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Association of Human Leukocyte Antigen Alleles with Carbamazepine- or Lamotrigine-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in an Iranian Population: A Case-control Study
|Iranian Journal of Medical Sciences|
|مقاله 9، دوره 48، شماره 1، فروردین 2023، صفحه 70-76 اصل مقاله (260.37 K)|
|نوع مقاله: Original Article(s)|
|شناسه دیجیتال (DOI): 10.30476/ijms.2022.91192.2241|
|Ladan Dastgheib1؛ Farima Rostams2؛ Behrouz Gharesi-Fard3؛ Ali Akbar Asadi-Pooya4، 5؛ Saba Namjoo6؛ Foroozan Tahmasebi3؛ Maryam Hadibarhaghtalab* 1|
|1Molecular Dermatology Research Center, Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran|
|2Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran|
|3Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran|
|4Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran|
|5Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA|
|6Blood Transfusion Research Center, High Institute for Education and Research in Transfusion Medicine, Tehran, Iran|
|Background: Genetic diversity in human leukocyte antigen (HLA) alleles across populations is a significant risk factor for drug-induced severe cutaneous adverse reactions (SCARs), e.g., carbamazepine (CBZ)- and lamotrigine (LTG)-induced Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). The present study aimed to investigate the frequency of different HLA alleles in Iranian patients with CBZ- and LTG-induced SJS/TEN.|
Methods: A case-control study was conducted from 2011 to 2018 at various hospitals affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). A total of 31 patients receiving anticonvulsant drugs (CZB or LTG) were recruited and divided into two groups. The drug-induced group (n=14) included hospitalized patients due to CBZ- or LTG-induced SJS/TEN. The drug-tolerant group (n=17) included individuals receiving CBZ or LTG for at least three months with no adverse effects. In addition, 46 healthy individuals (control group) were recruited. The frequency of HLA-A, -B, and -DRB1 alleles in patients with CZB- or LTG-induced SJS/TEN was investigated. HLA typing was performed using the allele-specific polymerase chain reaction method. The Chi square test and Fisher’s exact test were used to determine a potential association between SJS/TEN and HLA alleles. P<0.05 was considered statistically significant.
Results: CBZ- or LTG-induced SJS/TEN was not significantly associated with HLA alleles. However, HLA-DRB1*01 showed a significantly higher frequency in patients with CBZ-induced SJS/TEN than the CBZ-tolerant patients (30% vs. 9%, P=0.07).
Conclusion: Overall, no significant association was found between CBZ- or LTG-induced SJS/TEN and HLA alleles. Further large-scale studies are required to substantiate our findings.
|Stevens-Johnson syndrome؛ Anticonvulsants؛ Histocompatibility testing|
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