Rapid screening for the detection of HLA-B57 and HLA-B58 in prevention of drug hypersensitivity.
Tissue Antigens
; 78(1): 11-20, 2011 Jul.
Article
en En
| MEDLINE
| ID: mdl-21501118
HLA-B57 and HLA-B58 are major histocompatibility class (MHC)-I allotypes that are potentially predictive of important clinical immune phenotypes. HLA-B*5701 is strongly associated with hypersensitivity to the HIV drug abacavir, liver toxicity from the antibiotic flucloxacillin and is a marker for slow progression of HIV AIDS. HLA-B*5801 is associated with hypersensitivity to allopurinol used to treat hyperuricaemia and recurrent gout. Here we describe a monoclonal antibody (mAb) specific for HLA-B57 and HLA-B58 that provides an inexpensive and sensitive screen for these MHC-I allotypes. The usefulness of HLA-B57 screening for prediction of abacavir hypersensitivity was shown in three independent laboratories, including confirmation of the mAb sensitivity and specificity in a cohort of patients enrolled in the PREDICT-1 trial. Our data show that patients who test negative by mAb screening comprise 90%-95% of all individuals in most human populations and require no further human leukocyte antigen (HLA) typing. Patients who test positive by mAb screening should proceed to high-resolution typing to ascertain the presence of HLA-B*5701 or HLA-B*5801. Hence, mAb screening provides a low-cost alternative to high-resolution typing of all patients and lends itself to point-of-care diagnostics and rapid ascertainment of low-risk patients who can begin immediate therapy with abacavir, flucloxacillin or allopurinol.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Antígenos HLA-B
/
Tamizaje Masivo
/
Hipersensibilidad a las Drogas
Tipo de estudio:
Diagnostic_studies
/
Evaluation_studies
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Prognostic_studies
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Screening_studies
Límite:
Animals
/
Humans
Idioma:
En
Revista:
Tissue Antigens
Año:
2011
Tipo del documento:
Article
País de afiliación:
Australia
Pais de publicación:
Reino Unido