicrobial hypersensitivity. Curr. Opin. Infect. Dis. 2016 Dec; 29(6): 561-76. PMID: 27753687, PMCID: PMC5113146, DOI: 10.1097/QCO.0000000000000323, ISSN: 1473-6527.

Johnson DB, Balko JM, Compton ML, Chalkias S, Gorham J, Xu Y, Hicks M, Puzanov I, Alexander MR, Bloomer TL, Becker JR, Slosky DA, Phillips EJ, Pilkinton MA, Craig-Owens L, Kola N, Plautz G, Reshef DS, Deutsch JS, Deering RP, Olenchock BA, Lichtman AH, Roden DM, Seidman CE, Koralnik IJ, Seidman JG, Hoffman RD, Taube JM, Diaz LA, Anders RA, Sosman JA, Moslehi JJ. Fulminant Myocarditis with Combination Immune Checkpoint Blockade. N. Engl. J. Med. 2016 Nov 11/3/2016; 375(18): 1749-55. PMID: 27806233, PMCID: PMC5247797, DOI: 10.1056/NEJMoa1609214, ISSN: 1533-4406.

Trubiano JA, Beekmann SE, Worth LJ, Polgreen PM, Thursky KA, Slavin MA, Grayson ML, Phillips EJ. Improving Antimicrobial Stewardship by Antibiotic Allergy Delabeling: Evaluation of Knowledge, Attitude, and Practices Throughout the Emerging Infections Network. Open Forum Infect Dis. 2016 Sep; 3(3): ofw153. PMID: 27800527, PMCID: PMC5084721, PII: ofw153, DOI: 10.1093/ofid/ofw153, ISSN: 2328-8957.

Murray TS, Rice TW, Wheeler AP, Phillips EJ, Dworski RT, Stollings JL. Medication Desensitization: Characterization of Outcomes and Risk Factors for Reactions. Ann Pharmacother [print-electronic]. 2016 Mar; 50(3): 203-8. PMID: 26783356, PII: 1060028015625660, DOI: 10.1177/1060028015625660, ISSN: 1542-6270.

Jing L, Laing KJ, Dong L, Russell RM, Barlow RS, Haas JG, Ramchandani MS, Johnston C, Buus S, Redwood AJ, White KD, Mallal SA, Phillips EJ, Posavad CM, Wald A, Koelle DM. Extensive CD4 and CD8 T Cell Cross-Reactivity between Alphaherpesviruses. J. Immunol [print-electronic]. 2016 Mar 3/1/2016; 196(5): 2205-18. PMID: 26810224, PMCID: PMC4761520, PII: jimmunol.1502366, DOI: 10.4049/jimmunol.1502366, ISSN: 1550-6606.

Phillips EJ. Classifying ADRs--does dose matter?. Br J Clin Pharmacol [print-electronic]. 2016 Jan; 81(1): 10-2. PMID: 26286675, PMCID: PMC4693569, DOI: 10.1111/bcp.12749, ISSN: 1365-2125.

Saito Y, Stamp LK, Caudle KE, Hershfield MS, McDonagh EM, Callaghan JT, Tassaneeyakul W, Mushiroda T, Kamatani N, Goldspiel BR, Phillips EJ, Klein TE, Lee MT, . Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for human leukocyte antigen B (HLA-B) genotype and allopurinol dosing: 2015 update. Clin. Pharmacol. Ther [print-electronic]. 2016 Jan; 99(1): 36-7. PMID: 26094938, PMCID: PMC4675696, DOI: 10.1002/cpt.161.

Hemler JA, Phillips EJ, Mallal SA, Kendall PL. The evolving story of human leukocyte antigen and the immunogenetics of peanut allergy. Ann. Allergy Asthma Immunol [print-electronic]. 2015 Dec; 115(6): 471-6. PMID: 26522257, PII: S1081-1206(15)00693-6, DOI: 10.1016/j.anai.2015.10.008, ISSN: 1534-4436.

Wheatley LM, Plaut M, Schwaninger JM, Banerji A, Castells M, Finkelman FD, Gleich GJ, Guttman-Yassky E, Mallal SA, Naisbitt DJ, Ostrov DA, Phillips EJ, Pichler WJ, Platts-Mills TA, Roujeau JC, Schwartz LB, Trepanier LA. Report from the National Institute of Allergy and Infectious Diseases workshop on drug allergy. J. Allergy Clin. Immunol. 2015 Aug; 136(2): 262-71.e2. PMID: 26254053, PMCID: PMC4529958, PII: S0091-6749(15)00733-2, DOI: 10.1016/j.jaci.2015.05.027, ISSN: 1097-6825.

White KD, Chung WH, Hung SI, Mallal S, Phillips EJ. Evolving models of the immunopathogenesis of T cell-mediated drug allergy: The role of host, pathogens, and drug response. J. Allergy Clin. Immunol. 2015 Aug; 136(2): 219-34; quiz 235. PMID: 26254049, PMCID: PMC4577472, PII: S0091-6749(15)00869-6, DOI: 10.1016/j.jaci.2015.05.050, ISSN: 1097-6825.

Milpied-Homsi B, Moran EM, Phillips EJ. Antiviral drug allergy. Immunol Allergy Clin North Am. 2014 Aug; 34(3): 645-62, ix. PMID: 25017682, PMCID: PMC4140860, PII: S0889-8561(14)00059-9, DOI: 10.1016/j.iac.2014.04.011, ISSN: 1557-8607.

Stone SF, Phillips EJ, Wiese MD, Heddle RJ, Brown SG. Immediate-type hypersensitivity drug reactions. Br J Clin Pharmacol. 2014 Jul; 78(1): 1-13. PMID: 24286446, PMCID: PMC4168374, DOI: 10.1111/bcp.12297, ISSN: 1365-2125.

Brusch AM, Clarke RC, Platt PR, Phillips EJ. Exploring the link between pholcodine exposure and neuromuscular blocking agent anaphylaxis. Br J Clin Pharmacol. 2014 Jul; 78(1): 14-23. PMID: 24251966, PMCID: PMC4168376, DOI: 10.1111/bcp.12290, ISSN: 1365-2125.

Karlin E, Phillips E. Genotyping for severe drug hypersensitivity. Curr Allergy Asthma Rep. 2014 Mar; 14(3): 418. PMID: 24429903, PMCID: PMC4014135, DOI: 10.1007/s11882-013-0418-0, ISSN: 1534-6315.

Trubiano J, Phillips E. Antimicrobial stewardship's new weapon? A review of antibiotic allergy and pathways to 'de-labeling'. Curr. Opin. Infect. Dis. 2013 Dec; 26(6): 526-37. PMID: 24126717, PMCID: PMC3862073, DOI: 10.1097/QCO.0000000000000006, ISSN: 1473-6527.

Rive CM, Bourke J, Phillips EJ. Testing for drug hypersensitivity syndromes. Clin Biochem Rev. 2013 Feb; 34(1): 15-38. PMID: 23592889, PMCID: PMC3626363, ISSN: 0159-8090.

Phillips EJ, Mallal SA. HLA-B*5701 and flucloxacillin associated drug-induced liver disease [letter]. AIDS. 2013 Jan 1/28/2013; 27(3): 491-2. PMID: 23291545, PII: 00002030-201301280-00025, DOI: 10.1097/QAD.0b013e32835ca9d5, ISSN: 1473-5571.

Lee MH, Stocker SL, Anderson J, Phillips EJ, Nolan D, Williams KM, Graham GG, Sullivan JR, Day RO. Initiating allopurinol therapy: do we need to know the patient's human leucocyte antigen status?. Intern Med J. 2012 Apr; 42(4): 411-6. PMID: 21790926, DOI: 10.1111/j.1445-5994.2011.02567.x, ISSN: 1445-5994.

Pavlos R, Phillips EJ. Individualization of antiretroviral therapy. Pharmgenomics Pers Med [print-electronic]. 2012; 5: 1-17. PMID: 23226059, PMCID: PMC3513193, PII: pgpm-5-001, DOI: 10.2147/PGPM.S15303, ISSN: 1178-7066.

Haas DW, Kuritzkes DR, Ritchie MD, Amur S, Gage BF, Maartens G, Masys D, Fellay J, Phillips E, Ribaudo HJ, Freedberg KA, Petropoulos C, Manolio TA, Gulick RM, Haubrich R, Kim P, Dehlinger M, Abebe R, Telenti A, . Pharmacogenomics of HIV therapy: summary of a workshop sponsored by the National Institute of Allergy and Infectious Diseases. HIV Clin Trials. 2011 Sep; 12(5): 277-85. PMID: 22180526, PMCID: PMC3322423, PII: H4HV83200516XH08, DOI: 10.1310/hct1205-277, ISSN: 1528-4336.

Phillips EJ, Mallal SA. HLA-B*1502 screening and toxic effects of carbamazepine [letter]. N. Engl. J. Med. 2011 Aug 8/18/2011; 365(7): 672; author reply 673. PMID: 21848472, DOI: 10.1056/NEJMc1105467#SA1, ISSN: 1533-4406.

Phillips EJ, Chung WH, Mockenhaupt M, Roujeau JC, Mallal SA. Drug hypersensitivity: pharmacogenetics and clinical syndromes. J. Allergy Clin. Immunol. 2011 Mar; 127(3 Suppl): S60-6. PMID: 21354501, PMCID: PMC3061439, PII: S0091-6749(10)01943-3, DOI: 10.1016/j.jaci.2010.11.046, ISSN: 1097-6825.

Phillips EJ, Mallal SA. Pharmacogenetics of drug hypersensitivity. Pharmacogenomics. 2010 Jul; 11(7): 973-87. PMID: 20602616, PMCID: PMC2937181, DOI: 10.2217/pgs.10.77, ISSN: 1744-8042.

Phillips EJ, Mallal SA. HLA and drug-induced toxicity. Curr. Opin. Mol. Ther. 2009 Jun; 11(3): 231-42. PMID: 19479656, ISSN: 2040-3445.

Shear NH, Milpied B, Bruynzeel DP, Phillips EJ. A review of drug patch testing and implications for HIV clinicians. AIDS. 2008 May 5/31/2008; 22(9): 999-1007. PMID: 18520343, PII: 00002030-200805310-00001, DOI: 10.1097/QAD.0b013e3282f7cb60, ISSN: 1473-5571.

Phillips EJ, Mallal SA. Pharmacogenetics and the potential for the individualization of antiretroviral therapy. Curr. Opin. Infect. Dis. 2008 Feb; 21(1): 16-24. PMID: 18192781, PII: 00001432-200802000-00005, DOI: 10.1097/QCO.0b013e3282f42224, ISSN: 0951-7375.

Tansey CM, Louie M, Loeb M, Gold WL, Muller MP, de Jager J, Cameron JI, Tomlinson G, Mazzulli T, Walmsley SL, Rachlis AR, Mederski BD, Silverman M, Shainhouse Z, Ephtimios IE, Avendano M, Downey J, Styra R, Yamamura D, Gerson M, Stanbrook MB, Marras TK, Phillips EJ, Zamel N, Richardson SE, Slutsky AS, Herridge MS. One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome. Arch. Intern. Med. 2007 Jun 6/25/2007; 167(12): 1312-20. PMID: 17592106, PII: 167/12/1312, DOI: 10.1001/archinte.167.12.1312, ISSN: 0003-9926.

Chui CK, Brumme ZL, Brumme CJ, Yip B, Phillips EJ, Montaner JS, Harrigan PR. A simple screening approach to reduce B*5701-associated abacavir hypersensitivity on the basis of sequence variation in HIV reverse transcriptase. Clin. Infect. Dis [print-electronic]. 2007 Jun 6/1/2007; 44(11): 1503-8. PMID: 17479950, PII: CID41502, DOI: 10.1086/517499, ISSN: 1537-6591.

Phillips EJ. Genetic screening to prevent abacavir hypersensitivity reaction: are we there yet? [editorial]. Clin. Infect. Dis [print-electronic]. 2006 Jul 7/1/2006; 43(1): 103-5. PMID: 16758425, PII: CID39675, DOI: 10.1086/504878, ISSN: 1537-6591.

Phillips EJ. The pharmacogenetics of antiretroviral therapy. Curr Opin HIV AIDS. 2006 May; 1(3): 249-56. PMID: 19372817, PII: 01222929-200605000-00012, DOI: 10.1097/01.COH.0000221600.64659.d3, ISSN: 1746-6318.

Tailor SA, Simor AE, Cornish W, Phillips EJ, Knowles S, Rachlis A. Glucose homeostasis abnormalities and gatifloxacin [letter]. Clin. Infect. Dis. 2006 Mar 3/15/2006; 42(6): 895. PMID: 16477578, PII: CID38665, DOI: 10.1086/500454, ISSN: 1537-6591.

Notman MJ, Phillips EJ, Knowles SR, Weber EA, Shear NH. Clindamycin skin testing has limited diagnostic potential. Contact Derm. 2005 Dec; 53(6): 335-8. PMID: 16364122, PII: COD716, DOI: 10.1111/j.0105-1873.2005.00716.x, ISSN: 0105-1873.

Antoniou T, Tseng AL, van Heeswijk RP, Walker SE, Giguere P, Phillips EJ. Steady-state pharmacokinetics and tolerability of indinavir-lopinavir/r combination therapy in antiretroviral-experienced patients. Ther Drug Monit. 2005 Dec; 27(6): 779-81. PMID: 16306854, PII: 00007691-200512000-00021, ISSN: 0163-4356.

van Heeswijk RP, Cooper CL, Foster BC, Chauhan BM, Shirazi F, Seguin I, Phillips EJ, Mills E. Effect of high-dose vitamin C on hepatic cytochrome P450 3A4 activity. Pharmacotherapy. 2005 Dec; 25(12): 1725-8. PMID: 16305291, DOI: 10.1592/phco.2005.25.12.1725, ISSN: 0277-0008.