Esmaeilzadeh Hossein, Nabavi Mohammad, Aryan Zahra, Amirzargar Ali Akbar
a 1 Department of Allergy and Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
b 2 Allergy Research Center, Shiraz University of Medical Sciences, Shiraz , Iran.
Expert Rev Respir Med. 2015 Oct;9(5):511-8. doi: 10.1586/17476348.2015.1081062. Epub 2015 Aug 26.
This study is aimed at investigating the association of HLA-DRB1, HLA-DQA1, and HLA-DQB1 variability with the response to aspirin desensitization (AD). A total of 16 patients with aspirin-exacerbated respiratory diseases (AERD, 81.3% were female) with median age of 29 ± 4.3 years were included in this study. Following 6 months, Sino-Nasal Outcome Test-22 (SNOT-22), medication, symptom scores, and forced expiratory volume in 1 s (FEV1) (all p < 0.001) improved significantly. However, only seven patients (43.7%) had clinically significant improvement in all of the medication and symptom scores and FEV1, who were considered responders to AD. Responders to AD had significantly higher symptom scores compared with non-responders at baseline (20 ± 1.18 vs 10 ± 1.27; p = 0.003). HLADQB10302 was significantly lower in non-responders than in responders to AD (0.12 [0.02-0.76]; p = 0.022). Sensitivity and specificity of HLA-DQB10302 to predict response to AD was 71.4% (95% CI: 35.8-91.7) and 81.8% (95% CI: 52.3-94.8). This study introduces HLA-DQB1*0302 as a genetic marker for favorable response to AD.
本研究旨在调查人类白细胞抗原-DRB1（HLA-DRB1）、人类白细胞抗原-DQA1（HLA-DQA1）和人类白细胞抗原-DQB1（HLA-DQB1）基因变异与阿司匹林脱敏（AD）反应之间的关联。本研究纳入了16例阿司匹林诱发的呼吸道疾病（AERD）患者（81.3%为女性），中位年龄为29±4.3岁。6个月后，鼻-鼻窦结局测试22项（SNOT-22）、用药情况、症状评分和第1秒用力呼气量（FEV1）（所有p<0.001）均有显著改善。然而，只有7例患者（43.7%）在所有用药、症状评分和FEV1方面有临床显著改善，这些患者被视为AD反应者。与基线时的无反应者相比，AD反应者的症状评分显著更高（20±1.18对10±1.27；p=0.003）。AD无反应者的HLA-DQB10302显著低于AD反应者（0.12[0.02 - 0.76]；p=0.022）。HLA-DQB10302预测AD反应的敏感性和特异性分别为71.4%（95%CI：35.8 - 91.7）和81.8%（95%CI：52.3 - 94.8）。本研究引入HLA-DQB1*0302作为对AD有良好反应的遗传标志物。
