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中国中部地区患者中卡马西平诱导的皮肤不良反应与 HLA-B*1502 等位基因的相关性。

Association between carbamazepine-induced cutaneous adverse drug reactions and the HLA-B*1502 allele among patients in central China.

机构信息

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

出版信息

Epilepsy Behav. 2010 Nov;19(3):405-8. doi: 10.1016/j.yebeh.2010.08.007. Epub 2010 Sep 15.

Abstract

The aim of this study was to investigate the association between carbamazepine (CBZ)-induced cutaneous adverse drug reactions (cADRs) and the HLA-B1502 allele among patients from central China. Eight patients with Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), 28 with mild maculopapular eruptions (MPEs), 50 CBZ-tolerant controls, and 71 healthy volunteers were recruited. HLA genotyping was performed using the polymerase chain reaction sequence-based typing (SBT) method. As a result, the HLA-B1502 allele was observed at the following rates: (1) 100% (8/8) among those with CBZ-induced SJS/TEN, (2) 10.7% (3/28) among those with CBZ-induced MPEs; (3) 8.0% (4/50) among CBZ-tolerant controls; (4) 8.5% (6/71) among healthy volunteers. The eight patients with SJS/TEN positive for the HLA-B1502 allele had an odds ratio (OR) of 184 compared with CBZ-tolerant controls. There was no significant difference in frequency between patients with MPEs and CBZ-tolerant controls (P>0.05). Thus, CBZ-induced SJS/TEN, but not MPEs, is strongly associated with HLA-B1502. Testing for HLA-B*1502 should be recommended for patients from central China prior to initial CBZ treatment.

摘要

本研究旨在探讨中国中部地区患者中卡马西平(CBZ)诱导的皮肤不良反应(cADR)与 HLA-B1502 等位基因之间的关联。纳入了 8 例 Stevens-Johnson 综合征和中毒性表皮坏死松解症(SJS/TEN)患者、28 例轻度斑丘疹性皮疹(MPE)患者、50 例 CBZ 耐受对照者和 71 名健康志愿者。采用聚合酶链反应序列基定型(SBT)方法进行 HLA 基因分型。结果显示,HLA-B1502 等位基因的出现率如下:(1)CBZ 诱导 SJS/TEN 患者中为 100%(8/8),(2)CBZ 诱导 MPE 患者中为 10.7%(3/28),(3)CBZ 耐受对照者中为 8.0%(4/50),(4)健康志愿者中为 8.5%(6/71)。8 例 HLA-B1502 等位基因阳性的 SJS/TEN 患者与 CBZ 耐受对照者相比,其优势比(OR)为 184。MPE 患者与 CBZ 耐受对照者之间的频率无显著差异(P>0.05)。因此,CBZ 诱导的 SJS/TEN 而非 MPE 与 HLA-B1502 密切相关。在初始 CBZ 治疗前,建议对中国中部地区的患者进行 HLA-B*1502 检测。

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