Table of Contents Author Guidelines Submit a Manuscript
Journal of Immunology Research
Volume 2018 (2018), Article ID 2780272, 11 pages
https://doi.org/10.1155/2018/2780272
Clinical Study

Association between HLA-B Alleles and Carbamazepine-Induced Maculopapular Exanthema and Severe Cutaneous Reactions in Thai Patients

1Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
2Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, Thailand
3Ramathibodi Multidisciplinary Epilepsy Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
4The Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group, Bangkok, Thailand
5Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
6Department of Pharmacy, Prasat Neurological Institute, Bangkok, Thailand
7Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand
8Department of Clinical Pharmacy Practice, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
9School of Medicine, Mae Fah Luang University, Chiang Rai, Thailand
10Division of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
11Division of Allergy and Clinical Immunology, Skin and Allergy Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
12Division of Dermatology, Skin and Allergy Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
13Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
14Dermatological Division, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand
15Department of Community Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Correspondence should be addressed to Chonlaphat Sukasem; ht.ca.lodiham@kus.tahpalnohc

Received 17 August 2017; Revised 25 October 2017; Accepted 26 November 2017; Published 10 January 2018

Academic Editor: Riichiro Abe

Copyright © 2018 Chonlaphat Sukasem et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The HLA-B15:02 allele has been reported to have a strong association with carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in Thai patients. The HLA-B alleles associated with carbamazepine-induced maculopapular exanthema (MPE) and the drug reaction with eosinophilia and systemic symptoms (DRESS) among the Thai population have never been reported. The aim of the present study was to carry out an analysis of the involvement of HLA-B alleles in carbamazepine-induced cutaneous adverse drug reactions (cADRs) in the Thai population. A case-control study was performed by genotyping the HLA-B alleles of Thai carbamazepine-induced hypersensitivity reaction patients (17 MPE, 16 SJS/TEN, and 5 DRESS) and 271 carbamazepine-tolerant controls. We also recruited 470 healthy Thai candidate subjects who had not taken carbamazepine. HLA-B15:02 showed a significant association with carbamazepine-induced MPE (, odds ratio (OR) (95% confidence interval [CI]) = 7.27 (2.04–25.97)) and carbamazepine-induced SJS/TEN (; OR (95% CI) = 70.91(19.67–255.65)) when compared with carbamazepine-tolerant controls. Carbamazepine-induced SJS/TEN also showed an association with HLA-B15:21 allele (; OR (95% CI) = 9.54 (1.61–56.57)) when compared with carbamazepine-tolerant controls. HLA-B58:01 allele was significantly related to carbamazepine-induced MPE (; OR (95% CI) = 4.73 (1.53–14.66)) and DRESS (; OR (95% CI) = 7.55 (1.20–47.58)) when compared with carbamazepine-tolerant controls. These alleles may serve as markers to predict carbamazepine-induced cADRs in the Thai population.