Association between human leukocyte antigens and cutaneous adverse drug reactions to antiepileptics and antibiotics in the Iranian population.
Adult
Anti-Bacterial Agents
/ adverse effects
Anticonvulsants
/ adverse effects
Carbamazepine
/ adverse effects
Case-Control Studies
Ciprofloxacin
/ adverse effects
Female
Genotype
HLA Antigens
/ genetics
HLA-A Antigens
/ genetics
HLA-B Antigens
/ genetics
HLA-DRB1 Chains
/ genetics
Humans
Iran
Lamotrigine
Male
Middle Aged
Stevens-Johnson Syndrome
/ etiology
antibiotics
antiepileptics
culprit drug
cutaneous adverse drug reaction
human leukocyte antigen
Journal
Dermatologic therapy
ISSN: 1529-8019
Titre abrégé: Dermatol Ther
Pays: United States
ID NLM: 9700070
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
revised:
13
10
2021
received:
01
01
2021
accepted:
07
02
2022
pubmed:
22
2
2022
medline:
7
5
2022
entrez:
21
2
2022
Statut:
ppublish
Résumé
In this case-control study, class І and ІІ human leukocyte antigen (HLA) alleles in Iranian patients with benign and severe cutaneous adverse drug reactions (CADRs) due to aromatic anticonvulsants and antibiotics were evaluated. Patients diagnosed with CADRs (based on clinical and laboratory findings) with a Naranjo score of ≥ 4 underwent blood sampling and HLA-DNA typing. The control group comprised 90 healthy Iranian adults. Alleles with a frequency of more than two were reported. Deviations from Hardy-Weinberg equilibrium were not observed. Eighty patients with CADRs including 54 females and 26 males with a mean age of 41.49 ± 16.08 years were enrolled in this study. The culprit drugs included anticonvulsants (lamotrigine, carbamazepine, and phenytoin) and antibiotics (ciprofloxacin and co-trimoxazole). The comparison of allele frequencies in the Iranian healthy control group and the group with benign CADRs revealed that HLA-Cw*04, and HLA-A*24 were significantly associated with lamotrigine-induced maculopapular CADRs. Furthermore, HLA-B*51 showed a significant correlation with carbamazepine-induced maculopapular CADRs. Significant associations were also detected between ciprofloxacin-induced urticarial CADRs with HLA-B*40, and HLA-DRB1*14. In the severe group, HLA-B*38 and HLA-DRB1*13 were significantly associated with lamotrigine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Moreover, HLA-A*31 and HLA-Cw*04 were significantly correlated with carbamazepine-induced drug reactions with eosinophilia and systemic symptoms (DRESS). HLA-B*08 also showed a significant correlation with ciprofloxacin-induced acute generalized exanthematous pustulosis (AGEP). In conclusion, Lamotrigine-induced MPE was significantly correlated with HLA-Cw*04, and HLA-A*24. Similarly, lamotrigine-induced SJS/TEN was significantly associated with HLA-B*38 and HLA-DRB1*13. Additionally, HLA-A*31 was associated with DRESS caused by carbamazepine. The most frequent CADR-inducing drugs were anticonvulsants.
Substances chimiques
Anti-Bacterial Agents
0
Anticonvulsants
0
HLA Antigens
0
HLA-A Antigens
0
HLA-B Antigens
0
HLA-DRB1 Chains
0
Carbamazepine
33CM23913M
Ciprofloxacin
5E8K9I0O4U
Lamotrigine
U3H27498KS
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e15393Informations de copyright
© 2022 Wiley Periodicals LLC.
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