title: Hla-B alleles and lamotrigine-induced cutaneous adverse drug reactions in the Han Chinese population.
abstract: Lamotrigine (LTG) is a commonly used antiepileptic drug. However, the use of LTG is limited because of its cutaneous adverse drug reactions (cADRs) ranging from mild maculopapular eruption (MPE) to severe Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). A strong association between HLA-B*1502 and carbamazepine-induced SJS/TEN has been identified in Chinese and Thai. Although three of seven cases with HLA-B*1502 have been reported in LTG-induced SJS/TEN so far, the relationship between HLA-B*1502 and LTG-induced SJS/TEN needs further investigation. It is also unclear whether there is a specific genetic marker associated with LTG-induced MPE in Chinese. In this study, we genotyped 43 Han Chinese patients treated with LTG (14 cases with LTG-induced cADRs and 29 LTG-tolerant controls), using PCR-SSP for HLA-B*1502 testing and low-resolution genotyping, as well as sequencing for four-digit genotyping. The two cases with SJS were negative for HLA-B*1502, with B1301/1301 and 4601/5610, respectively. Combining the data with previous studies, there was no significant difference in the frequency of subjects with HLA-B*1502 between the LTG-induced SJS/TEN group and the LTG-tolerant group (p = 0.08, OR 4.23, 95% CI 0.94-18.97). In the MPE group, only one was positive for HLA-B*1502. There was no significant difference in the frequency of a specific HLA-B allele between the MPE group and the LTG-tolerant group either. In this study, no significant association between HLA-B*1502 and LTG-induced SJS or MPE was found. Given the small sample size and only HLA-B locus genotyping, further large-scale studies are required to explore genetic associations with LTG-induced cADRs.
authors.affiliation: Institute of Neuroscience and Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Guangzhou, China.
authors.forename: Yi-Wu
authors.initials: YW
authors.lastname: Shi
authors.forename: Fu-Li
authors.initials: FL
authors.lastname: Min
authors.forename: Xiao-Rong
authors.initials: XR
authors.lastname: Liu
authors.forename: Li-Xuan
authors.initials: LX
authors.lastname: Zan
authors.forename: Mei-Mei
authors.initials: MM
authors.lastname: Gao
authors.forename: Mei-Juan
authors.initials: MJ
authors.lastname: Yu
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Liao
mesh_terms: D000293:Adolescent; D000368:Aged; D000483:Alleles; D000927:Anticonvulsants / Q000009:adverse effects*; D044466:Asian People / Q000235:genetics; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D002681:China; D017931:DNA Primers; D003875:Drug Eruptions / Q000209:etiology* / Q000235:genetics; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D014227:Triazines / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D017931:DNA Primers; D015235:HLA-B Antigens; D014227:Triazines; D000077213:Lamotrigine