Quiralte J, Sánchez-García F, Torres M J, Blanco C, Castillo R, Ortega N, de Castro F R, Pérez-Aciego P, Carrillo T
Unidad de Alergia, Hospital Ciudad de Jaén, Jaén, Spain.
J Allergy Clin Immunol. 1999 Apr;103(4):685-9. doi: 10.1016/s0091-6749(99)70243-5.
Several HLA alleles have been associated with asthma induced by nonsteroidal anti-inflammatory drugs (NSAIDs). The existence of HLA markers linked to other NSAID-induced reactions, such as cutaneous and anaphylactoid reactions, has not been established.
The purpose of our work was to study the HLA-DRB1 and HLA-DQB1 alleles in patients with cutaneous and anaphylactoid reactions caused by NSAIDs.
We have analyzed 114 HLA DRB1 and 26 HLA-DQB1 alleles in 21 patients with anaphylactoid reactions caused by NSAIDs, 47 patients who had exclusively cutaneous reactions during single-blind, placebo-controlled oral challenges with NSAIDs, and 167 tolerant control subjects (29 of whom had also had an IgE-mediated anaphylaxis to different agents). HLA-DRB1 and HLA-DQB1 alleles were typed by the polymerase chain reaction sequence-specific primers method with genomic DNA.
The frequency of HLA-DR11 alleles was 58.8% in the anaphylactoid reaction group, compared with 15.9% in the NSAID-tolerant healthy control subjects (OR, 7:3; 95% confidence interval, 2.8-19.0; P <.02) and 6.3% in the group of the patients with a tolerance for NSAIDs and with IgE-mediated anaphylaxis (OR, 18.75; 95% confidence interval, 4.3-81.1; P <.004). No differences were observed among HLA-DR11 alleles analyzed. There were no significant HLA-DQB1 associations with NSAID-induced anaphylactoid reactions. Patients with cutaneous reactions had HLA frequencies that did not differ significantly from the tolerant control subjects.
The HLA-DRB1*11 alleles showed a positive association with NSAID-induced anaphylactoid reactions.
多种人类白细胞抗原（HLA）等位基因与非甾体抗炎药（NSAIDs）诱发的哮喘相关。与其他NSAIDs诱发反应（如皮肤和类过敏反应）相关的HLA标志物是否存在尚未明确。
我们研究的目的是分析NSAIDs引起的皮肤和类过敏反应患者的HLA - DRB1和HLA - DQB1等位基因。
我们分析了21例NSAIDs引起类过敏反应患者、47例在NSAIDs单盲、安慰剂对照口服激发试验中仅出现皮肤反应的患者以及167例耐受对照受试者（其中29例也对不同药物有IgE介导的过敏反应）的114个HLA DRB1和26个HLA - DQB1等位基因。采用聚合酶链反应序列特异性引物法对基因组DNA进行HLA - DRB1和HLA - DQB1等位基因分型。
类过敏反应组中HLA - DR11等位基因频率为58.8%，而NSAIDs耐受健康对照受试者中为15.9%（比值比[OR]，7.3；95%置信区间，2.8 - 19.0；P < 0.02），在对NSAIDs耐受且有IgE介导过敏反应的患者组中为6.3%（OR，18.75；95%置信区间，4.3 - 81.1；P < 0.004）。分析的HLA - DR11等位基因之间未观察到差异。HLA - DQB1与NSAIDs诱发的类过敏反应无显著关联。有皮肤反应的患者的HLA频率与耐受对照受试者无显著差异。
HLA - DRB1*11等位基因与NSAIDs诱发的类过敏反应呈正相关。
