Kallam Anji Reddy Molecular Genetics Laboratory, Prof Brien Holden Eye Research Centre; Tej Kohli Cornea Institute, Hyderabad, India.
Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Sci Rep. 2017 Nov 21;7(1):15960. doi: 10.1038/s41598-017-15965-7.
Stevens Johnson syndrome (SJS) is part of a spectrum of adverse drug reactions resulting in the destruction of skin, mucous membranes, and the ocular surface. A similar, more severe form of the disorder included in this spectrum is toxic epidermal necrolysis (TEN). Approximately 35% of patients suffer chronic sequelae such as vascularization, corneal scarring, conjunctival inversion to the cornea, keratinization, symblepharon, scarring of the palpebral conjunctiva, trichiasis, and severe dry eye. We focused on 80 Indian patients with SJS/TEN with severe ocular complications (SOC) and investigated the association of alleles at HLA -A, HLA-B and HLA-C loci; the controls were 50 healthy Indian volunteers. Genotyping at HLA-A, HLA-B, and HLA-C loci showed a significant positive association with HLA-A33:03, HLA-B44:03, and HLA-C07:01 alleles, and a significant negative association with HLA-B57:01 and HLA-C06:02. This indicates that HLA-A33:03, HLA-B44:03 and HLA-C07:01 are risk alleles, and HLA-B57:01 and HLA-C06:02 are protective alleles in this population. We also found that the haplotypes consisting of HLA-B44:03 and HLA-C07:01 were strongly associated with SJS/TEN with SOC in our Indian population (p = 1.1 × 10, odds ratio = 11.0). Describing the association of the haplotype could facilitate the understanding of increased risk factors for developing SJS/TEN with SOC.
史蒂文斯-约翰逊综合征(SJS)是导致皮肤、黏膜和眼表面破坏的一系列药物不良反应的一部分。该谱中的一种类似的、更严重的疾病形式包括中毒性表皮坏死松解症(TEN)。大约 35%的患者患有慢性后遗症,如血管化、角膜瘢痕、结膜向角膜反转、角化、睑球粘连、睑结膜瘢痕、倒睫和严重干眼症。我们关注了 80 名患有严重眼部并发症(SOC)的 SJS/TEN 印度患者,并研究了 HLA-A、HLA-B 和 HLA-C 基因座等位基因的关联;对照组为 50 名健康的印度志愿者。HLA-A、HLA-B 和 HLA-C 基因座的基因分型显示 HLA-A33:03、HLA-B44:03 和 HLA-C07:01 等位基因与 SOC 呈显著正相关,而 HLA-B57:01 和 HLA-C06:02 与 SOC 呈显著负相关。这表明 HLA-A33:03、HLA-B44:03 和 HLA-C07:01 是风险等位基因,而 HLA-B57:01 和 HLA-C06:02 是该人群中的保护性等位基因。我们还发现,在我们的印度人群中,由 HLA-B44:03 和 HLA-C07:01 组成的单体型与 SJS/TEN 伴 SOC 强烈相关(p=1.1×10,优势比=11.0)。描述单体型的关联可以帮助我们理解增加 SJS/TEN 伴 SOC 发病风险的因素。