RESUMO
Stevens-Johnson syndrome (SJS) and its severe variant, toxic epidermal necrolysis (TEN), are acute inflammatory vesiculobullous reactions of the skin and mucous membranes. Cold medicines including non-steroidal anti-inflammatory drugs and multi-ingredient cold medications are reported to be important inciting drugs. Recently, we reported that cold medicine related SJS/TEN (CM-SJS/TEN) with severe mucosal involvement including severe ocular surface complications (SOC) is associated with HLA-A*02:06 and HLA-B*44:03 in the Japanese. In this study, to determine whether HLA-B*44:03 is a common risk factor for CM-SJS/TEN with SOC in different ethnic groups we used samples from Indian, Brazilian, and Korean patients with CM-SJS/TEN with SOC, and investigated the association between CM-SJS/TEN with SOC and HLA-B*44:03 and/or HLA-A*02:06. We found that HLA-B*44:03 was significantly associated with CM-SJS/TEN with SOC in the Indian and Brazilian but not the Korean population, and that HLA-A*02:06 might be weakly associated in the Korean- but not the Indian and Brazilian population.
Assuntos
Síndromes do Olho Seco/genética , Antígeno HLA-A2/genética , Antígeno HLA-B44/genética , Síndrome de Stevens-Johnson/genética , Triquíase/genética , Adolescente , Adulto , Alelos , Anti-Inflamatórios não Esteroides/efeitos adversos , Brasil , Criança , Síndromes do Olho Seco/etnologia , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/imunologia , Epitélio Corneano/imunologia , Epitélio Corneano/patologia , Etnicidade , Feminino , Frequência do Gene , Antígeno HLA-A2/imunologia , Antígeno HLA-B44/imunologia , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Medicamentos Compostos contra Resfriado, Influenza e Alergia/efeitos adversos , República da Coreia , Epitélio Pigmentado da Retina/imunologia , Epitélio Pigmentado da Retina/patologia , Fatores de Risco , Síndrome de Stevens-Johnson/etnologia , Síndrome de Stevens-Johnson/etiologia , Síndrome de Stevens-Johnson/imunologia , Triquíase/etnologia , Triquíase/etiologia , Triquíase/imunologiaRESUMO
Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) are rare, but potentially life-threatening diseases, characterized by widespread epidermal necrosis and are predominantly drug induced. There is a paucity of data regarding the role of cytokine and cytokine receptors polymorphisms in the pathoimmunology of SJS/TEN. The aim of this study was to investigate the role of TNF-α-308, IFN-γ +874, IL-10-1082, IL-13 Arg130Gln, and IL-4R Gln551Arg gene polymorphisms in SJS/TEN in Mexican Mestizo patients. Twenty-nine unrelated SJS/TEN patients and 128 unrelated healthy individuals were studied. Genomic extraction was carried out from complete blood samples using the salting out method. The PCR-RFLP method was used to amplify the following polymorphisms: TNF-α-308, IFN-γ +874, IL-10-1082, IL-13 Arg130Gln, and IL-4R Gln551Arg. TNF-α-308, IL-10-1082, IL-13 Arg130Gln, and IL-4R Gln551Arg polymorphisms were not associated with the genetic susceptibility to SJS/TEN. The distribution of TT, TA, AA genotypes of IFN-γ +874 was significantly different in SJS/TEN patients compared with controls (pC = 0.012). TA and AA genotypes were grouped to highlight the differences between patients and controls given by the absence of the AA genotype in the group of patients (pC = 0.03, OR = 3.61 95 % CI 1.20-11.6). This preliminary study suggests that IFN-γ +874 T/A polymorphism is associated with SJS/TEN.