HLA-A Antigens

HLA - A 抗原
  • 文章类型: Journal Article
    目的:本研究旨在阐明HLA-A,HLA-B,和HLA-DRB1等位基因及其对伊朗队列中ALL的相对风险贡献。
    方法:利用稳健的案例控制设计,这项研究涉及71例ALL患者和71例年龄和性别匹配的健康个体.使用高级PCR-SSP技术进行特定HLA等位基因的基因分型。
    结果:我们的发现显示,与对照组相比,诊断为ALL的患者中HLA-DRB1*04等位基因的患病率明显增加(P<0.027)。相反,等位基因HLA-A*26(P=0.025),HLA-A*33(P=0.020),和HLA-DRB1*03(P=0.035)在患者群体中观察到显著降低的频率。
    结论:我们的研究结果强调了HLA-DRB1*04作为增加ALL易感性的潜在遗传标记,而HLA-A*26、HLA-A*33和HLA-DRB1*03作为保护因子出现。
    OBJECTIVE: This study seeks to elucidate the association between HLA-A, HLA-B, and HLA-DRB1 alleles and their relative risk contributions to ALL within an Iranian cohort.
    METHODS: Utilizing a robust case-control design, this research involved 71 ALL patients and 71 age and sex-matched healthy individuals. Genotyping of specified HLA alleles was performed using the advanced PCR-SSP technique.
    RESULTS: Our findings reveal a marked increase in the prevalence of the HLA-DRB1*04 allele among patients diagnosed with ALL compared to the control group (P<0.027). Conversely, the alleles HLA-A*26 (P=0.025), HLA-A*33 (P=0.020), and HLA-DRB1*03 (P=0.035) were observed at significantly reduced frequencies within the patient population.
    CONCLUSIONS: Our findings highlight HLA-DRB1*04 as a potential genetic marker for increased susceptibility to ALL, while HLA-A*26, HLA-A*33, and HLA-DRB1*03 emerge as protective factors.
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  • 文章类型: Journal Article
    目的:基因成分在慢性淋巴组织增生性疾病的发生和发展中的意义一直是研究的主题。涉及这些病理的发生和进化的一些最重要的基因是HLA基因。本研究的目的是分析,第一次,罗马尼亚人群中慢性淋巴增殖性疾病与某些HLA等位基因之间可能存在关联。
    方法:本研究纳入了38例慢性淋巴增生性疾病患者,2021年至2022年在Fundeni临床研究所诊断,布加勒斯特,罗马尼亚,和50个健康对照。HLAI类和II类基因(HLA-A/B/C,通过使用序列特异性引物(SSP)进行高分辨率基因分型来研究HLA-DQB1/DPB1/DRB1)。
    结果:一些HLA等位基因与慢性淋巴增生性疾病密切相关。最重要的发现是HLA-C*02:02(p=0.002,OR=1.101),和HLA-C*12:02(p=0.002,OR=1.101)在慢性淋巴增生性疾病的发展中具有易感作用。此外,我们确定HLA-A*11:01(p=0.01,OR=0.16),HLA-B*35:02(p=0.037,OR=0.94),HLA-B*81:01(p=0.037,OR=0.94),HLA-C*07:02(p=0.036,OR=0.34),HLA-DRB1*11:01(p=0.021,OR=0.19),和HLA-DRB1*13:02(p=0.037,OR=0.94),等位基因具有保护作用。
    结论:我们的研究表明,HLA-C*02:02和HLA-C*12:02与罗马尼亚患者的慢性淋巴增生性疾病呈正相关,而HLA-DRB1*11:01,HLA-DRB1*13:02和HLA-B*35:02等位基因对这些疾病具有保护作用。
    The implications of the genetic component in the initiation and development of chronic lymphoproliferative disorders have been the subject of intense research efforts. Some of the most important genes involved in the occurrence and evolution of these pathologies are the HLA genes. The aim of this study is to analyze, for the first time, possible associations between chronic lymphoproliferative diseases and certain HLA alleles in the Romanian population.
    This study included 38 patients with chronic lymphoproliferative disorders, diagnosed between 2021 and 2022 at Fundeni Clinical Institute, Bucharest, Romania, and 50 healthy controls. HLA class I and class II genes (HLA-A/B/C, HLA-DQB1/DPB1/DRB1) were investigated by doing high resolution genotyping using sequence specific primers (SSP).
    Several HLA alleles were strongly associated with chronic lymphoproliferative disorders. The most important finding was that the HLA-C*02:02 (p = 0.002, OR = 1.101), and HLA-C*12:02 (p = 0.002, OR = 1.101) have a predisposing role in the development of chronic lymphoproliferative disorders. Moreover, we identified that HLA-A*11:01 (p = 0.01, OR = 0.16), HLA-B*35:02 (p = 0.037, OR = 0.94), HLA-B*81:01 (p = 0.037, OR = 0.94), HLA-C*07:02 (p = 0.036, OR = 0.34), HLA-DRB1*11:01 (p = 0.021, OR = 0.19), and HLA-DRB1*13:02 (p = 0.037, OR = 0.94), alleles have protective roles.
    Our study indicates that HLA-C*02:02 and HLA-C*12:02 are positively associated with chronic lymphoproliferative disorders for our Romanian patients while HLA-DRB1*11:01, HLA-DRB1*13:02, and HLA-B*35:02 alleles have a protective role against these diseases.
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  • 文章类型: Journal Article
    背景:作为一种新兴的大流行性疾病,COVID-19涵盖了一系列临床诊断,从普通感冒到严重的呼吸道综合症。考虑到证据表明人类白细胞抗原(HLA)等位基因多样性与传染病易感性之间的关系的碎片,本研究旨在确定伊朗受试者中HLA等位基因与COVID-19严重程度的相关性.
    方法:在本病例对照研究中,共有200名无关个体(病例组包括100名重症COVID-19患者,平均年龄55.54岁,并招募100名平均年龄48.97岁的轻度COVID-19患者作为对照组),和HLA分型(基因座A,B,和DR)使用Olerup序列特异性寡核苷酸(SSO)HLA分型试剂盒进行。
    结果:我们的结果表明,在重症COVID-19病例中,HLA-A*11和HLA-DRB1*14等位基因更为常见,而HLA-B*52在轻度病例中更为常见,这与以前的一些研究一致。
    结论:我们的结果证实了HLA等位基因与COVID-19结局相关的证据。我们发现HLA-A*11和HLA-DRB1*14等位基因可能是严重COVID-19的易感因素,而HLA-B*52可能是保护因素。这些发现为COVID-19的发病机制提供了新的见解,并有助于患者管理。
    BACKGROUND: As an emerging pandemic disease, COVID-19 encompasses a spectrum of clinical diagnoses, from the common cold to severe respiratory syndrome. Considering the shreds of evidence demonstrating the relationship between human leukocyte antigen (HLA) allele diversity and infectious disease susceptibility, this study was conducted to determine the association of HLA alleles with COVID-19 severity in Iranian subjects.
    METHODS: In this case-control study, a total of 200 unrelated individuals (consisting of 100 people with severe COVID-19 and an average age of 55.54 as the case group, and 100 patients with mild COVID-19 with an average age of 48.97 as the control group) were recruited, and HLA typing (Locus A, B, and DR) was performed using the Olerup sequence-specific oligonucleotide (SSO) HLA-typing kit.
    RESULTS: Our results showed that HLA-A*11 and HLA-DRB1*14 alleles were more frequently observed in severe COVID-19 cases, while HLA-B*52 was more common in mild cases, which was in agreement with some previous studies.
    CONCLUSIONS: Our results confirmed the evidence for the association of HLA alleles with COVID-19 outcomes. We found that HLA-A*11 and HLA-DRB1*14 alleles may be susceptibility factors for severe COVID-19, while HLA-B*52 may be a protective factor. These findings provide new insight into the pathogenesis of COVID-19 and help patient management.
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  • 文章类型: Journal Article
    背景:急性白血病(AL)构成了一组具有多因素起源的恶性血液病。某些人类白细胞等位基因(HLA)可能是急性髓性白血病(AML)和急性淋巴细胞白血病(ALL)发展的重要遗传风险因素。尚不清楚ALL和AML与主要组织相容性复合体的某些等位基因之间是否存在关系。我们的研究特别针对阿尔及利亚西部和西南部人群。
    方法:使用聚合酶链反应与序列特异性探针(PCR-SSP)方法,我们调查了163名阿尔及利亚AL患者和293名同一种族对照组的HLA-B等位基因之间的关系.该研究从2013年至2020年进行。
    结果:与对照组相比,AL患者中HLA-B*27和HLA-B*58的等位基因频率更高;分别为p=0.05和p=0.03。有趣的是,所有携带HLA-B*27等位基因的患者和88%携带HLA-B*58等位基因的患者均患有AML.然而,当我们将这些结果与其余AL组(HLA-B*X等位基因)进行比较时,没有显着差异(p=0.387)。两组患者对诱导化疗治疗的反应分别为67%和65%(p=0.978)。
    结论:这些结果表明,HLA-B*27和HLA-B*58可能是诱发个体急性白血病的因素,阿尔及利亚西部和西南部的病人。仍然需要大规模的研究来证实这些发现。
    Acute leukemia (AL) constitutes a group of malignant hematological diseases with multifactor origins. Some human leukocyte alleles (HLA) may be important genetic risk factors for development of acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). It is still unknown whether there is a relationship between ALL and AML with some alleles of the major histocompatibility complex. Our study looks specifically at western and southwest Algerian populations.
    Using the polymerase chain reaction with the sequence specific probe (PCR- SSP) method, we investigated the relationship of HLA-B alleles in 163 Algerian AL patients and 293 controls from the same ethnic origin. The study ran from 2013 - 2020.
    Allele frequencies of HLA-B*27 and HLA-B*58 was higher in AL patients compared with control individuals; p=0.05 and p=0.03 respectively. Interestingly, all patients carrying HLA-B*27 allele and 88% of patients carrying HLA-B*58 allele had AML. However, there were no significant differences when we compared these results with the rest of AL group (HLA-B*X allele) (p=0.387). Response to induction chemotherapy treatment were comparable between the two patient groups 67% and 65% (p=0.978) respectively.
    These results suggest that the HLA-B*27 and HLA-B*58, may be factors predisposing individuals to acute leukemia, in west and southwest Algerian patients. A large-scale study is still needed to confirm these findings.
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  • 文章类型: Journal Article
    背景:人类白细胞抗原(HLA)等位基因频率与各种自身免疫性疾病的发病机理有关。
    方法:我们招募了31名印度获得性皮肤黄斑色素沉着(ADMH)患者和60名无关患者,年龄和性别匹配的健康对照。经过病史和临床检查,收集EDTA小瓶中的5ml血液。对这些样品进行DNA提取和HLAA的表达,B,C,DR,DQ-A,并对DQ-B进行了研究。
    结果:女性的性别比例为23:8,最常见的光型是FitzpatrickIV型(83.9%)。HLAA*03:01有显著关联(OR:5.8,CI:1.7-17.0,P=0.005),HLAB*07:02(OR:5.3,CI:1.9-14.6,P=0.003),HLAC*07:02(OR:4.3,CI:1.8-9.6,P=0.001),HLADRB1*10:01(OR:7.6,CI:1.7-38.00,P=0.022),与对照组相比,患者的HLADRB1*15:02(OR:31.0,CI:4.4-341.8,P<0.001),与对照组相比,HLADQB*03:01与患者的相关性较低(OR:0.2,CI:0.0-0.6,P=0.009)。
    结论:ADMH患者更可能具有HLAA*03:01,HLAB07*02,HLAC*07:02,HLADRB1*10:01,HLADRB1*15:02,而不太可能具有HLADQB*03:01等位基因。因此,可以进行更大的队列研究,研究这些特定的等位基因。
    BACKGROUND: Human leukocyte antigen (HLA) allele frequencies have a known association with the pathogenesis of various autoimmune diseases.
    METHODS: We recruited 31 Indian patients of acquired dermal macular hyperpigmentation (ADMH) and 60 unrelated, age-and-gender-matched healthy controls. After history and clinical examination, 5 ml of blood in EDTA vials was collected. These samples were subjected to DNA extraction and the expression of HLA A, B, C, DR, DQ-A, and DQ-B was studied.
    RESULTS: There was a predominance of females with a gender ratio of 23 : 8 and the most common phototype was Fitzpatrick type IV (83.9%). There was a significant association of HLA A*03:01 (OR: 5.8, CI: 1.7-17.0, P = 0.005), HLA B*07:02 (OR: 5.3, CI: 1.9-14.6, P = 0.003), HLA C*07:02 (OR: 4.3, CI: 1.8-9.6, P = 0.001), HLA DRB1*10:01 (OR: 7.6, CI: 1.7-38.00, P = 0.022), and HLA DRB1*15:02 (OR: 31.0, CI: 4.4-341.8, P < 0.001) with patients compared to controls, whereas HLA DQB*03:01 was less associated with patients compared to controls (OR: 0.2, CI: 0.0-0.6, P = 0.009).
    CONCLUSIONS: Patients with ADMH are more likely to have the HLA A*03:01, HLA B 07*02, HLA C*07:02, HLA DRB1*10:01, HLA DRB1*15:02 and less likely to have the HLA DQB*03:01 allele. Larger cohort studies may thus be conducted studying these specific alleles.
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  • 文章类型: Journal Article
    长型Covid-19综合征(LCS)表现出广泛的临床症状,然而,与LCS相关的因素仍然知之甚少。当前的研究旨在调查人口统计学特征,临床病史,实验室指标,HLA-I等位基因的频率与发展LCS的可能性有关。我们从88例LCS病例(LCS组)和96例无LCS患者(LCS组)的病历中提取了人口统计学特征和临床病史。此外,我们评估了临床症状,血清白细胞介素(IL)-6和肿瘤坏死因子-α,实验室参数,和HLA-I等位基因的频率。之后,我们使用多元逻辑回归来研究这些变量与LCS的关联。LCS+组的受试者更有可能出现严重的新冠肺炎症状,并且体重指数(BMI)更高,白细胞,淋巴细胞计数,C反应蛋白(CRP),IL-6水平高于LCS组(P<0.05)。此外,LCS+组HLA-A*11、-B*14、-B*38、-B*50和-C*07等位基因频率较高(P<0.05)。调整最重要的变量后,患LCS的可能性与BMI显著相关,CRP,IL-6、HLA-A*11和-C*07等位基因,以及严重Covid-19的阳性病史(全部:P<0.05)。我们的研究表明,在疾病的急性期有严重的新冠肺炎病史,HLA-A*11和-C*07等位基因,BMI较高,以及血清CRP和IL-6水平升高,都与LCS的可能性增加有关。
    Long Covid-19 syndrome (LCS) manifests with a wide range of clinical symptoms, yet the factors associated with LCS remain poorly understood. The current study aimed to investigate the relationships that demographic characteristics, clinical history, laboratory indicators, and the frequency of HLA-I alleles have with the likelihood of developing LCS. We extracted the demographic characteristics and clinical histories from the medical records of 88 LCS cases (LCS+ group) and 96 individuals without LCS (LCS- group). Furthermore, we evaluated the clinical symptoms, serum levels of interleukin (IL)-6 and tumor necrosis factor-α, laboratory parameters, and the frequencies of HLA-I alleles. Following this we used multiple logistic regression to investigate the association these variables had with LCS. Subjects in the LCS+ group were more likely to have experienced severe Covid-19 symptoms and had higher body mass index (BMI), white blood cell, lymphocyte counts, C-reactive protein (CRP), and IL-6 levels than those in the LCS- group (for all: P < 0.05). Moreover, the frequencies of the HLA-A*11, -B*14, -B*38, -B*50, and -C*07 alleles were higher in the LCS+ group (for all: P < 0.05). After adjusting for the most important variables, the likelihood of suffering from LCS was significantly associated with BMI, CRP, IL-6, the HLA-A*11, and -C*07 alleles, as well as a positive history of severe Covid-19 (for all: P < 0.05). Our study showed that a history of severe Covid-19 during the acute phase of the disease, the HLA-A*11, and -C*07 alleles, higher BMI, as well as elevated serum CRP and IL-6 levels, were all associated with an increased likelihood of LCS.
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  • 文章类型: Journal Article
    主要组织相容性复合体(MHC)基因座,人类基因组中最多态的区域,编码负责抗原呈递和CD4+和CD8+细胞活化的蛋白质复合物。在前列腺癌(PCa)中,男性人群中第二大被诊断出的癌症,MHC基因座的表达模式发生显著变化,影响免疫系统攻击和消除恶性细胞的能力。目的通过利用NGS技术进行HLA基因分型,探讨PCa患者和健康对照者(HCs)人类白细胞抗原(HLA)-A和HLA-B的遗传多样性。该分析突出了三个等位基因(A*11:01、A*24:02和B*18:01)的患病率的统计学显著差异(p<0.05)。在分析的HC中,14.89%为A*11:01,20.21%为A*24:02,30.61%为B*18:01;而5.21%的PCa患者呈现A*11:01,9.38%呈现A*24:02,18.08%呈现B*18:01。比值比(OR)计算强调了三个等位基因与PCa风险之间的负相关(OR<1)。本研究中呈现的结果表明A*11:01、A*24:02和B*18:01在PCa中具有保护作用。
    The major histocompatibility complex (MHC) loci, the most polymorphic regions within the human genome, encode protein complexes responsible for antigen presentation and CD4+ and CD8+ cell activation. In prostate cancer (PCa), the second most diagnosed cancer in the male population, MHC loci undergo significant changes in their expression patterns, which affect the ability of the immune system to attack and eliminate malignant cells. The purpose of this study was to explore the genetic diversity of human leukocyte antigen (HLA)-A and HLA-B in patients with PCa and healthy controls (HCs) by performing HLA genotyping using NGS technology. The analysis highlighted statistically significant differences (p < 0.05) in the prevalence of three alleles (A*11:01, A*24:02, and B*18:01). Among the HCs analyzed, 14.89% had A*11:01, 20.21% had A*24:02, and 30.61% had B*18:01; while 5.21% of patients with PCa presented A*11:01, 9.38% presented A*24:02, 18.08% presented B*18:01. Odds ratio (OR) calculations underlined a negative association between the three alleles and the risk of PCa (OR < 1). The results presented in this study suggest a protective role of A*11:01, A*24:02, and B*18:01 in PCa.
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    文章类型: Case Reports
    Stevens-Johnson综合征是一种严重的药疹,其特点是起病快、进展快。如果不及时治疗,它可以发展成毒性表皮坏死松解症,甚至危及生命.常见的致敏药物包括磺胺,卡马西平,等。在中国,卡马西平引起Stevens-Johnson综合征的报道和研究主要集中在HLA-B*1502基因,没有HLA-A*3101基因阳性的报道。我们报道了一例由卡马西平引起的HLA-A*3101基因阳性的史蒂文斯-约翰逊综合征患者。她服用卡马西平治疗三叉神经痛,以前从未服用过这种药物。2周后,躯干和四肢逐渐出现丘疹和水肿样红斑,表面水泡和痂,和口头,眼睛,外阴粘膜出现糜烂,伴有发烧和疼痛,面积约为3%的去角质。她被诊断出患有史蒂文斯-约翰逊综合征,并于2020年3月24日入住北京大学第三医院。入院后,为了确定致敏药物,我们对她进行了卡马西平相关药物的基因测试。结果显示HLA-A*3101基因阳性,HLA-B*1502和HLA-B*5801基因均为阴性。在治疗方面,患者被系统地给予300mg英夫利昔单抗的单次静脉输注,以及口腔的对症治疗和护理,眼睛,和外阴粘膜。6天后,躯干和四肢的皮疹消退,粘膜恢复正常并出院。检索国内外文献,报道卡马西平引起药疹并不少见,包括严重的药疹,HLA基因分型的致病性存在明显的种族差异。在中国和亚洲,卡马西平导致Stevens-Johnson综合征的试验结果强调,这些不良反应与HLA-B*1502基因密切相关.然而,在欧洲和日本,患有这种疾病的人与HLA-A*3101基因有很强的相关性。在这个案例报告中,HLA-B*1502基因为阴性,HLA-A*3101基因为阳性.这是国内首次报道卡巴-马西平引起史蒂文斯-约翰逊综合征HLA-A*3101阳性。该报告提醒,除HLA-B*1502基因外,还应认真对待HLA-A*3101基因的检测。
    Stevens-Johnson syndrome is a type of severe drug eruption, which is characterized by rapid onset and rapid progress. If not treated in time, it can develop into toxic epidermal necrolysis, even life-threatening. Common sensitizing drugs include sulfa, carbamazepine, etc. In China, reports and studies of carbamazepine causing Stevens-Johnson syndrome mainly focus on the HLA-B * 1502 gene, and there are no reports of HLA-A * 3101 gene positive. We reported a patient who got Stevens-Johnson syndrome with HLA-A * 3101 gene positive caused by carbamazepine. She took carbamazepine for trigeminal neuralgia and had never taken the drug before. After 2 weeks, papules and edematous target-like erythema gradually appeared on the trunk and limbs, surface blisters and scabs, and the oral, eyes, and vulvar mucosa appeared erosion, accompanied by fever and pain, with an area of about 3% exfoliation. She was diagnosed with Stevens-Johnson syndrome and admitted to Peking University Third Hospital on March 24, 2020. After admission, in order to identify the sensitizing drugs, We performed a genetic test on her for carbamazepine-related drugs. The results showed that the HLA-A * 3101 gene was positive, and the HLA-B * 1502 and HLA-B * 5801 genes were negative. In terms of treatment, the patient was systematically given a single intravenous infusion of 300 mg of infliximab, and symptomatic treatment and care of the oral, eye, and vulvar mucosa. After 6 days, the rash on the trunk and limbs subsided, and the mucosa returned to normal and was discharged from the hospital. Retrieving domestic and foreign literature, it is not uncommon to report that carbamazepine causes drug eruption, including severe drug eruption, and there are obvious ethnic differences in the pathogenicity of HLA genotyping. In China and Asia, stu-dies on carbamazepine causing Stevens-Johnson syndrome emphasized that the adverse reactions were strongly related to the HLA-B * 1502 gene. However, there is a strong correlation with HLA-A * 3101 gene in people suffering from the disease in Europe and Japan. In this case report, the HLA-B * 1502 gene was negative and the HLA-A * 3101 gene was positive. This is the first domestic report that carba-mazepine causes HLA-A * 3101 positive for Stevens-Johnson syndrome. This report reminds that HLA-A * 3101 gene testing should be taken seriously besides HLA-B * 1502 gene.
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  • 文章类型: Observational Study
    在这项观察性病例对照研究中,确定了107例皮肤不良反应(CAR)病例(CAR)在开始抗癫痫药物(ASM)治疗后长达12周出现。对照组包括98名没有CAR(CAR-)病史的癫痫患者和巴西国家骨髓捐献者注册中的3965名健康个体。所有参与者均通过高分辨率下一代HLA-A测序进行HLA分型,B,C,DQB1和DRB1;HLA-DPA1、DPB1、DQA1、DRB3、DRB4和DRB5也在来自CAR+和CAR-个体的样品中测序。各等位基因的载波频率之间的关系,对所有参与者的CAR类型和ASM进行了调查。与CAR最常见相关的ASM是卡马西平(占CAR+受试者的48%),拉莫三嗪(23%),苯妥英(18%),苯巴比妥(13%)和奥卡西平(5%)。与CAR风险相关的主要等位基因是HLA-A*02:05(OR=6.28;p=0.019,卡马西平或奥卡西平);HLA-DPA1*02:02(OR=4.16,p=0.003,卡马西平);HLA-B*53:01(OR=47.9,p=0.014,卡西平),HLA-DPA1*03:01/DPB1*105:01(OR=25.7,p=0.005,苯巴比妥);HLA-C*02:10(OR=25.7,p=0.005,苯巴比妥)和HLA-DRB1*04:02(OR=17.22,p=0.007,苯妥英)。HLA-A*03:01增加苯妥英钠诱导的斑丘疹性出斑的风险4.71倍(p=0.009),HLA-B*35:02与卡马西平诱导的Stevens-Johnson综合征的风险增加25.6倍相关(p=0.005)。4170名受试者均未携带HLA-B*15:02等位基因,HLA-A*31:01与CAR无关。因此,HLA-A*31:01和HLA-B*15:02在该人群中与CAR无关。尽管测试的其他HLAI类和II类等位基因与CAR的风险相关,这些关联均不足以保证在处方ASM前进行HLA检测.
    In this observational case-control study, 107 cutaneous adverse reaction (CAR) cases (CAR+) manifesting up to 12 weeks after the start of treatment with antiseizure medication (ASM) were identified. Control groups consisted of 98 epilepsy patients without a history of CAR (CAR-) and 3965 healthy individuals in the Brazilian National Registry of Bone Marrow Donors. All participants were HLA typed by high-resolution Next Generation Sequencing for HLA-A, B, C, DQB1 and DRB1; HLA-DPA1, DPB1, DQA1, DRB3, DRB4 and DRB5 were also sequenced in samples from CAR+ and CAR- individuals. The relationship between the carrier frequency of each allele, CAR type and ASM for all participants was investigated. The ASMs most frequently associated with CAR were carbamazepine (48% of CAR+ subjects), lamotrigine (23%), phenytoin (18%), phenobarbital (13%) and oxcarbazepine (5%). The main alleles associated with a risk of CAR were HLA-A*02:05 (OR = 6.28; p = 0.019, carbamazepine or oxcarbazepine); HLA-DPA1*02:02 (OR = 4.16, p = 0.003, carbamazepine); HLA-B*53:01 (OR = 47.9, p = 0.014, oxcarbazepine), HLA-DPA1*03:01/DPB1*105:01 (OR = 25.7, p = 0.005, phenobarbital); HLA-C*02:10 (OR = 25.7, p = 0.005, phenobarbital) and HLA-DRB1*04:02 (OR = 17.22, p = 0.007, phenytoin). HLA-A*03:01 increased the risk for phenytoin-induced maculopapular exanthema 4.71-fold (p = 0.009), and HLA-B*35:02 was associated with a 25.6-fold increase in the risk of carbamazepine-induced Stevens-Johnson syndrome (p = 0.005). None of the 4170 subjects carried the HLA-B*15:02 allele, and HLA-A*31:01 was not associated with CAR. Hence, HLA-A*31:01 and HLA-B*15:02 were not associated with CAR in this population. Although other HLA class I and II alleles tested were associated with a risk of CAR, none of these associations were strong enough to warrant HLA testing before prescribing ASM.
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  • 文章类型: Case Reports
    造血干细胞移植(HSCT)治疗恶性淋巴瘤后肾移植的报道尤其少,在接受不同供者HSCT肾移植的患者中,没有一例报告良好的结局。在这份报告中,我们描述了第一例从不同供体到HSCT的肾移植成功的结果.此外,我们回顾了以前报告的病例。一名59岁的女性患者在接受恶性淋巴瘤化疗后接受了弟弟的HSCT。在HSCT之后,她没有需要维持治疗的移植物抗宿主病(GVHD).患者出现慢性肾病,需要肾脏替代治疗,可能是由于药物毒性或心肾综合征。65岁时,她接受了ABO兼容,HLA-A,-B,-DR5/6与她丈夫的肾移植不匹配。他克莫司免疫抑制治疗,霉酚酸酯,甲基强的松龙,并给予巴利昔单抗。患者在7天出现尿路感染,9周,肾移植后4个月,肾移植后9周巨细胞病毒抗原血症,用抗生素和伐更昔洛韦改善了,分别。每次感染发生时,我们削弱了免疫抑制疗法.肾移植4年后,患者临床状况良好,血清肌酐为1.2mg/dL,没有严重感染或恶性肿瘤。在这种情况下,我们认为优化免疫抑制治疗非常重要。此外,根据对以前案件的回顾,似乎重要的是,没有需要维持治疗以防止过度免疫抑制的GVHD.
    There are particularly few reports on kidney transplantation after hematopoietic stem cell transplantation (HSCT) for malignant lymphoma, and none of the cases reported a favorable outcome in patients who received kidney transplantation from a different donor to HSCT. In this report, we describe the first case of kidney transplantation from a different donor to HSCT with a successful outcome. Furthermore, we reviewed the previously reported cases. A 59-year-old female patient received an HSCT from her younger brother after chemotherapy for malignant lymphoma. After HSCT, she did not have graft-versus-host disease (GVHD) requiring maintenance treatment. The patient developed chronic kidney disease requiring kidney replacement therapy, probably due to drug toxicity or cardio-renal syndrome. At age 65, she underwent an ABO-compatible, HLA-A, -B, -DR 5/6 mismatched kidney transplantation from her husband. Immunosuppressive therapy with tacrolimus, mycophenolate mofetil, methylprednisolone, and basiliximab was administered. The patient had urinary tract infections at 7 days, 9 weeks, and 4 months after kidney transplantation, and cytomegalovirus antigenemia at 9 weeks after kidney transplantation, which improved with antibiotic and valganciclovir, respectively. When each infection occurred, we weakened immunosuppressive therapy. Four years after kidney transplantation, the patient is in good clinical condition with a serum creatinine of 1.2 mg/dL, without critical infection or malignancy. In this case, we believe that it was important to optimize the immunosuppressive therapy. In addition, from a review of previous cases, it seemed important that there was no GVHD requiring maintenance therapy in order to prevent excessive immunosuppression.
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