Human leukocyte antigens and drug hypersensitivity.

Published

Journal Article (Review)

PURPOSE OF REVIEW: The present article reviews the recent literature on the identification of human leukocyte antigen (HLA) alleles as major susceptible genes for drug hypersensitivity and discusses the clinical implications. RECENT FINDINGS: Several recent studies have reported strong genetic associations between HLA alleles and susceptibility to drug hypersensitivity. The genetic associations can be drug specific, such as HLA-B*1502 being associated with carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), HLA-B*5701 with abacavir hypersensitivity and HLA-B*5801 with allopurinol-induced severe cutaneous adverse reactions. A genetic association can also be phenotype-specific, as B*1502 is associated solely with carbamazepine-SJS/TEN, and not with either maculopapular eruption or hypersensitivity syndrome. Furthermore, a genetic association can also be ethnicity specific; carbamazepine-SJS/TEN associated with B*1502 is seen in south-east Asians but not in whites, which may be explained by the different allele frequencies. SUMMARY: The strong genetic association suggests a direct involvement of HLA in the pathogenesis of drug hypersensitivity when the HLA molecule presents an antigenic drug for T cell activation. The high sensitivity/specificity of some markers provides a plausible basis for developing tests to identify individuals at risk for drug hypersensitivity. Application of HLA-B*1502 genotyping as a screening tool before prescribing carbamazepine could be a valuable tool in preventing carbamazepine-induced SJS/TEN in south-east Asian countries.

Full Text

Duke Authors

Cited Authors

  • Chung, W-H; Hung, S-I; Chen, Y-T

Published Date

  • August 2007

Published In

Volume / Issue

  • 7 / 4

Start / End Page

  • 317 - 323

PubMed ID

  • 17620823

Pubmed Central ID

  • 17620823

International Standard Serial Number (ISSN)

  • 1528-4050

Digital Object Identifier (DOI)

  • 10.1097/ACI.0b013e3282370c5f

Language

  • eng

Conference Location

  • United States