HLA-A*3101 and carbamazepine-induced hypersensitivity reactions in Europeans.

Published

Journal Article

Carbamazepine causes various forms of hypersensitivity reactions, ranging from maculopapular exanthema to severe blistering reactions. The HLA-B*1502 allele has been shown to be strongly correlated with carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS-TEN) in the Han Chinese and other Asian populations but not in European populations.We performed a genomewide association study of samples obtained from 22 subjects with carbamazepine-induced hypersensitivity syndrome, 43 subjects with carbamazepine-induced maculopapular exanthema, and 3987 control subjects, all of European descent. We tested for an association between disease and HLA alleles through proxy single-nucleotide polymorphisms and imputation, confirming associations by high-resolution sequence-based HLA typing. We replicated the associations in samples from 145 subjects with carbamazepine-induced hypersensitivity reactions.The HLA-A*3101 allele, which has a prevalence of 2 to 5% in Northern European populations, was significantly associated with the hypersensitivity syndrome (P=3.5×10(-8)). An independent genomewide association study of samples from subjects with maculopapular exanthema also showed an association with the HLA-A*3101 allele (P=1.1×10(-6)). Follow-up genotyping confirmed the variant as a risk factor for the hypersensitivity syndrome (odds ratio, 12.41; 95% confidence interval [CI], 1.27 to 121.03), maculopapular exanthema (odds ratio, 8.33; 95% CI, 3.59 to 19.36), and SJS-TEN (odds ratio, 25.93; 95% CI, 4.93 to 116.18).The presence of the HLA-A*3101 allele was associated with carbamazepine-induced hypersensitivity reactions among subjects of Northern European ancestry. The presence of the allele increased the risk from 5.0% to 26.0%, whereas its absence reduced the risk from 5.0% to 3.8%. (Funded by the U.K. Department of Health and others.).

Full Text

Duke Authors

Cited Authors

  • McCormack, M; Alfirevic, A; Bourgeois, S; Farrell, JJ; Kasperavičiūtė, D; Carrington, M; Sills, GJ; Marson, T; Jia, X; de Bakker, PIW; Chinthapalli, K; Molokhia, M; Johnson, MR; O'Connor, GD; Chaila, E; Alhusaini, S; Shianna, KV; Radtke, RA; Heinzen, EL; Walley, N; Pandolfo, M; Pichler, W; Park, BK; Depondt, C; Sisodiya, SM; Goldstein, DB; Deloukas, P; Delanty, N; Cavalleri, GL; Pirmohamed, M

Published Date

  • March 2011

Published In

Volume / Issue

  • 364 / 12

Start / End Page

  • 1134 - 1143

PubMed ID

  • 21428769

Pubmed Central ID

  • 21428769

Electronic International Standard Serial Number (EISSN)

  • 1533-4406

International Standard Serial Number (ISSN)

  • 0028-4793

Digital Object Identifier (DOI)

  • 10.1056/NEJMoa1013297

Language

  • eng