Man Celeste B L, Kwan Patrick, Baum Larry, Yu Evelyn, Lau K M, Cheng Alice S H, Ng Margaret H L
Division of Neurology, Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Epilepsia. 2007 May;48(5):1015-8. doi: 10.1111/j.1528-1167.2007.01022.x.
A previous study conducted in Taiwan found a 100% association between HLA-B1502 allele and carbamazepine-induced Stevens-Johnson syndrome (SJS) in Han Chinese subjects, with an extremely high odds ratio compared with carbamazepine-tolerant subjects (odds ratio = 2,504). We examined this association in 24 Hong Kong Han Chinese subjects who had cutaneous adverse reactions induced by different antiepileptic drugs (AEDs). They were matched with 48 AED-tolerant controls. HLA-B1502 was associated with severe cutaneous reactions (SCR) induced by AEDs, which included carbamazepine, phenytoin, and lamotrigine (p = 0.001, odds ratio = 17.6), but was not associated with maculopapular exanthema (MPE) (p = 0.32). Further studies in larger samples of ethnically matched subjects should be conducted to confirm the findings. Identification of genetic polymorphisms predisposing to development of AED-induced SCR offers the possibility of avoiding these high-risk drugs in genetically susceptible individuals.
台湾此前进行的一项研究发现，汉族受试者中HLA - B1502等位基因与卡马西平诱发的史蒂文斯 - 约翰逊综合征（SJS）之间存在100%的关联，与耐受卡马西平的受试者相比，优势比极高（优势比 = 2504）。我们对24名因不同抗癫痫药物（AED）诱发皮肤不良反应的香港汉族受试者进行了此项关联研究。他们与48名耐受AED的对照者进行了匹配。HLA - B1502与AED诱发的严重皮肤反应（SCR）相关，其中包括卡马西平、苯妥英和拉莫三嗪（p = 0.001，优势比 = 17.6），但与斑丘疹（MPE）无关（p = 0.32）。应在更大样本的种族匹配受试者中进行进一步研究以证实这些发现。识别易导致AED诱发SCR的基因多态性为在遗传易感个体中避免使用这些高风险药物提供了可能性。
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