Associations of and with vancomycin-induced drug reaction with eosinophilia and systemic symptoms in the Han-Chinese population.

Vancomycin is a commonly used antibiotic; however, it can cause life-threatening severe cutaneous adverse reactions, such as drug reaction with eosinophilia and systemic symptoms (DRESS). A previous study has reported a strong association between and vancomycin-induced DRESS in European ethnicity. Herein, we aim to investigate the genetic predisposition of vancomycin-induced DRESS in the Han-Chinese population. In this study, we enrolled a total of 26 patients with vancomycin-induced DRESS, 1,616 general population controls, and 51 subjects tolerant to vancomycin. granulysin-based lymphocyte activation tests (LAT) were conducted among 6 vancomycin-induced DRESS patients who were concomitantly receiving other medicines. and genotypes were determined by sequencing-based typing. Our results found that vancomycin-induced DRESS was associated with [odds ratio (OR) = 7.8, 95% confidence interval (CI) = 1.7-35.8; -value = 0.035], (OR = 32.3, 95% CI = 2.8-367.7; -value = 0.047), (OR = 4.7, 95% CI = 1.3-16.1; -value = 0.036) and (OR = 44.8, 95% CI = 7.2-280.4; -value = 0.002) when comparing the vancomycin-induced DRESS patients with the general population controls. LAT results showed that granulysin significantly increased in the vancomycin-induced DRESS patients upon vancomycin stimulation (4.7 ± 3.7 fold increased), but not upon other co-medicines. This study identified that, in addition to , , , and were also genetic markers for vancomycin-induced DRESS in the Han-Chinese population. Associations of ethnic variances in with vancomycin-DRESS were observed.