Detection of HLA-B*58:01, the susceptible allele for allopurinol-induced hypersensitivity, by loop-mediated isothermal amplification.
BACKGROUND
Allopurinol, a common medication for gout treatment, can cause rare but life-threatening severe cutaneous adverse reactions. A strong pharmacogenetic association of human leucocyte antigen (HLA)-B*58:01 with allopurinol-induced drug hypersensitivity has been reported, especially in the Han Chinese population.


OBJECTIVE
To develop a rapid and simple loop-mediated isothermal amplification (LAMP) assay of HLA-B*58:01 and evaluate its feasibility in predicting allopurinol-induced drug hypersensitivity.


METHODS
Two sets of LAMP primers targeting exons 2 and 3 of HLA-B*58:01 were designed. DNA extracted from 20 clinical blood samples of patients with gout was used to evaluate the effectiveness of the two LAMP primer sets for the detection of HLA-B*58:01.


RESULTS
The results were compared with routine clinical genotyping methods. All extracted DNA samples tested with the HLA-B*58:01 LAMP assay showed agreement with the routine genotyping results. No amplifications were observed when unextracted blood samples were tested.


CONCLUSIONS
The HLA-B*58:01 LAMP assay was confirmed to be simple, rapid and specific for the detection of HLA-B*58:01, and therefore of potential value in the diagnosis of allopurinol-induced hypersensitivity.
Division of Transplantation and Immunogenetics, Department of Pathology and Clinical Biochemistry, Queen Mary Hospital, Hong Kong SAR, China. kwoksy@ha.org.hk
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D000493:Allopurinol / Q000009:adverse effects*; D003362:Cost-Benefit Analysis; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000191:economics / Q000235:genetics; D005240:Feasibility Studies; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006074:Gout Suppressants / Q000009:adverse effects*; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D021141:Nucleic Acid Amplification Techniques / Q000191:economics / Q000379:methods* / Q000592:standards; D012680:Sensitivity and Specificity
D006074:Gout Suppressants; D015235:HLA-B Antigens; C041533:HLA-B58 antigen; D000493:Allopurinol