Beta-lactam-induced immediate hypersensitivity reactions: A genome-wide association study of a deeply phenotyped cohort.


Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
05 2021
Historique:
received: 09 06 2020
revised: 27 09 2020
accepted: 05 10 2020
pubmed: 16 10 2020
medline: 25 9 2021
entrez: 15 10 2020
Statut: ppublish

Résumé

β-lactam antibiotics are associated with a variety of immune-mediated or hypersensitivity reactions, including immediate (type I) reactions mediated by antigen-specific IgE. We sought to identify genetic predisposing factors for immediate reactions to β-lactam antibiotics. Patients with a clinical history of immediate hypersensitivity reactions to either penicillins or cephalosporins, which were immunologically confirmed, were recruited from allergy clinics. A genome-wide association study was conducted on 662 patients (the discovery cohort) with a diagnosis of immediate hypersensitivity and the main finding was replicated in a cohort of 98 Spanish cases, recruited using the same diagnostic criteria as the discovery cohort. Genome-wide association study identified rs71542416 within the Class II HLA region as the top hit (P = 2 × 10 HLA-DRB1∗10:01 predisposed to immediate hypersensitivity reactions to penicillins. Further work to identify other predisposing HLA and non-HLA loci is required.

Sections du résumé

BACKGROUND
β-lactam antibiotics are associated with a variety of immune-mediated or hypersensitivity reactions, including immediate (type I) reactions mediated by antigen-specific IgE.
OBJECTIVE
We sought to identify genetic predisposing factors for immediate reactions to β-lactam antibiotics.
METHODS
Patients with a clinical history of immediate hypersensitivity reactions to either penicillins or cephalosporins, which were immunologically confirmed, were recruited from allergy clinics. A genome-wide association study was conducted on 662 patients (the discovery cohort) with a diagnosis of immediate hypersensitivity and the main finding was replicated in a cohort of 98 Spanish cases, recruited using the same diagnostic criteria as the discovery cohort.
RESULTS
Genome-wide association study identified rs71542416 within the Class II HLA region as the top hit (P = 2 × 10
CONCLUSIONS
HLA-DRB1∗10:01 predisposed to immediate hypersensitivity reactions to penicillins. Further work to identify other predisposing HLA and non-HLA loci is required.

Identifiants

pubmed: 33058932
pii: S0091-6749(20)31405-6
doi: 10.1016/j.jaci.2020.10.004
pmc: PMC8100096
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0
Cephalosporins 0
HLA-DQ alpha-Chains 0
HLA-DQA1 antigen 0
HLA-DRB1 Chains 0
Penicillins 0

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1830-1837.e15

Subventions

Organisme : NHGRI NIH HHS
ID : R01 HG010863
Pays : United States
Organisme : NIGMS NIH HHS
ID : P50 GM115305
Pays : United States
Organisme : NIAID NIH HHS
ID : R21 AI139021
Pays : United States
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : NIAID NIH HHS
ID : R34 AI136815
Pays : United States
Organisme : Department of Health
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/L006758/1
Pays : United Kingdom

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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Auteurs

Paola Nicoletti (P)

Icahn School of Medicine at Mount Sinai, New York, NY; Sema4, Stamford, Conn.

Daniel F Carr (DF)

Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom.

Sarah Barrett (S)

Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom.

Laurence McEvoy (L)

Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom.

Peter S Friedmann (PS)

Dermatology Unit, Sir Henry Wellcome Research Laboratories, School of Medicine, University of Southampton, Southampton, United Kingdom.

Neil H Shear (NH)

Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Matthew R Nelson (MR)

Deerfield, New York, NY.

Anca M Chiriac (AM)

Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France.

Natalia Blanca-López (N)

Infanta Leonor University Hospital, Madrid, Spain.

José A Cornejo-García (JA)

Allergy Research Group, Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, ARADyAL, Malaga, Spain.

Francesco Gaeta (F)

Allergy Unit, Columbus Hospital, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.

Alla Nakonechna (A)

Liverpool University Hospitals Foundation National Health Service Trust, Liverpool, United Kingdom.

Maria J Torres (MJ)

Allergy Research Group, Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, ARADyAL, Malaga, Spain; Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain.

Cristiano Caruso (C)

Allergy Unit, Columbus Hospital, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.

Rocco L Valluzzi (RL)

Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy.

Aris Floratos (A)

Department of Systems Biology, New York, NY; Department of Biomedical Informatics, Columbia University, New York, NY.

Yufeng Shen (Y)

Department of Systems Biology, New York, NY.

Rebecca K Pavlos (RK)

Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia.

Elizabeth J Phillips (EJ)

Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Centre for Clinical Pharmacology and Infectious Diseases, Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia.

Pascal Demoly (P)

Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France; Unité Mixte de Recherche en Santé (UMR-S) 1136 Institut National de la Santé et de la Recherche Médicale-Sorbonne Université, Equipe Epidemiology of allergic and respiratory diseases (EPAR)- Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France.

Antonino Romano (A)

Istituto di Ricovero e Cura a Carattere Scientifico Oasi Maria SS, Troina, Italy; Fondazione Mediterranea GB Morgagni, Catania, Italy.

Miguel Blanca (M)

Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain.

Munir Pirmohamed (M)

Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals Foundation National Health Service Trust, Liverpool, United Kingdom. Electronic address: munirp@liverpool.ac.uk.

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