Genetic markers of severe cutaneous adverse reactions.
- Author:
Jae Woo JUNG
1
;
Jae Yeol KIM
;
In Won PARK
;
Byoung Whui CHOI
;
Hye Ryun KANG
Author Information
- Publication Type:Review
- Keywords: Stevens-Johnson syndrome; Drug hypersensitivity syndrome; Pharmacogenetics; HLA antigens
- MeSH: Allopurinol; Carbamazepine; Cicatrix; Dapsone; Drug Hypersensitivity; Drug Hypersensitivity Syndrome; Drug-Related Side Effects and Adverse Reactions; Epidemiologic Studies; Genetic Markers*; Genetic Testing; Genotype; Health Care Costs; HLA Antigens; Hospitalization; Humans; Incidence; Leukocytes; Mass Screening; Methazolamide; Pharmacogenetics; Stevens-Johnson Syndrome
- From:The Korean Journal of Internal Medicine 2018;33(5):867-875
- CountryRepublic of Korea
- Language:English
- Abstract: Adverse drug reactions can cause considerable discomfort. They can be life-threatening in severe cases, requiring or prolonging hospitalization, impeding proper treatment, and increasing treatment costs considerably. Although the incidence of severe cutaneous adverse reactions (SCARs) is low, they can be serious, have permanent sequelae, or lead to death. A recent pharmacogenomic study confirmed that genetic factors can predispose an individual to SCARs. Genetic markers enable not only elucidation of the pathogenesis of SCARs, but also screening of susceptible subjects. The human leukocyte antigen (HLA) genotypes associated with SCARs include HLA-B*57:01 for abacavir (Caucasians), HLA-B*58:01 for allopurinol (Asians), HLA-B*15:02 (Han Chinese) and HLA-A*31:01 (Europeans and Koreans) for carbamazepine, HLA-B*59:01 for methazolamide (Koreans and Japanese), and HLA-B*13:01 for dapsone (Asians). Therefore, prescreening genetic testing could prevent severe drug hypersensitivity reactions. Large-scale epidemiologic studies are required to demonstrate the usefulness and cost-effectiveness of screening tests because their efficacy is affected by the genetic differences among ethnicities.
