title: Genetic and immunologic studies of patients on procainamide.
abstract: Forty (40) patients with cardiac arrhythmias receiving procainamide (PA) therapy and 24 patients who were receiving other drugs for their cardiac disorders were investigated for class II HLA phenotypes and their DRB1*04 and DQB1*03 subtypes. Other genetic marker evaluations in the PA patients included: 1) class III MHC C4A and C4B null alleles of complement; and, 2) acetylation phenotype. Twenty (20) of the PA patients were also tested for the ability of their stimulated cells to secrete Interleukin-1 (IL-1 beta) and tumor necrosis factor (TNF alpha). We also examined the spontaneous production of these cytokines by peripheral blood leukocytes (PBL) from patients who were receiving chronic PA treatment. The results revealed no association of acetylation phenotypes with the class II HLA phenotypes nor class III MHC C4 allotypes in these patients. The results did show a significant increase in class III C4 complement allotypes in the PA patients when compared to the controls. The results also showed a significant increase in autoantibodies and DQw3 phenotypes in the PA patient group when compared to control populations. Results of spontaneous IL-1 and TNF production suggested there may be an association of select class II HLA phenotypes in some patients and this may be relevant to host responsiveness to PA treatment.
authors.affiliation: Department of Medicine, University of Cincinnati Medical Center, Ohio 45267-0563, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Adams
authors.forename: K
authors.initials: K
authors.lastname: Balakrishnan
authors.forename: S
authors.initials: S
authors.lastname: Malik
authors.forename: A B
authors.initials: AB
authors.lastname: Mongey
authors.forename: L
authors.initials: L
authors.lastname: Whitacre
authors.forename: E V
authors.initials: EV
authors.lastname: Hess
mesh_terms: D000107:Acetylation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000276:immunology* / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000235:genetics* / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003165:Complement System Proteins / Q000276:immunology; D005260:Female; D006683:HLA-DQ Antigens / Q000235:genetics / Q000276:immunology; D015804:HLA-DR4 Antigen / Q000235:genetics / Q000276:immunology; D006801:Humans; D007223:Infant; D007375:Interleukin-1 / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011342:Procainamide / Q000276:immunology* / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D000889:Anti-Arrhythmia Agents; D001323:Autoantibodies; D006683:HLA-DQ Antigens; C051569:HLA-DQ3 antigen; D015804:HLA-DR4 Antigen; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha; D003165:Complement System Proteins; D011342:Procainamide