HLA-A*24:02 as a common risk factor for antiepileptic drug-induced cutaneous adverse reactions
Autor: | Dong Zhou, Xiao Yan Deng, Bi Jun Mao, Bing Mei Li, Yong Hong Yi, Amy Hui-Ping Khor, Jie Pan, Yao Yun Kuan, Ching Ching Ng, Kheng Seang Lim, Yang Mei Ou, Tao Su, Xiang Shu Hu, Xue Lian He, Fa Yun Hu, Zhong Zheng Zheng, Na He, Yun Qi Hou, Bin Qin, Juan Wang, Xiao Rong Liu, Ying Kit Cheung, Lie Min Zhou, Zhi Sheng Liu, Wei-Ping Liao, Jue Qian Zhou, Jin Hua Zhou, Yi Wu Shi, Patrick Kwan, Fu Li Min |
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Rok vydání: | 2016 |
Předmět: |
Phenytoin
Adult Male medicine.medical_specialty China Adolescent HLA-A24 Antigen Human leukocyte antigen Lamotrigine HLA-B15 Antigen 030226 pharmacology & pharmacy Gastroenterology Article 03 medical and health sciences Young Adult 0302 clinical medicine Asian People Internal medicine Genotype medicine Humans Genetic Predisposition to Disease Risk factor Child Aged Aged 80 and over business.industry Case-control study Infant Carbamazepine Middle Aged 3. Good health HLA-A Case-Control Studies Child Preschool Stevens-Johnson Syndrome Anticonvulsants Female Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug Follow-Up Studies |
Zdroj: | Neurology |
ISSN: | 1526-632X |
Popis: | Objective:To investigate the involvement of human leukocyte antigen (HLA) loci in aromatic antiepileptic drug–induced cutaneous adverse reactions.Methods:A case-control study was performed to detect HLA loci involved in aromatic antiepileptic drug–induced Stevens-Johnson syndrome in a southern Han Chinese population. Between January 1, 2006, and December 31, 2015, 91 cases of Stevens-Johnson syndrome induced by aromatic antiepileptic drugs and 322 matched drug-tolerant controls were enrolled from 8 centers. Important genotypes were replicated in cases with maculopapular eruption and in the meta-analyses of data from other populations. Sequence-based typing determined the HLA-A, HLA-B, HLA-C, and HLA-DRB1 genotypes.Results:HLA-B*15:02 was confirmed as strongly associated with carbamazepine-induced Stevens-Johnson syndrome (p = 5.63 × 10−15). In addition, HLA-A*24:02 was associated significantly with Stevens-Johnson syndrome induced by the aromatic antiepileptic drugs as a group (p = 1.02 × 10−5) and by individual drugs (carbamazepine p = 0.015, lamotrigine p = 0.005, phenytoin p = 0.027). Logistic regression analysis revealed a multiplicative interaction between HLA-B*15:02 and HLA-A*24:02. Positivity for HLA-A*24:02 and/or HLA-B*15:02 showed a sensitivity of 72.5% and a specificity of 69.0%. The presence of HLA-A*24:02 in cases with maculopapular exanthema was also significantly higher than in controls (p = 0.023). Meta-analysis of data from Japan, Korea, Malaysia, Mexico, Norway, and China revealed a similar association.Conclusions:HLA-A*24:02 is a common genetic risk factor for cutaneous adverse reactions induced by aromatic antiepileptic drugs in the southern Han Chinese and possibly other ethnic populations. Pretreatment screening is recommended for people in southern China. |
Databáze: | OpenAIRE |
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