Transl Clin Pharmacol.  2016 Sep;24(3):143-146. 10.12793/tcp.2016.24.3.143.

HLA-A*24:02/B*51:01 haplotype and lamotrigine-induced cutaneous adverse drug reactions in Koreans

Affiliations
  • 1Department of Clinical Pharmacology, Inje University College of Medicine, Busan Paik Hospital, Busan 47392, Republic of Korea. phshinjg@gmail.com
  • 2Department of Neurology, Inje University College of Medicine, Busan Paik Hospital, Busan 47392, Republic of Korea.
  • 3Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan 47392, Republic of Korea.

Abstract

Antiepileptic drugs (AEDs) have been known to induce cutaneous adverse drug reaction (cADR), ranging from a mild maculopapular eruption (MPE) to potentially life-threatening cADRs such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Despite studies examining mechanisms associated with human leukocyte antigen (HLA), the association between lamotrigine (LTG)-induced cADR and HLA alleles still has room to investigate. We investigated HLA-A,-B, and -C alleles in LTG-induced cADR. The medical records of four patients with LTG-induced cADR were retrospectively reviewed. All patients were treated with LTG for epilepsy. All recovered from cADR after stopping LTG treatment and receiving intensive care. HLA-A, -B, and -C genotyping was performed in all four patients using a PCR-sequence-based typing (SBT) method. Two patients had SJS, and the other two had MPE due to LTG. The range of latency to cADR after the initial LTG dose was 19-42 days. Two patients experienced cross-reactivity with other aromatic or new AEDs. Expression of the HLA-A*24:02/B*51:01 haplotype was detected in three (75%) patients with LTG-induced cADR. The other patient carried homozygous HLA-B*58:01 alleles. The results suggest that Korean individuals with the HLA-A*24:02/B*51:01 haplotype may be susceptible to LTG-induced cADR. Further investigations are necessary to confirm these findings.

Keyword

Lamotrigine; cutaneous adverse drug reactions; Stevens–Johnson syndrome; maculopapular eruption; HLA class I genotype

MeSH Terms

Alleles
Anticonvulsants
Critical Care
Drug-Related Side Effects and Adverse Reactions*
Epilepsy
Haplotypes*
HLA-A Antigens
Humans
Leukocytes
Medical Records
Methods
Retrospective Studies
Stevens-Johnson Syndrome
Anticonvulsants
HLA-A Antigens

Reference

1.Błaszczyk B., Lasoń W., Czuczwar SJ. Antiepileptic drugs and adverse skin reactions: An update. Pharmacol Rep. 2015. 67:426–434. DOI: doi: 10.1016/j. pharep.2014.11.009.
Article
2.Chung WH., Hung SI., Hong HS., Hsih MS., Yang LC., Ho HC, et al. Medical genetics: A marker for stevens-johnson syndrome. Nature. 2004. 428:486.
3.Kulkantrakorn K., Tassaneeyakul W., Tiamkao S., Jantararoungtong T., Prab-mechai N., Vannaprasaht S, et al. HLA-B∗1502 strongly predicts carbamazepine-induced stevens-johnson syndrome and toxic epidermal necrolysis in thai patients with neuropathic pain. Pain Pract. 2012. 12:202–208. DOI: doi: 10.1111/j.1533-2500.2011.00479.x.
Article
4.Chang CC., Too CL., Murad S., Hussein SH. Association of HLA-B∗1502 allele with carbamazepine-induced toxic epidermal necrolysis and Stevens-johnson syndrome in the multi-ethnic malaysian population. Int J Dermatol. 2011. 50:221–224. DOI: doi: 10.1111/j.1365-4632.2010.04745.x.
Article
5.Aggarwal R., Sharma M., Modi M., Garg VK., Salaria M. HLA-B∗1502 is associated with carbamazepine induced stevens-johnson syndrome in north indian population. Hum Immunol. 2014. 75:1120–1122. DOI: doi: 10.1016/j.hu-mimm.2014.09.022.
Article
6.Alfirevic A., Jorgensen AL., Williamson PR., Chadwick DW., Park BK., Pirmo-hamed M. HLA-B locus in caucasian patients with carbamazepine hypersensitivity. Pharmacogenomics. 2006. 7:813–818.
Article
7.Ikeda H., Takahashi Y., Yamazaki E., Fujiwara T., Kaniwa N., Saito Y, et al. HLA class i markers in japanese patients with carbamazepine-induced cutaneous adverse reactions. Epilepsia. 2010. 51:297–300. DOI: doi: 10.1111/j.1528-1167.2009.02269.x.
Article
8.Kim SH., Lee KW., Song WJ., Jee YK., Lee SM., Kang HR, et al. Carbamazepine-induced severe cutaneous adverse reactions and HLA genotypes in Koreans. Epilepsy Res. 2011. 97:190–197. DOI: doi: 10.1016/j.eplepsyres.2011. 08.010.
Article
9.Song JS., Kang ES., Joo EY., Hong SB., Seo DW., Lee SY. Absence of HLA-B∗1502 and HLA-A∗3101 alleles in 9 Korean patients with antiepileptic drug-induced skin rash: A preliminary study. Ann Lab Med. 2014. 34:372–375. DOI: doi: 10.3343/alm.2014.34.5.372.
Article
10.Moon J., Park HK., Chu K., Sunwoo JS., Byun JI., Lim JA, et al. The HLA-A∗2402/Cw∗0102 haplotype is associated with lamotrigine-induced maculopapular eruption in the Korean population. Epilepsia. 2015. 56:e161–e167. DOI: doi: 10.1111/epi.13087.
Article
11.Li LJ., Hu FY., Wu XT., An DM., Yan B., Zhou D. Predictive markers for carbamazepine and lamotrigine-induced maculopapular exanthema in Han Chinese. Epilepsy Res. 2013. 106:296–300. DOI: doi: 10.1016/j.eplepsyres.2013.05. 004.
Article
12.Park HJ., Kim YJ., Kim DH., Kim J., Park KH., Park JW., Lee JH. HLA allele frequencies in 5802 Koreans: Varied allele types associated with sjs/ten according to culprit drugs. Yonsei Med J. 2016. 57:118–126.
Article
13.Pirmohamed M. Genetics and the potential for predictive tests in adverse drug reactions. Chem Immunol Allergy. 2012. 97:18–31. DOI: doi: 10.1159/00033 5613.
Article
14.Mehta M., Shah J., Khakhkhar T., Shah R., Hemavathi KG. Anticonvulsant hypersensitivity syndrome associated with carbamazepine administration: Case series. J Pharmacol Pharmacother. 2014. 5:59–62. DOI: doi: 10.4103/0976-500X.124428.
Article
15.Ghosh K., Banerjee G., Ghosal AK., Nandi J. Cutaneous drug hypersensitivity: Immunological and genetic perspective. Indian J Dermatol. 2011. 56:137–144. DOI: doi: 10.4103/0019-5154.80402.
16.Piga M., Mathieu A. Genetic susceptibility to behcet's disease: Role of genes belonging to the MHC region. Rheumatology (Oxford). 2011. 50:299–310. DOI: doi: 10.1093/rheumatology/keq331.
Article
17.Sakane T., Takeno M., Suzuki N., Inaba G. Behcet's disease. N Engl J Med. 1999. 341:1284–1291.
18.Lee KW., Oh DH., Lee C., Yang SY. Allelic and haplotypic diversity of HLA-A, -B, -C, -DRB1, and -DQB1 genes in the Korean population. Tissue Antigens. 2005. 65:437–447.
Article
19.Wang W., Hu FY., Wu XT., An DM., Yan B., Zhou D. Genetic susceptibility to the cross-reactivity of aromatic antiepileptic drugs-induced cutaneous adverse reactions. Epilepsy Res. 2014. 108:1041–1045. DOI: doi: 10.1016/j. eplepsyres.2014.03.017.
Article
20.Shirzadi M., Thorstensen K., Helde G., Moen T., Brodtkorb E. Do hla-a markers predict skin-reactions from aromatic antiepileptic drugs in a norwegian population? A case control study. Epilepsy Res. 2015. 118:5–9. DOI: doi: 10.1016/j. eplepsyres.2015.09.011.
Article
21.Kazeem GR., Cox C., Aponte J., Messenheimer J., Brazell C., Nelsen AC, et al. High-resolution HLA genotyping and severe cutaneous adverse reactions in lamotrigine-treated patients. Pharmacogenet Genomics. 2009. 19:661–665. DOI: doi: 10.1097/FPC.0b013e32832c347d.
Article
22.Wang XQ., Lv B., Wang HF., Zhang X., Yu SY., Huang XS, et al. Lamotrigine-induced severe cutaneous adverse reaction: Update data from 1999-2014. J Clin Neurosci. 2015. 22:1005–1011. DOI: doi: 10.1016/j.jocn.2015.01.016.
Article
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