The Link between HLA-B Alleles and Causative Drugs in Vietnamese Patients with Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
DOI:
https://doi.org/10.3889/oamjms.2020.4906Keywords:
HLA-B allele, Stevens-Johnson syndrome/toxic epidermal necrolysis, Polymerase chain reaction-sequence-specific oligonucleotide, Carbamazepine, Traditional medicine, AllopurinolAbstract
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Human leukocyte antigens (HLA) may play an important role in the pathogenesis of SJS/TEN.
AIMS: This study aims to identify HLA-B alleles in Vietnamese patients with SJS/TEN and to investigate the possible link between HLA-B alleles and causative drugs.
MATERIALS AND METHODS: Sixty patients including SJS (30 patients) and TEN (30 patients) were enrolled in a cross-sectional descriptive study at two hospitals in Hanoi, Vietnam, from July 2018 to July 2019. Clinical features and laboratory findings were noted, HLA-B alleles were analyzed by the polymerase chain reaction (PCR)-sequence-specific oligonucleotide assay and LuminexTM Multiplex Technology.
RESULTS: The most common HLA-B allele was HLA-B*15:02 (41.7%) followed by HLA-B*58:01 (25%) and HLA-B*46:01 (15%). Of the 25 patients possessing HLA-B*15:02 allele, culprit medicines were carbamazepine (13 patients; 52%), traditional medicine (two patients; 8%), and unknown drugs (seven patients; 28%). Of the 15 patients carrying HLA-B*58:01 allele, there were 13 patients whose offending medicine was allopurinol. Of the eight patients whose culprit drug was traditional medicine, there were 6 patients (75%) carrying HLA-B*51:02. Patients who carry HLA-B*15:02 were found to have 4 times higher risk of developing carbamazepine-induced SJS/TEN as compared with the tolerant control group (OR=4.17; 95% CI=2.07–8.37; p < 0.001).
CONCLUSION: HLA-B*15:02 was the most common HLA-B allele in Vietnamese patients with SJS/TEN. In traditional medicine-induced SJS/TEN patients, HLA-B*51:02 allele might play an important role. The link between the HLA-B genotypes and causative drugs may suggest physicians to avoid risk medications for certain patients.
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Chung WH, Wang CW, Dao RL. Severe cutaneous adverse drug reactions. J Dermatol 2016;43(7):758-66. https://doi. org/10.1111/1346-8138.13430 PMid:27154258
Schwartz RA, McDonough PH, Lee BW. Toxic epidermal necrolysis: Part I. Introduction, history, classification, clinical features, systemic manifestations, etiology, and immunopathogenesis. J Am Acad Dermatol 2013;69(2):173. e1-13; quiz 185-6. PMid:23866878
Su SC, Mockenhaupt M, Wolkenstein P, Dunant A, Le Gouvello S, Chen CB, et al. Interleukin-15 is associated with severity and mortality in Stevens-Johnson syndrome/toxic epidermal necrolysis. J Invest Dermatol 2017;137(5):1065-73. https://doi.org/10.1016/j.jid.2016.11.034 PMid:28011147
Creamer D, Walsh SA, Dziewulski P, Exton LS, Lee HY, Dart JK, et al. U.K. guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 2016. Br J Dermatol 2016;174(6):1194-227. PMid:27216885
Sassolas B, Haddad C, Mockenhaupt M. ALDEN, an algorthm for assessment of drug causality in Stevens-Johnson syndrome and toxic epidermal necrolysis: Compatison with case-control analysis. Clin Pharmacol Ther. 2010;88(1):60-8. https://doi. org/10.1038/clpt.2009.252 PMid:20375998
Chung WH, Hung SI, Yang JY, Su SC, Huang SP, Wei CY, et al. Granulysin is a key mediator for disseminated keratinocyte death in Stevens-Johnson syndrome and toxic epidermal necrolysis. Nat Med 2008;14(12):1343-50. https://doi.org/10.1038/nm.1884 PMid:19029983
Saito N, Qiao H, Yanagi T, Shinkuma S, Nishimura K, Suto A, et al. An annexin A1-FPR1 interaction contributes to necroptosis of keratinocytes in severe cutaneous adverse drug reactions. Sci Transl Med 2014;6(245):245ra95. https://doi.org/10.1126/ scitranslmed.3008227 PMid:25031270
Pichler WJ, Naisbitt DJ, Park BK. Immune pathomechanism of drug hypersensitivity reactions. J Allergy Clin Immunol 2011;127(3 Suppl):S74-81. https://doi.org/10.1016/j. jaci.2010.11.048 PMid:21354503
Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol 1993;129(1):92-6. https://doi. org/10.1001/archderm.129.1.92
Hung SI, Chung WH, Liou LB, Chu CC, Lin M, Huang HP, et al. HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci U S A 2005;102(11):4134-9. https://doi. org/10.3410/f.1088014.540977 PMid:15743917
Jaruthamsophon K, Tipmanee V, Sangiemchoey A, Sukasem C, Limprasert P. HLA-B*15:21 and carbamazepine-induced Stevens-Johnson syndrome: Pooled-data and in silico analysis. Sci Rep 2017;7:45553. https://doi.org/10.1038/srep45553 PMid:28358139
Kaniwa N, Saito Y, Aihara M, Matsunaga K, Tohkin M, Kurose K, et al. HLA-B*1511 is a risk factor for carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Japanese patients. Epilepsia 2010;51(12):2461-5. https://doi. org/10.1111/j.1528-1167.2010.02766.x PMid:21204807
Mounzer K, Hsu R, Fusco JS, Brunet L, Henegar CE, Vannappagari V, et al. HLA-B*57:01 screening and hypersensitivity reaction to abacavir between 1999 and 2016 in the OPERA® observational database: A cohort study. AIDS Res Ther 2019;16(1):1. https://doi.org/10.1186/s12981-019-0217-3 PMid:30651100
Man CB, Kwan P, Baum L, Yu E, Lau KM, Cheng AS, et al. Association between HLA-B*1502 allele and antiepileptic drug-induced cutaneous reactions in Han Chinese. Epilepsia 2007;48(5):1015-8. https://doi. org/10.1111/j.1528-1167.2007.01022.x PMid:17509004
Fricke-Galindo I, LLerena A, López-López M. An update on HLA alleles associated with adverse drug reactions. Drug Metab Pers Ther 2017;32(2):73-87. https://doi.org/10.1515/ dmpt-2016-0025 PMid:28315856
Buitrago EM, Oñate JM, García-Goez JF, Oñate JM, García- Goez JF, Álvarez J, et al. HLA-B*57:01 allele prevalence in treatment-Naïve HIV-infected patients from Colombia. BMC Infect Dis 2019;19(1):793. https://doi.org/10.1186/ s12879-019-4415-3 PMid:31500584
Mushiroda T, Takahashi Y, Onuma T, et al. Association of HLA-A*31:01 Screening With the Incidence of Carbamazepine- Induced Cutaneous Adverse Reactions in a Japanese Population. JAMA Neurol 2018;75(7):842-9. https://doi. org/10.1001/jamaneurol.2018.0278 PMid:29610831
Nguyen DV, Chu HC, Nguyen DV, Phan MH, Craig T, Baumgart K, et al. HLA-B*1502 and carbamazepine-induced severe cutaneous adverse drug reactions in Vietnamese. Asia Pac Allergy 2015;5(2):68-77. https://doi.org/10.5415/ apallergy.2015.5.2.68 PMid:25938071
Do TQ, Tran TH, Vu TK. The association between HLA-B*58:01 and the risk of severe cutaneous adverse drug reactions at Bach Mai hospital, Hanoi, Vietnam. J Prevent Med 2015;8(168):396.
Hoa BK, Hang NT, Kashiwase K, Ohashi J, Lien LT, Horie T, et al. HLA-A, -B, -C, -DRB1 and -DQB1 alleles and haplotypes in the Kinh population in Vietnam. Tissue Antigens 2008;71(2):127-34. https://doi. org/10.1111/j.1399-0039.2007.00982.x.
Yu CY, Lin CH, Yang YH. Human body surface area database and estimation formula. Burns 2010;36(5):616-29. https://doi. org/10.1016/j.burns.2009.05.013 PMid:19900761
Yang CW, Hung SI, Juo CG, Lin YP, Fang WH, Lu IH, et al. HLA-B*1502-bound peptides: implications for the pathogenesis of carbamazepine-induced Stevens-Johnson syndrome. J Allergy Clin Immunol 2007;120(4):870-7. https://doi. org/10.1016/j.jaci.2007.06.017 PMid:17697703
Park HJ, Kim YJ, Kim DH, Kim J, Park KH, Park JW, et al. HLA allele frequencies in 5802 Koreans: Varied allele types associated with SJS/TEN according to culprit drugs. Yonsei Med J. 2016;57(1):118-26. https://doi.org/10.3349/ymj.2016.57.1.118 PMid:26632391
Puangpetch A, Koomdee N, Chamnanphol M, Jantararoungtong T, Santon S, Prommas S, et al. HLA-B allele and haplotype diversity among Thai patients identified by PCR-SSOP: Evidence for high risk of drug-induced hypersensitivity. Front Genet 2014;5:478. https://doi.org/10.3389/ fgene.2014.00478 PMid:25657656
Phillips EJ, Sukasem C, Whirl-Carrillo M, Müller DJ, Dunnenberger HM, Chantratita W, et al. Clinical pharmacogenetics implementation consortium guideline for HLA genotype and use of carbamazepine and oxcarbazepine: 2017 update. Clin Pharmacol Ther 2018;103(4):574-81. https:// doi.org/10.1002/cpt.1004 PMid:29392710
Jung JW, Kim JY, Park IW, Choi BW, Kang HR. Genetic markers of severe cutaneous adverse reactions. Korean J Intern Med 2018;33(5):867-75. https://doi.org/10.3904/kjim.2018.126 PMid:29921043
Luong DD, Hoang TL, Nguyen VD. Clinical and paraclinical manifestations of drug-induced Stevens-Johnson syndrome and Lyell syndrome. J Med Res 2014;86(1):15-21. Available from: http://www.library.cesti.gov.vn/opac/search/detail2. asp?aID=3&ID=197360&title=%C4%90%E1%BA%B7c+ % C 4 % 9 1 i % E 1 % B B % 8 3 m + l % C 3 % A 2 m + s % C 3 % A 0 n g %2C+c%E1%BA%ADn+l%C3%A2m+s%C3%A0ng+c% E 1 % B B % A 7 a + h % E 1 % B B % 9 9 i + c h % E 1 % B B % A 9 n g + Stevens+%2D+Johnson+v%C3%A0+Lyell+do+d%E1%BB% 8B+%E1%BB%A9ng+thu%E1%BB%91c%2F+++L%C6% B0%C6%A1ng+%C4%90%E1%BB%A9c+D%C5%A9ng%2C +Ho%C3%A0ng+Th%E1%BB%8B+L%C3%A2m%2C+Nguy% E1%BB%85n+V%C4%83n+%C4%90o%C3%A0n.
Alvestad S, Lydersen S, Brodtkorb E. Cross-reactivity pattern of rash from current aromatic antiepileptic drugs. Epilepsy Res 2008;80(2-3):194-200. https://doi.org/10.1016/j. eplepsyres.2008.04.003 PMid:18490142
Seitz CS, Pfeuffer P, Raith P, Bröcker EB, Trautmann A. Anticonvulsant hypersensitivity syndrome: Cross-reactivity with tricyclic antidepressant agents. Ann Allergy Asthma Immunol 2006;97(5):698-702. https://doi.org/10.1016/ s1081-1206(10)61103-9 PMid:17165282
Sierra NM, García B, Marco J, Plaza S, Hidalgo F, Bermejo T. Cross hypersensitivity syndrome between phenytoin and carbamazepine. Pharm World Sci PWS 2005;27(3):170-4. https://doi.org/10.1007/s11096-004-1736-z PMid:16096883
Wang X, Lang S, Shi X, Tian H, Wang R, Yang F. Cross-reactivity of skin rashes with current antiepileptic drugs in Chinese population. Seizure 2010;19(9):562-6. https://doi.org/10.1016/j. seizure.2010.09.003 PMid:20888266
Koomdee N, Pratoomwun J, Jantararoungtong T, Theeramoke V, Tassaneeyakul W, Klaewsongkram J, et al. Association of HLA-A and HLA-B alleles with lamotrigine-induced cutaneous adverse drug reactions in the Thai population. Front Pharmacol 2017;8:879. https://doi. org/10.3389/fphar.2017.00879 PMid:29238301
Capule F, Tragulpiankit P, Mahasirimongkol S, Wichukchinda N, Jittikoon J, Alentajan-Aleta LT, et al. Carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis overlap in a Filipino with positive HLA-B75 serotype. BMJ Case Rep 2018;2018:bcr2018225028. https://doi.org/10.1136/ bcr-2018-225028 PMid:30018035
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Copyright (c) 2020 Tran Thi Huyen, Pham Dinh Hoa, Trinh Minh Trang, Nguyen Ba Khanh, Tran Ngoc Que, Nguyen Hoang Phuong, Nguyen Minh Hoang, Riichiro Abe, Nguyen Van Thuong, Pham Thi Lan, Michael Tirant (Author)
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