文章摘要
张祥,储海峰,胡白,陆闻生.MHC区域HLA-B类基因与抗癫痫药诱发重症药疹的相关性研究[J].中国临床保健杂志,2019,22(5):697-700.
MHC区域HLA-B类基因与抗癫痫药诱发重症药疹的相关性研究
Correlation analysis of HLA-B gene within MHC region with severe cutaneous reactions to antiepileptic drugs in Chinese Han population
投稿时间:2018-09-10  
DOI:10.3969/J.issn.1672-6790.2019.05.034
中文关键词: 药疹  抗惊厥药  等位基因
英文关键词: Drug eruptions  Anticonvulsants  Alleles 〖FL
基金项目:中国肝炎防治基金会——天晴肝病研究基金资助课题(TQGB2014102)
作者单位E-mail
张祥 皖南医学院,芜湖 241002 2546606379@qq.com 
储海峰 中国科学技术大学附属第一医院安徽省立医院皮肤性病科]  
胡白 中国科学技术大学附属第一医院安徽省立医院皮肤性病科]  
陆闻生 中国科学技术大学附属第一医院安徽省立医院皮肤性病科] luws2004@sina.com 
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中文摘要:
      目的 探讨HLA-B类基因与抗癫痫药物诱发重症药疹的相关性,了解重症药疹的免疫学发病机制。方法 收集25例抗癫痫药物诱发重症药疹患者和50例耐受对照血样,提取DNA,应用序列特异性引物-聚合酶链反应法(PCR-SSP)分型HLA-B基因,PLINK1.07软件分析HLA-B等位基因频率在患者组和耐受对照组之间差异。结果 (1)病例组携带HLA-B*1502等位基因显著高于耐受对照组(P=9.6×10-6,OR=10.92,95%CI:3.07~41.00)。HLA-B*1502携带率,很大程度是由卡马西平引起 (P=7.0×10-6,OR=36,95% CI :4.65~375.97),这种增高趋势也存在苯巴比妥诱发重症药疹组(P=0.013,OR=45, 95%CI :1.47~7827.55),但拉莫三嗪组未见相关性(P=0.879,OR=0.33,95%CI: 0.01~8.01)。(2)病例组携带HLA-B*40:01等位基因低于耐受对照组(P=0.045, OR=0.18,95%CI:0.03~0.97)。结论 HLA-B*40:01可能在抗癫痫药物诱发重症药疹中扮演一种保护因素。
英文摘要:
      Objective To investigate the relationship between HLA-B alleles associated with severe cutaneous reactions to antiepileptic drugs,and to demonstrate the immune pathogenesis of drug-related severe cutaneous adverse reactions.Methods We collected the data and blood samples from 25 cases of severe cutaneous adverse reactions patients and 50 antiepileptic drugs-tolerant controls in study.HLA-B genotying was performed by polymerase chain reaction sequence-specific primers (PCR-SSP) method,respectively.PLINK1.07 was used to analyze whether there are differences in the frequencies of these alleles between severe cutaneous adverse reactions patients and tolerant controls or not.Results (1)In drug-specific analysis,the carrier rate of HLA-B*15:02 was significantly higher in antiepileptic drugs compared with antiepileptic drugs-tolerant controls (P=9.6×10-6,OR=10.92,5% CI:3.07-41.00),especially in carbamazepine-severe cutaneous adverse reactions case (P=7.0×10-6,OR=36,5% CI:4.65-375.97).Similar associations in phenobarbital were seen for groups with severe cutaneous adverse reactions case compared with drugs-tolerant controls groups (P=0.013,OR=45,5% CI:1.47-7827.55).No associations between severe cutaneous adverse reactions case to drugs-tolerant controls groups were observed for the lamotrigine (P=0.879,OR=0.33,5% CI:0.01-8.01).(2)Compared with drug-tolerant controls,the carrier rates of HLA-B*40:01 was lower in cases of induced by AEDs (P=0.045,OR=0.18,5% CI:0.03-0.97).Conclusions Anticonrulsant-induced HLA-B*40:01 allele may be a protective factor in severe cutaneous adverse reactions.
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