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Lumkul L, Wongyikul P, Kulalert P, Sompornrattanaphan M, Lao-Araya M, Chuamanochan M, Nochaiwong S, Phinyo P. Genetic association of beta-lactams-induced hypersensitivity reactions: A systematic review of genome-wide evidence and meta-analysis of candidate genes. World Allergy Organ J 2023; 16:100816. [PMID: 37780578 PMCID: PMC10541471 DOI: 10.1016/j.waojou.2023.100816] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Importance Beta-lactams (BLs) are the most prescribed antibiotics, being the most frequent cause of drug allergy. However, the association between BL allergy and genetic variations is still unclear. Objective This systematic review and meta-analysis aimed to summarize the genetic effects of BL-induced hypersensitivity using existing evidence. Methods We searched PubMed, Medline, Scopus, EMBASE, CINAHL, and Cochrane Library from inception to September 15, 2022 with no language restriction. Genetic association studies investigating genetic variant/polymorphism and risk of drug-induced hypersensitivity reactions among individuals receiving BL-antibiotics were included. We excluded studies of acute interstitial nephritis, drug-induced liver injury, serum sickness, and isolated drug fever. Data were comprehensively synthesized and quality of study were assessed using STrengthening the Reporting of Genetic Association Studies (STREGA). The record screening, extraction and quality assessment were performed by two reviewers and discussions were made to resolve discrepancies. The effects of each variant were pooled and evaluated by modified Venice criteria. Results A total of 9276 records were identified, and 31 studies were eligible for inclusion. Twenty-seven were candidate-gene association studies (5416 cases and 5939 controls), while the others were next-generation sequencing (NGS) or genome-wide association studies (GWASs) (119 838 cases and 1 487 111 controls). Forty-nine polymorphisms were identified and most of them located in allergic reaction pathways. Meta-analyses of 15 candidate variants in a mixture of both immediate and non-immediate reactions revealed weak genetic effects of rs1801275 (8 studies; n = 1,560; odd ratio 0.73; 95%CI: 0.57-0.93) and rs20541 (4 studies; n = 1,482; odd ratio 1.34; 95%CI: 1.07-1.68) in IL4R and IL13, respectively. Results from GWASs and NGS identified, and confirmed associations in HLA regions including HLA-DRA, HLA-B, HLA-DQA, HLA-DRB1, and HLA-DRB3. Conclusion Our study summarized genetic evidence influencing BL-induced hypersensitivity and estimated effects of potential variants. We postulated that the genomic studies provide better insights to the mechanism of reactions and suggest potential effects of HLA Class II variants. However, results were inconsistent and unable to generalize in different settings. Further high-throughput studies with a well-defined function, epigenetic interaction, incorporated with clinical factors, would be beneficial for risk identification in BL-induced hypersensitivity.
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Affiliation(s)
- Lalita Lumkul
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Center of Multidisciplinary Technology for Advanced Medicine (CMUTEAM), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Pakpoom Wongyikul
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Prapasri Kulalert
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, 12120, Thailand
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, 12120, Thailand
| | - Mongkhon Sompornrattanaphan
- Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Mongkol Lao-Araya
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Mati Chuamanochan
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Surapon Nochaiwong
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Phichayut Phinyo
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai 50200, Thailand
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Doña I, Jurado-Escobar R, Pérez-Sánchez N, Laguna JJ, Bartra J, Testera-Montes A, de Santa María RS, Torres MJ, Cornejo-García JA. Genetic Variants Associated With Drug-Induced Hypersensitivity Reactions: towards Precision Medicine? CURRENT TREATMENT OPTIONS IN ALLERGY 2021. [DOI: 10.1007/s40521-020-00278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Collins C. The Low Risks and High Rewards of Penicillin Allergy Delabeling: An Algorithm to Expedite the Evaluation. J Pediatr 2019; 212:216-223. [PMID: 31253408 DOI: 10.1016/j.jpeds.2019.05.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/15/2019] [Accepted: 05/24/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Cathleen Collins
- Division of Allergy Immunology, Department of Pediatrics, University of California San Diego and Rady Children's Hospital San Diego, San Diego, CA.
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Pérez-Sánchez N, Jurado-Escobar R, Doña I, Soriano-Gomis V, Moreno-Aguilar C, Bartra J, Isidoro-García M, Torres MJ, Cornejo-García JA. Pharmacogenomics as a Tool for Management of Drug Hypersensitivity Reactions. CURRENT TREATMENT OPTIONS IN ALLERGY 2019. [DOI: 10.1007/s40521-019-0199-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity. J Immunol Res 2018; 2018:6431694. [PMID: 29651444 PMCID: PMC5830968 DOI: 10.1155/2018/6431694] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/09/2017] [Indexed: 02/07/2023] Open
Abstract
Drug hypersensitivity may manifest ranging from milder skin reactions (e.g., maculopapular exanthema and urticaria) to severe systemic reactions, such as anaphylaxis, drug reactions with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS), or Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). Current pharmacogenomic studies have made important strides in the prevention of some drug hypersensitivity through the identification of relevant genetic variants, particularly for genes encoding drug-metabolizing enzymes and human leukocyte antigens (HLAs). The associations identified by these studies are usually drug, phenotype, and ethnic specific. The drug presentation models that explain how small drug antigens might interact with HLA and T cell receptor (TCR) molecules in drug hypersensitivity include the hapten theory, the p-i concept, the altered peptide repertoire model, and the altered TCR repertoire model. The broad spectrum of clinical manifestations of drug hypersensitivity involving different drugs, as well as the various pathomechanisms involved, makes the diagnosis and management of it more challenging. This review highlights recent advances in our understanding of the predisposing factors, immune mechanisms, pathogenesis, diagnostic tools, and therapeutic approaches for drug hypersensitivity.
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Dodiuk-Gad RP, Chung WH, Shear NH. Adverse Medication Reactions. CLINICAL AND BASIC IMMUNODERMATOLOGY 2017. [PMCID: PMC7123512 DOI: 10.1007/978-3-319-29785-9_25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cutaneous adverse drug reactions (ADRs) are among the most frequent adverse reactions in patients receiving drug therapy. They have a broad spectrum of clinical manifestations, are caused by various drugs, and result from different pathophysiological mechanisms. Hence, their diagnosis and management is challenging. Severe cutaneous ADRs comprise a group of diseases with major morbidity and mortality, reaching 30 % mortality rate in cases of Toxic Epidermal Necrolysis. This chapter covers the terminology, epidemiology, pathogenesis and classification of cutaneous ADR, describes the severe cutaneous ADRs and the clinical and laboratory approach to the patient with cutaneous ADR and presents the translation of laboratory-based discoveries on the genetic predisposition and pathogenesis of cutaneous ADRs to clinical management guidelines.
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Khan DA. Pharmacogenomics and adverse drug reactions: Primetime and not ready for primetime tests. J Allergy Clin Immunol 2016; 138:943-955. [DOI: 10.1016/j.jaci.2016.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/24/2016] [Accepted: 08/24/2016] [Indexed: 10/20/2022]
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Oussalah A, Mayorga C, Blanca M, Barbaud A, Nakonechna A, Cernadas J, Gotua M, Brockow K, Caubet JC, Bircher A, Atanaskovic M, Demoly P, K. Tanno L, Terreehorst I, Laguna JJ, Romano A, Guéant JL. Genetic variants associated with drugs-induced immediate hypersensitivity reactions: a PRISMA-compliant systematic review. Allergy 2016; 71:443-62. [PMID: 26678823 DOI: 10.1111/all.12821] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2015] [Indexed: 12/31/2022]
Abstract
Drug hypersensitivity includes allergic (AR) and nonallergic reactions (NARs) influenced by genetic predisposition. We performed a systematic review of genetic predictors of IgE-mediated AR and NAR with MEDLINE and PubMed search engine between January 1966 and December 2014. Among 3110 citations, the search selected 53 studies, 42 of which remained eligible. These eligible studies have evaluated genetic determinants of immediate reactions (IR) to beta-lactams (n = 19), NAR against aspirin (n = 12) and other nonsteroidal anti-inflammatory drugs (NSAIDs) (n = 8), and IR to biologics (n = 3). We reported two genomewide association studies and four case-control studies on candidate genes validated by replication. Genes involved in IR to beta-lactams belonged to HLA type 2 antigen processing, IgE production, atopy, and inflammation, including 4 genes validated by replications, HLA-DRA, ILR4, NOD2, and LGALS3. Genes involved in NAR to aspirin belonged to arachidonic acid pathway, membrane-spanning 4A gene family, histamine production pathway, and pro-inflammatory cytokines, while those involved in NAR to all NSAIDs belonged to arachidonic acid pathway and HLA antigen processing pathway. ALOX5 was a common predictor of studies on NAR to both aspirin and NSAIDs. Although these first conclusions could be drawn, this review highlights also the lack of reliable data and the need for replicating studies in contrasted populations, taking into account worldwide allele frequencies, gene-gene interactions, and contrasted situations of environmental exposure.
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Affiliation(s)
- A. Oussalah
- Faculty of Medicine of Nancy; NGERE - Nutrition, Genetics and Environmental Risk Exposure; INSERM U954; University of Lorraine; Vandoeuvre-lès-Nancy France
- Department of Molecular Medicine and Personalized Therapeutics; Department of Biochemistry, Molecular Biology, Nutrition and Metabolism; University Hospital of Nancy; Vandoeuvre-lès-Nancy France
| | - C. Mayorga
- Research Laboratory; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
- Allergy Unit; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
| | - M. Blanca
- Allergy Unit; IBIMA; Regional University Hospital of Malaga; UMA; Malaga Spain
| | - A. Barbaud
- Department of Dermatology and Allergology; University Hospital of Nancy; Vandoeuvre-lès-Nancy France
| | - A. Nakonechna
- Allergy and Immunology; Clinic Royal Liverpool and Broadgreen University Hospital; Thomas Drive Liverpool UK
| | - J. Cernadas
- Immunoallergy Department; Centro Hospitalar Sao Joao; Porto Portugal
| | - M. Gotua
- Center for Allergy and Immunology Research; Tbilisi Georgia
| | - K. Brockow
- Klinik für Dermatologie und Allergologie am Biederstein; Technische Universität München; München Germany
| | - J.-C. Caubet
- Division of Paediatrics; University Hospital of Geneva; Geneva Switzerland
| | - A. Bircher
- Dermatologie/Allergologie; Universitätsspital Basel; Basel Switzerland
| | - M. Atanaskovic
- Department of Allergology and Pulmonology; University Children's Hospital; Belgrade Serbia
| | - P. Demoly
- Department of Pulmonology; Division of Allergy; Hôpital Arnaud de Villeneuve; University Hospital of Montpellier; Montpellier France
| | | | - I. Terreehorst
- Academisch Medisch Centrum; University of Amsterdam; Amsterdam Netherlands
| | - J. J. Laguna
- Allergy Unit; Hospital de la Cruz Roja and Department of Immunology Alfonso X el Sabio University; Madrid Spain
| | - A. Romano
- Allergy Unit; Complesso Integrato Columbus, Rome and IRCCS Oasi Maria S.S.; Troina Italy
| | - J.-L. Guéant
- Faculty of Medicine of Nancy; NGERE - Nutrition, Genetics and Environmental Risk Exposure; INSERM U954; University of Lorraine; Vandoeuvre-lès-Nancy France
- Department of Molecular Medicine and Personalized Therapeutics; Department of Biochemistry, Molecular Biology, Nutrition and Metabolism; University Hospital of Nancy; Vandoeuvre-lès-Nancy France
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Fernandez TD, Mayorga C, Guéant JL, Blanca M, Cornejo-García JA. Contributions of pharmacogenetics and transcriptomics to the understanding of the hypersensitivity drug reactions. Allergy 2014; 69:150-8. [PMID: 24467839 DOI: 10.1111/all.12304] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2013] [Indexed: 01/11/2023]
Abstract
Hypersensitivity drug reactions (HDRs) represent a large and important health problem, affecting many patients and leading to a variety of clinical entities, some of which can be life-threatening. The culprit drugs include commonly used medications including antibiotics and NSAIDs. Nontherapeutical agents, such as contrast media, are also involved. Because the pathophysiological mechanisms are not well known and the current diagnostic procedures are somewhat insufficient, new approaches are needed for understanding the complexity of HDRs. Histochemical and molecular biology studies have enabled us to classify these reactions more precisely. Pharmacogenetics has led to the identification of several genes, involved mainly in T-cell-dependent responses, with a number of markers being replicated in different studies. These markers are now being considered as potential targets for reducing the number of HDRs. Transcriptomic approaches have also been used to investigate HDRs by identifying genes that show different patterns of expression in a number of clinical entities. This information can be of value for further elucidation of the mechanisms involved. Although first studies were performed using RT-PCR analysis to monitor the acute phase of the reaction, nowadays high-density expression platforms represent a more integrative way for providing a complete view of gene expression. By combining a detailed and precise clinical description with information obtained by these approaches, we will obtain a better understanding and management of patients with HDRs.
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Affiliation(s)
- T. D. Fernandez
- Research Laboratory; Malaga General Hospital-IBIMA; Malaga Spain
| | - C. Mayorga
- Research Laboratory; Malaga General Hospital-IBIMA; Malaga Spain
| | - J. L. Guéant
- Faculty of Medicine; INSERM U-954; Nutrition-Génétique et exposition aux risques environmentaux; University of Nancy; Vandoeuvre-les-Nancy France
- University Hospital Center of Nancy; Vandoeuvre-les-Nancy France
| | - M. Blanca
- Allergy Service; Malaga General Hospital; Malaga Spain
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Aimone-Gastin I. Prédispositions génétiques aux réactions d’HS allergiques aux médicaments. REVUE FRANÇAISE D'ALLERGOLOGIE 2013. [DOI: 10.1016/j.reval.2013.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Ming L, Wen Q, Qiao HL, Dong ZM. Interleukin-18 and IL18 -607A/C and -137G/C gene polymorphisms in patients with penicillin allergy. J Int Med Res 2011; 39:388-98. [PMID: 21672342 DOI: 10.1177/147323001103900206] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This study investigated the association between polymorphisms (-607A/C and -137G/C) in the promoter region of the IL18 gene (which encodes interleukin [IL]-18) and serum levels of IL-18, using standard genotyping techniques (sequence specific primer-polymerase chain reaction) and an enzyme-linked immunosorbent assay, respectively, in patients allergic to penicillin. A higher frequency of A alleles and the AA genotype was found at position -607A/C in patients allergic to penicillin than in control subjects. For the -137G/C position, the C allele was more frequent in patients allergic to penicillin than in control subjects. Haplotype analysis showed that the -607A/-137C haplotype was more frequent in patients allergic to penicillin than in control subjects. The patients had a significantly higher serum IL-18 level than the control subjects. In conclusion, IL18 -607A/C and -137G/C promoter polymorphisms are associated with susceptibility to penicillin allergy. In particular, the -137G/C position appears to play an important role in IL18 expression.
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Affiliation(s)
- L Ming
- Department of Clinical Pharmacology, School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
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Genetic and ethnic risk factors associated with drug hypersensitivity. Curr Opin Allergy Clin Immunol 2010; 10:280-90. [DOI: 10.1097/aci.0b013e32833b1eb3] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Abstract
Cytokines are thought to play a role in acute and/or immune-mediated adverse drug reactions (ADRs) due to their ability to regulate the innate and adaptive immune systems. This role is highly complex owing to the pluripotent nature of cytokines, which enables the same cytokine to play multiple roles depending on target organ(s) involved. As a result, the discussion of cytokine involvement in ADRs is organized according to target organ(s); specifically, ADRs targeting skin and liver, as well as ADRs targeting multiple organs, such as drug-induced autoimmunity and infusion-related reactions. In addition to discussing the mechanism(s) by which cytokines contribute to the initiation, propagation, and resolution of ADRs, we also discuss the usefulness and limitations of current methodologies available to conduct such mechanistic studies. While animal models appear to hold the most promise for uncovering additional mechanisms, this field is plagued by a lack of good animal models and, as a result, the mechanism of cytokine involvement in ADRs is often studied using less informative in vitro studies. The recent formation of the Drug-Induced Liver Injury Network, whose goal is collect thousands of samples from drug-induced liver injury patients, has enormous potential to advance knowledge in this field, by enabling large-scale cytokine polymorphism studies. In conclusion, we discuss how further advances in this field could be of significant benefit to patients in terms of preventing, predicting, and treating ADRs.
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Polymorphisms and haplotype analysis of IL-4Rα Q576R and I75V in patients with penicillin allergy. Eur J Clin Pharmacol 2009; 65:895-902. [DOI: 10.1007/s00228-009-0659-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Accepted: 04/07/2009] [Indexed: 10/20/2022]
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Guéant JL, Guéant-Rodriguez RM, Cornejo-Garcia JA, Viola M, Blanca M, Romano A. Gene variants of IL13, IL4, and IL4RA are predictors of β-lactam allergy. J Allergy Clin Immunol 2009; 123:509; author reply 509-10. [DOI: 10.1016/j.jaci.2008.10.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Accepted: 10/15/2008] [Indexed: 11/24/2022]
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Dickinson AM, Holler E. Polymorphisms of cytokine and innate immunity genes and GVHD. Best Pract Res Clin Haematol 2008; 21:149-64. [PMID: 18503983 DOI: 10.1016/j.beha.2008.03.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In the last 10 years, non-HLA genotypes have been investigated for their potential roles in the occurrence and severity of graft-versus-host disease (GVHD) as well as for their contribution to overall transplant-related mortality, infectious episodes, and overall survival. This chapter will review the latest results of cytokine gene polymorphisms between patient and donor which may cause the production of high or low levels of cytokines during the three-stage process of the GVHD 'cytokine storm'. More recent investigations into innate immunity and the interaction with subsequent downstream cytokine production and ultimate tissue damage are discussed. The potential of these non-HLA genetics to aid in predicting GVHD and post-transplant survival and the relevance of this information to the clinic are reviewed.
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Affiliation(s)
- A M Dickinson
- School of Clinical and Laboratory Sciences, Institute of Cellular Medicine, Newcastle University Medical School, Newcastle upon Tyne, UK.
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Apter AJ, Schelleman H, Walker A, Addya K, Rebbeck T. Clinical and genetic risk factors of self-reported penicillin allergy. J Allergy Clin Immunol 2008; 122:152-8. [DOI: 10.1016/j.jaci.2008.03.037] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Revised: 03/20/2008] [Accepted: 03/28/2008] [Indexed: 12/01/2022]
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Aberer W, Kränke B. Clinical manifestations and mechanisms of skin reactions after systemic drug administration. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.ddmec.2008.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Haematopoietic stem cell transplantation (HSCT) is currently the only curative treatment for many patients with malignant and non-malignant haematological diseases. The success of HSCT is greatly reduced by the development of complications, which include graft-versus-host disease (GVHD), relapse and infection. Human leukocyte antigen (HLA) matching of patients and donors is essential, but does not completely prevent these complications; non-HLA genes may also have an impact upon transplant outcome. Polymorphisms within genes that are associated with an individual's capability to mount an immune response to alloantigen and infectious pathogens and/or response to drugs (pharmacogenomics) are all currently being studied for their association with HSCT outcome. This review summarises the potential role of non-HLA polymorphisms in predicting HSCT outcome, from studies on retrospective transplant cohorts of HLA-identical siblings and matched unrelated donors. The clinical relevance and interpretation of non-HLA genetics, and how these could be used alongside clinical risk factors in HSCT, are also discussed.
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Qiao HL, Wen Q, Gao N, Tian X, Jia LJ. Association of IL-10 level and IL-10 promoter SNPs with specific antibodies in penicillin-allergic patients. Eur J Clin Pharmacol 2007; 63:263-9. [PMID: 17225142 DOI: 10.1007/s00228-006-0245-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 11/24/2006] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Our aim was to investigate the hypothesis that the sera interleukin-10 (IL-10) level and polymorphic nucleotides within the IL-10 gene promoters would link to specific IgE and IgG production and the expression of penicillin allergy. METHODS One hundred and two patients and 86 healthy subjects were chosen for assay of serum IL-10 level by enzyme-linked immunosorbent assay (ELISA) and type -1082 G/A and -819 C/T alleles by sequence-specific primer polymerase chain reaction (SSP-PCR). Radioallergosorbent test (RAST) and ELISA were used to examine eight types of specific immunoglobulin-E (IgE) and IgG antibodies, respectively, which included four types of antibodies to major and minor antigenic determinants. RESULTS Compared with control subjects and patients with negative-specific IgE, there were significantly lower levels of IL-10 in patients with positive-specific IgE (P < 0.05). Similarly, there were significantly lower levels of IL-10 in patients with positive-specific IgG compared with normal controls and allergic patients with negative-specific IgG (P < 0.05). The visible negative correlations existed between IL-10 and four types of specific IgE [benzylpenicilloyl (BPO), phenoxomethylpenicilloyl (PVO), benzylpenicillanyl (BPA), amoxicillanyl (AXA)], and patients with three or more positive-specific IgE had significantly lower IL-10 levels than normal controls (P < 0.01). There was a declining trend for IL-10 level in serum with the increase in types of positive-specific IgE. But there was no significant difference in serum IL-10 level between the positive skin-test group and the allergic-history group. Compared with controls and patients with negative antibodies, a significantly decreased frequency of the -1082 G allele was present in patients with positive antibodies (P < 0.01). The allele T and TT genotype at -819 C/T position had lower frequency in the negative-specific IgG group than that in the positive group and controls (P < 0.01). CONCLUSIONS Positive specific IgE and IgG are associated with decreased IL-10 level in allergic reaction to penicillins. The distributions of genotype and frequency of allele at the -1082 G/A position may be associated with the production of both specific IgE and IgG antibodies.
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Affiliation(s)
- Hai-Ling Qiao
- Department of Clinical Pharmacology, School of Medicine, Zhengzhou University, Zhengzhou, 450052, People's Republic of China.
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YANG J, QIAO HL, ZHANG YW, JIA LJ, TIAN X, GAO N. HLA-DRB genotype and specific IgE responses in patients with allergies to penicillins. Chin Med J (Engl) 2006. [DOI: 10.1097/00029330-200603020-00005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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