Human leucocyte antigen-adverse drug reaction associations: from a perspective of ethnicity

Int J Immunogenet. 2017 Feb;44(1):7-26. doi: 10.1111/iji.12304.

Abstract

Whilst immune-mediated adverse drug reactions (ADRs) are rare, they are potentially life-threatening and present a major problem for clinicians. The underlying mechanisms that cause ADRs are not fully understood although genomewide association studies (GWAS) and case-control investigations have associated human leucocyte antigen (HLA) alleles as risk factors. There is evidence that a patient's ethnic background can have an impact on their risk of developing an ADR. This review summarizes the evidence related to HLA alleles and ADRs with particular focus on patient ethnicity. Our analysis indicated that many of the alleles which have been associated with ADRs are found at higher frequencies in Asian populations. The data also showed that many of the alleles that are reported to be statistically significantly associated with ADRs are in linkage disequilibrium with each other and that they form haplotypes specific to certain ethnicities indicating at least some of the allele associations may not be causal.

Publication types

  • Review

MeSH terms

  • Alleles
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects*
  • Asian People
  • Bacterial Infections / drug therapy
  • Bacterial Infections / ethnology*
  • Bacterial Infections / genetics
  • Bacterial Infections / immunology
  • Epilepsy / drug therapy
  • Epilepsy / ethnology*
  • Epilepsy / genetics
  • Epilepsy / immunology
  • Ethnicity
  • Gene Expression Regulation / immunology
  • Gene Frequency
  • Genome-Wide Association Study
  • Gout Suppressants / administration & dosage
  • Gout Suppressants / adverse effects*
  • HLA Antigens / genetics
  • HLA Antigens / immunology*
  • Haplotypes
  • Humans
  • Linkage Disequilibrium
  • Rheumatic Diseases / drug therapy
  • Rheumatic Diseases / ethnology*
  • Rheumatic Diseases / genetics
  • Rheumatic Diseases / immunology
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • Anticonvulsants
  • Gout Suppressants
  • HLA Antigens