HLA-DRA variants predict penicillin allergy in genome-wide fine-mapping genotyping

J Guéant*, Antonino Romano, J Cornejo Garcia, A Oussalah, C Chery, N Blanca López, R Guéant Rodriguez, F Gaeta, P Rouyer, T Josse, G Canto, Fd Carmona, L Bossini Castillo, J Martin, J Laguna, J Fernandez, F Feo, Da Ostrov, Pc Plasencia, C MayorgaM Torres, M. Blanca

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo

52 Citazioni (Scopus)

Abstract

BACKGROUND:\r\n\r\nImmediate reactions to β-lactams are the most common causes of anaphylactic reactions and can be life-threatening. The few known genetic factors influencing these reactions suggest a link with atopy and inflammation.\r\nOBJECTIVE:\r\n\r\nWe performed a fine-mapping genome-wide association study of the genetic predictors of β-lactam allergy to better understand the underlying mechanisms.\r\nMETHODS:\r\n\r\nWe studied 387 patients with immediate allergic reactions to β-lactams and 1124 paired control subjects from Spain. We replicated the results in 299 patients and 362 paired control subjects from Italy.\r\nRESULTS:\r\n\r\nWe found significant associations with the single nucleotide polymorphisms rs4958427 of ZNF300 (c.64-471G>A, P = 9.9 × 10(-9)), rs17612 of C5 (c.4311A>C [p.Glu1437Asp], P = 7.5 × 10(-7)), rs7754768 and rs9268832 of the HLA-DRA | HLA-DRB5 interregion (P = 1.6 × 10(-6) and 4.9 × 10(-6)), and rs7192 of HLA-DRA (c.724T>G [p.Leu242Val], P = 7.4 × 10(-6)) in an allelic model, with similar results in an additive model. Single nucleotide polymorphisms of HLA-DRA and ZNF300 predicted skin test positivity to amoxicillin and other penicillins but not to cephalosporins. A haplotype block in HLA-DRA and the HLA-DRA | HLA-DRB5 interregion encompassed a motif involved in balanced expression of the α- and β-chains of MHC class II, whereas rs7192 was predicted to influence α-chain conformation. HLA-DRA rs7192 and rs8084 were significantly associated with allergy to penicillins and amoxicillin (P = 6.0 × 10(-4) and P = 4.0 × 10(-4), respectively) but not to cephalosporins in the replication study.\r\nCONCLUSIONS:\r\n\r\nGene variants of HLA-DRA and the HLA-DRA | HLA-DRB5 interregion were significant predictors of allergy to penicillins but not to cephalosporins. These data suggest complex gene-environment interactions in which genetic susceptibility of HLA type 2 antigen presentation plays a central role.\r\n\r\nCopyright © 2014 American Academy of Allergy, Asthma & Immunology. All rights reserved.\r\nKEYWORDS:\r\n\r\nDrug allergy; HLA-DRA; amoxicillin; anaphylaxis; genome-wide association; immediate-type reactions; penicillins; β-lactams
Lingua originaleInglese
pagine (da-a)253-259
Numero di pagine7
RivistaJournal of Allergy and Clinical Immunology
Volume135
Numero di pubblicazione1
DOI
Stato di pubblicazionePubblicato - 2015
Pubblicato esternamente

All Science Journal Classification (ASJC) codes

  • Immunologia e Allergia
  • Immunologia

Keywords

  • genetic predictors

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