<i>HLA-B</i>
            Locus in Caucasian Patients with Carbamazepine hypersensitivity

Alfirevic, Ana; Jorgensen, Andrea; Williamson, Paula; Chadwick, David; Park, B Kevin; Pirmohamed, Munir

doi:10.2217/14622416.7.6.813

Cited by 250 publications

(152 citation statements)

References 21 publications

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“…On the other hand, a protecting effect of HLA has been suggested. Alfirevic et al 29 reported a potential protecting effect of HLA-B*0702 against carbamazepine-induced severe cutaneous adverse reactions in Caucasian patients. Functional studies together with genomic approaches are required for further progress in understanding the pathogenesis of ADR.…”

Section: Future Perspective Of Pharmacogenomics In Cutaneous Adrmentioning

confidence: 99%

Pharmacogenetics of cutaneous adverse drug reactions

Aihara

2011

The Journal of Dermatology

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Drug-induced hypersensitivity reactions are of major medical concern because they are associated with high morbidity and high mortality. In addition, individual patients' reactions are impossible to predict in each patient. In the field of severe cutaneous adverse drug reactions (cutaneous ADR) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug-induced hypersensitivity syndrome (DHIS) or drug rash with eosinophilia and systemic symptoms (DRESS), major advances have recently been gained through studies of an association between HLA alleles and drug hypersensitivity induced by specific drugs. The results of these pharmacogenomic studies allow prediction of the risk of adverse reactions in patients treated with certain drugs, including carbamazepine and other aromatic antiepileptic drugs, allopurinol and abacavir. However, different ethnic populations show variations in the genetic associations. A strong association between carbamazepine-induced SJS ⁄ TEN and HLA-B*1502 has been found in Southeast Asian patients but not in Caucasian and Japanese patients. Moderate associations between aromatic amine anticonvulsants and other HLA alleles have been proposed in Japanese patients. In contrast, HLA-B*5801 was found to be associated with allopurinol-induced cutaneous ADR, including SJS ⁄ TEN and DIHS ⁄ DRESS, in Caucasian and Asian patients, including the Japanese. These differences may, at least in part, be due to the differences in allele frequency in different ethnic populations. This article reviews the progress in pharmacogenomics, associated mainly with carbamazepine and allopurinol in different ethnic populations. Pharmacogenetic screening based on associations between adverse reactions and specific HLA alleles helps to avoid serious conditions associated with drug hypersensitivity.

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Section: Future Perspective Of Pharmacogenomics In Cutaneous Adrmentioning

confidence: 99%

Pharmacogenetics of cutaneous adverse drug reactions

Aihara

2011

The Journal of Dermatology

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“…[62] Buna karşın beyaz ırkta benzer birliktelik anlamlı görülmemiştir. [63] Medikal namaması nedeniyle yeni mekanizmalar ve hipotezler savunulmaya başlanmıştır. Rogawski ve Johnson, yakın zamanda ilgi çekici epidemiyolojik bulguları değerlendiren intrensek şiddet hipotezini ileri sürmüştür.…”

Section: İntrensek şIddet Hipotezi ("Intrinsic Severity Hypothesis")unclassified

Drug Resistance and Resistance Mechanisms in Epilepsy

Taşkıran¹

2015

Epilepsi

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SummaryEpilepsy is a commonly encountered disorder among neurological disorders in our country and in the world. Almost 30% of seizures persist in spite of medical treatment. Resistance to medical treatment is important with regard to cognitive and psychosocial problems, and increased risk in mortality and morbidity. It may emerge due to the type of epilepsy, underlying epileptogenic process, and individual differences. Immunological, genetic and plasticity-related mechanisms are most relevant. The literature related to this subject is growing constantly, and increased understanding of the underlying mechanisms of drug resistance will play an important role in the development of more efficient treatment strategies. Contributing to this body of work, this article discusses drug resistance in epilepsy, its underlying mechanisms and accompanying clinical issues.Key words: Resistance mechanisms; epilepsy; drug resistance; pseudoresistance. ÖzetEpilepsi ülkemizde ve dünyada sık görülen nörolojik hastalıklardan biridir. Hastaların yaklaşık %30'unda nöbetler ilaç tedavisine rağmen devam etmektedir. Tedaviye direnç kognitif ve psikososyal sorunlar ile mortalite ve morbidite riskinde artışa neden olması açısından önem taşımaktadır. Tedaviye direnç, epilepsi tipi, altta yatan epileptogenez süreci ve bireysel farklılıklar nedeni ile gelişebilir. Başlıca mekanizmalar immünolojik, genetik ve plastisite ile ilişkili olmak üzere dikkat çekmekte ve gün geçtikçe bilgi birikimimiz artmaktadır. Daha etkin tedavi ve yaklaşımlarının geliştirilebilmesi için, ilaç direncinin altında yatan mekanizmaların anlaşılması önem taşımaktadır. Bu amaçla, epilepside ilaç direnci, altta yatan mekanizmalar ile bunlara eşlik eden klinik sorunlar ele alınmıştır.

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“…Etnik kökenin, HLA allelleriyle ilişkili olmasından dolayı ilaçlara bağlı gelişen İHSS, bazı toplumlarda daha sık görülebilmektedir. HLA-B 1502 allelinin sık görüldüğü uzakdoğu ülkelerinde karbamazepine bağlı fatal İHSS olgularının sık görüldüğü bildirilmiştir (11).…”

Section: Resim1bilateral Tonsillerde Hipertrofi Ve Kriptlerunclassified