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Nguyen DV, Vida C, Chu HC, et al. Validation of a Rapid, Robust, Inexpensive Screening Method for Detecting the HLA-B*58:01 Allele in the Prevention of Allopurinol-Induced Severe Cutaneous Adverse Reactions. Allergy Asthma Immunol Res. 2017;9(1):79-84doi: 10.4168/aair.2017.9.1.79.
Nguyen, D. V., Vida, C., Chu, H. C., Fulton, R., Li, J., & Fernando, S. L. (2017). Validation of a Rapid, Robust, Inexpensive Screening Method for Detecting the HLA-B*58:01 Allele in the Prevention of Allopurinol-Induced Severe Cutaneous Adverse Reactions. Allergy, asthma & immunology research, 9(1), 79-84. https://doi.org/10.4168/aair.2017.9.1.79
Nguyen, Dinh Van, et al. "Validation of a Rapid, Robust, Inexpensive Screening Method for Detecting the HLA-B*58:01 Allele in the Prevention of Allopurinol-Induced Severe Cutaneous Adverse Reactions." Allergy, asthma & immunology research vol. 9,1 (2017): 79-84. doi: https://doi.org/10.4168/aair.2017.9.1.79
Nguyen DV, Vida C, Chu HC, Fulton R, Li J, Fernando SL. Validation of a Rapid, Robust, Inexpensive Screening Method for Detecting the HLA-B*58:01 Allele in the Prevention of Allopurinol-Induced Severe Cutaneous Adverse Reactions. Allergy Asthma Immunol Res. 2017 Jan;9(1):79-84. doi: 10.4168/aair.2017.9.1.79. PMID: 27826965; PMCID: PMC5102839.
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Allergy Asthma Immunol Res. 2017 Jan;9(1):79-84. doi: 10.4168/aair.2017.9.1.79.

Validation of a Rapid, Robust, Inexpensive Screening Method for Detecting the HLA-B*58:01 Allele in the Prevention of Allopurinol-Induced Severe Cutaneous Adverse Reactions.

Allergy, asthma & immunology research

Dinh Van Nguyen, Christopher Vida, Hieu Chi Chu, Richard Fulton, Jamma Li, Suran L Fernando

Affiliations

  1. Sydney Medical School - Northern, University of Sydney, Sydney, Australia.
  2. ImmunoRheumatology Laboratory, Pathology North-Northern Sydney, St Leonards, Australia.
  3. Department of Allergy and Clinical Immunology, Hanoi Medical University, Hanoi, Vietnam. [email protected].
  4. ImmunoRheumatology Laboratory, Pathology North-Northern Sydney, St Leonards, Australia. [email protected].
  5. Center of Allergology and Clinical Immunology, Bach Mai Hospital, Hanoi, Vietnam.
  6. Department of Clinical Immunology and Allergy, Royal North Shore Hospital, Sydney, Australia.

PMID: 27826965 PMCID: PMC5102839 DOI: 10.4168/aair.2017.9.1.79

Abstract

The HLA B*58:01 allele has been worldwide reported as a pharmacogenetic susceptibility to allopurinol-induced severe cutaneous adverse reactions (SCARs). To prevent these life-threatening conditions, the American College of Rheumatology hingly recommended that the HLA-B*58:01 be screened prior to the initiation of allopurinol therapy. Therefore, we developed a rapid, robust, inexpensive screening method using SYBR® Green real time PCR to detect the HLA-B*58:01 allele. A total of 119 samples were tested. The assay has a sensitivity of 100% (95% CI: 69.15%-100%), a specificity of 100% (95% CI: 96.67%-100%), a positive predictive value of 100% (95% CI: 69.15%-100%) and a negative predictive value of 100% (95% CI: 96.67%-100%). HLA-B*58:01 genotyping results showed 100% agreement with those obtained from Luminex SSO/SBT/SSP. The lowest limit of detection of this method is 0.8 ng/μL of DNA. The unit cost of the test is only $3.8 USD. This novel screening test using SYBR® real time PCR would be appropriate to identify individuals with the HLA-B*58:01 allele for the prevention of allopurinol-induced SCARs.

Keywords: Allopurinol hypersensitivity; HLA-B antigens; Stevens Johnson syndrome; drug reactions with eosinophilia and systemic symptoms; real time polymerase chain reaction; severe cutaneous adverse reactions; toxic epidermal necrolysis

Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

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