HLA and Delayed Drug-Induced Hypersensitivity

Int Arch Allergy Immunol. 2016;170(3):163-79. doi: 10.1159/000448217. Epub 2016 Aug 26.

Abstract

Delayed drug allergy reactions (DDAR) are potentially fatal. Certain human leukocyte antigen (HLA) alleles have been associated with delayed allergy reactions following the administration of particular drugs. Examples are HLA-B*57:01 (abacavir), HLA-B*15:02/HLA-A*31:01 (carbamazepine), and HLA-B*58:01 (allopurinol). Based on the identification of these associations, it may now be possible to prevent certain allergy reactions that were, until recently, considered unpredictable. In this review, we will focus on the pharmacogenetics of the best-studied associations between specific HLA alleles and delayed allergy reactions and describe the pathogenesis models proposed so far. Finally, we will evaluate the genetic screening strategies available and discuss the clinical relevance of a better understanding of the immunogenetics and mechanisms involved in DDAR.

Publication types

  • Review

MeSH terms

  • Alleles
  • Anticonvulsants / adverse effects
  • Antiviral Agents / adverse effects
  • Disease Susceptibility
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / genetics
  • Drug Hypersensitivity / immunology*
  • Drug Hypersensitivity Syndrome / genetics
  • Drug Hypersensitivity Syndrome / immunology
  • Female
  • Genetic Testing
  • HLA Antigens / genetics
  • HLA Antigens / immunology*
  • Haptens / immunology
  • Humans
  • Hypersensitivity, Delayed / diagnosis
  • Hypersensitivity, Delayed / genetics
  • Hypersensitivity, Delayed / immunology*
  • Male
  • Odds Ratio
  • Receptors, Immunologic / metabolism
  • Stevens-Johnson Syndrome / genetics
  • Stevens-Johnson Syndrome / immunology
  • Virus Diseases / immunology
  • Virus Diseases / virology
  • Viruses / immunology

Substances

  • Anticonvulsants
  • Antiviral Agents
  • HLA Antigens
  • Haptens
  • Receptors, Immunologic