HLA-DRB genotype and specific IgE responses in patients with allergies to penicillins

• Published in: Chinese medical journal Vol. 119; no. 6; pp. 458 - 466
• Main Authors: Yang, Jing, Qiao, Hai-ling, Zhang, Yue-wen, Jia, Lin-jing, Tian, Xin, Gao, Na
• Format: Journal Article
• Language: English
• Published: China Department of Clinical Pharmacology, School of Medicine, Zhengzhou University, Zhengzhou 450052, China 20.03.2006
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Alleles; Child; Child, Preschool; Drug Hypersensitivity - genetics; Drug Hypersensitivity - immunology; Female; Genotype; HLA-DR Antigens - genetics; Humans; IgE; Immunoglobulin E - blood; Male; Middle Aged; Penicillins - adverse effects; Penicillins - immunology; 变态反应; 基因型; 青霉素; hypersensitivity; HLA-DRB gene; immunoglobulin E; penicillins
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/00029330-200603020-00005

Background Because of the pivotal role of the human leukocyte antigen （HLA） class II molecules in regulating the immune response and their extensive polymorphism, it is not surprising that particular HLA class II alleles have been implicated in susceptibility to allergic diseases and in restriction of the IgE responses to a variety of allergens. We investigated the relationship between HLA-DRB genotype and allergies to various penicillins and explored HLA-DRB restriction of IgE responses to these derivatives of penicillin. Methods Radioallergosorbent test was used to examine 8 kinds of specific IgE antibodies （4 major and 4 minor antigenic determinants） in the sera of 248 patients with an allergy to penicillins and 101 healthy subjects without any allergic reaction. Some （113 patients and 87 healthy control subjects） were chosen from all subjects to type for HLA-DRB alleles by sequence specific primer-polymerase chain reaction. Results Compared with control subjects, a sign/ficantly increased frequency of DR9 was present in 77 patients with allergic reactions, with immediate hypersensitive reaction and with urticaria （P = 0.011; P = 0.019; P = 0.005 respectively）. Conversely, a significantly decreased frequency of DR14.1 was found in 80 patients with positive IgE antibodies, with immediate reaction and with urticaria compared with control group （P = 0.024; P = 0.038; P = 0.038）. A possible excess of HLA-DR17 was found in subjects who were responsive to benzylpenicilloyl compared with those were not （X^2 = 5.134, P = 0.023）, and of HLA-DR4 was found in subjects responsive to phenoxomethylpenicillanyl （PVA, X^2 = 4.057, P = 0.044）. Conclusion I-ILA-DRB gene may be involved in allergy to pcnicillins through modulating spvcific serum IgE to penicillins.