ABSTRACT
PURPOSE: Previous studies found a strong association between HLA-B*1502 and carbamazepine (CBZ)-induced Stevens-Johnson syndrome (SJS) in Han Chinese, but not in Caucasian populations. Even in Han Chinese, the HLA-B*1502 was not associated with CBZ-induced maculopapular eruptions (MPE). This study seeks to identify whether HLA-B*1502 is associated with CBZ- or phenytoin (PHT)-induced SJS or MPE in a Thai population. METHODS: Eighty-one Thai epileptic patients between 1994 and 2007 from the Chulalongkorn Comprehensive Epilepsy Program were recruited. Thirty-one subjects had antiepileptic drug (AED)-induced SJS or MPE (6 CBZ-SJS, 4 PHT-SJS, 9 CBZ-MPE, 12 PHT-MPE), and 50 were AED-tolerant controls. RESULTS: For the first time, a strong association between HLA-B*1502 and PHT-induced SJS was found (p = 0.005). A strong association was also found between the HLA-B*1502 and CBZ-induced SJS (p = 0.0005), making Thai the first non-Chinese population demonstrating such an association. Some patients, who were HLA-B*1502 and suffered from CBZ-induced SJS, could be tolerant to PHT and vice versa. This suggests that HLA-B*1502 may be a common attribute required for a Thai patient to develop SJS from these two AEDs; other different elements, however, are also needed for each AED. In addition, no association between HLA-B alleles and CBZ- or PHT-induced MPE was found. CONCLUSIONS: CBZ- and PHT-induced SJS, but not MPE, is associated with HLA-B*1502 allele in Thai population.
Subject(s)
Anticonvulsants/adverse effects , Carbamazepine/adverse effects , HLA-B Antigens/genetics , Pharmacogenetics , Phenytoin/adverse effects , Stevens-Johnson Syndrome/chemically induced , Stevens-Johnson Syndrome/genetics , Adolescent , Adult , Child , Epilepsy/drug therapy , Epilepsy/genetics , Female , Genetic Predisposition to Disease/ethnology , Humans , Male , Middle Aged , Retrospective Studies , Thailand/ethnology , Young AdultABSTRACT
OBJECTIVE: To study the distribution of human leukocyte antigens (HLA) -A and -B antigens by standard microlymphocytotoxicity assay in Thai nasopharyngeal carcinoma (NPC) patients compared to normal controls in order to identify the alleles associated with NPC in Thailand. DESIGN: Retrospective-Analytical study. SUBJECTS: Fifty-three unrelated Thai patients with histologically confirmed NPC diagnosed at King Chulalongkorn Memorial Hospital and 70 healthy unrelated Thai individuals served as controls. METHOD: Lymphocyte separation and HLA typing were performed from freshly drawn blood by standard microlymphocytotoxicity assay. The significance of differences between the two groups was analyzed by the chi-square test. RESULTS: HLA-A2 was observed at a greater frequency in patients being found in 31/53 (58%) NPC patients compared to 27/70 (38%) controls (p = 0.02). An increase in HLA-B46 was also demonstrated. HLA-B46 was present in 16/53 (30%) NPC patients but was observed in 10/70 (14%) in controls (p = 0.03). CONCLUSIONS: This study reported two susceptible, HLA-A2 and HLA-B46 antigens, for NPC in a Thai population.
