Ethnic Differences in the Association Between Human Leukocyte Antigen and Stevens-Johnson Syndrome

2009 ◽  
Vol 03 (01) ◽  
pp. 15 ◽  
Author(s):  
Mayumi Ueta ◽  
Keyword(s):  
Ethnic Differences ◽  
Human Leukocyte ◽  
Japanese Patients ◽  
Han Chinese ◽  
Stevens Johnson Syndrome ◽  
Antiinflammatory Drugs ◽  
Ocular Complications ◽  
Drug Induced ◽  
Johnson Syndrome ◽  
Specific Association

The HLA-B12 antigen is significantly increased in Caucasian patients with Stevens-Johnson syndrome (SJS) with ocular complications, whileHLA-A*0206is strongly associated with Japanese patients with SJS/toxic epidermal necrolysis (TEN) with ocular complications. There are strong ethnic differences in the association between HLA and SJS/TEN. Regarding the association between HLA and drug-induced severe cutaneous adverse reactions (SCAR), including SJS and TEN, the strong allopurinol-specific association betweenHLA-B*5801and allopurinol-induced SCAR may be a universal phenomenon, since it has been identified in all Han Chinese, Caucasian and Japanese patients. In contrast, the carbamazepine-specific association betweenHLA-B*1502and carbamazepine-induced SJS may be specific to certain ethnic groups, as it has been identified in Han Chinese but not in Caucasian and Japanese patients. Dermatologists have reported that allopurinol and anticonvulsant drugs such as carbamazepine are commonly associated with SJS/TEN, while many of the author’s patients developed SJS after receiving treatment for the common cold with antibiotics, cold remedies and/or non-steroidal antiinflammatory drugs (NSAIDs). This article posits that the SJS/TEN patients seen by dermatologists are not always the same as the SJS/TEN patients consulting opthalmologists.

scholarly journals Human leukocyte antigen B*0702 is protective against ocular Stevens–Johnson syndrome/toxic epidermal necrolysis in the UK population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gibran F. Butt ◽  
Ali Hassan ◽  
Graham R. Wallace ◽  
Shigeru Kinoshita ◽  
Sajjad Ahmad ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Toxic Epidermal Necrolysis ◽  
Human Leukocyte ◽  
Stevens Johnson Syndrome ◽  
Ocular Complications ◽  
Leukocyte Antigen ◽  
Asian Populations ◽  
Risk Alleles ◽  
Johnson Syndrome ◽  
The Uk

AbstractStevens–Johnson Syndrome and Toxic Epidermal Necrolysis (SJS/TEN) are part of a disease continuum of vesiculobullous mucocutaneous reactions affecting the skin and mucous membranes including the ocular surface. Manifestations of disease range from mild dry eye to progressive conjunctival cicatrisation, limbal epithelial stem cell failure and corneal blindness. In Far Eastern and South East Asian populations where SJS/TEN is prevalent, numerous human leukocyte antigen (HLA) gene variants at the A, B and C loci have been identified as risk factors for developing SJS/TEN with severe ocular complications (SOC). By contrast, the incidence of SJS/TEN with SOC in European countries is relatively low. To date, ocular SJS/TEN risk altering alleles have not been widely investigated in European populations. In this study, we analysed the association of HLA -A, -B and -C alleles with SJS/TEN in 33 patients residing in the UK with age matched controls. The data showed statistically significant novel negative allele association with HLA-B*0702 and a trend with HLA-C*0702 in the patient group, indicating these alleles are protective. Further characterisation of protective and risk alleles in other ethnic groups is required to fully elucidate the putative role of these alleles in the susceptibility of SJS/TEN with or without severe ocular complications in patients in the UK.

scholarly journals HLA Association with Drug-Induced Adverse Reactions

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Wen-Lang Fan ◽  
Meng-Shin Shiao ◽  
Rosaline Chung-Yee Hui ◽  
Shih-Chi Su ◽  
Chuang-Wei Wang ◽  
...  
Keyword(s):  
Adverse Drug Reactions ◽  
Antithyroid Drug ◽  
Human Leukocyte ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Drug Induced ◽  
Hla Association ◽  
Hla Genes ◽  
Johnson Syndrome ◽  
Life Threatening

Adverse drug reactions (ADRs) remain a common and major problem in healthcare. Severe cutaneous adverse drug reactions (SCARs), such as Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) with mortality rate ranges from 10% to more than 30%, can be life threatening. A number of recent studies demonstrated that ADRs possess strong genetic predisposition. ADRs induced by several drugs have been shown to have significant associations with specific alleles of human leukocyte antigen (HLA) genes. For example, hypersensitivity to abacavir, a drug used for treating of human immunodeficiency virus (HIV) infection, has been proposed to be associated with allele 57:01 of HLA-B gene (terms HLA-B∗57:01). The incidences of abacavir hypersensitivity are much higher in Caucasians compared to other populations due to various allele frequencies in different ethnic populations. The antithyroid drug- (ATDs- ) induced agranulocytosis are strongly associated with two alleles: HLA-B∗38:02 and HLA-DRB1∗08:03. In addition, HLA-B∗15:02 allele was reported to be related to carbamazepine-induced SJS/TEN, and HLA-B∗57:01 in abacavir hypersensitivity and flucloxacillin induced drug-induced liver injury (DILI). In this review, we summarized the alleles of HLA genes which have been proposed to have association with ADRs caused by different drugs.

Common risk allele in aromatic antiepileptic-drug induced Stevens–Johnson syndrome and toxic epidermal necrolysis in Han Chinese

2010 ◽  
Vol 11 (3) ◽  
pp. 349-356 ◽  
Author(s):  
Shuen-Iu Hung ◽  
Wen-Hung Chung ◽  
Zhi-Sheng Liu ◽  
Chien-Hsiun Chen ◽  
Mo-Song Hsih ◽  
...  
Keyword(s):  
Antiepileptic Drug ◽  
Toxic Epidermal Necrolysis ◽  
Risk Allele ◽  
Han Chinese ◽  
Stevens Johnson Syndrome ◽  
Drug Induced ◽  
Johnson Syndrome

scholarly journals The Roles of Immunoregulatory Networks in Severe Drug Hypersensitivity

2021 ◽  
Vol 12 ◽  
Author(s):  
Yun-Shiuan Olivia Hsu ◽  
Kun-Lin Lu ◽  
Yun Fu ◽  
Chuang-Wei Wang ◽  
Chun-Wei Lu ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Drug Hypersensitivity ◽  
Human Leukocyte ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Drug Induced ◽  
Johnson Syndrome ◽  
Signaling Receptors ◽  
Systemic Symptoms

The immunomodulatory effects of regulatory T cells (Tregs) and co-signaling receptors have gained much attention, as they help balance immunogenic and immunotolerant responses that may be disrupted in autoimmune and infectious diseases. Drug hypersensitivity has a myriad of manifestations, which ranges from the mild maculopapular exanthema to the severe Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DRESS/DIHS). While studies have identified high-risk human leukocyte antigen (HLA) allotypes, the presence of the HLA allotype at risk is not sufficient to elicit drug hypersensitivity. Recent studies have suggested that insufficient regulation by Tregs may play a role in severe hypersensitivity reactions. Furthermore, immune checkpoint inhibitors, such as anti-CTLA-4 or anti-PD-1, in cancer treatment also induce hypersensitivity reactions including SJS/TEN and DRESS/DIHS. Taken together, mechanisms involving both Tregs as well as coinhibitory and costimulatory receptors may be crucial in the pathogenesis of drug hypersensitivity. In this review, we summarize the currently implicated roles of co-signaling receptors and Tregs in delayed-type drug hypersensitivity in the hope of identifying potential pharmacologic targets.

Sign in / Sign up

Export Citation Format

Share Document