Neil H. Shear, Antonino Romano, Anca Mirela Chiriac, Matthew R. Nelson, Peter S. Friedmann, Alla Nakonechna, Rocco Luigi Valluzzi, S. Barrett, Jose A. Cornejo-Garcia, Miguel Blanca, Paola Nicoletti, Munir Pirmohamed, Daniel F. Carr, Pascal Demoly, Aris Floratos, Yufeng Shen, Natalia Blanca-López, Elizabeth J. Phillips, Cristiano Caruso, Laurence McEvoy, Francesco Gaeta, María José Torres, Rebecca Pavlos, Icahn School of Medicine at Mount Sinai [New York] (MSSM), SEMA4, University of Liverpool, University of Southampton, University of Toronto, Sunnybrook Health Sciences Centre, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hospital Universitario Infanta Leonor [Madrid], Instituto de Investigación Biomédica [Malaga, Spain] (IBIMA), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Columbia University [New York], The University of Western Australia (UWA), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Murdoch University, Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Oasi Maria Santissima Srl [Troina, Italy], Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Herrada, Anthony, Fondazione Policlinico Universitario Agostino Gemelli [Rome], Université de Montpellier (UM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Hospital Regional Universitario de Málaga [Spain]
International audience; Background: β-lactam antibiotics are associated with a variety of immune-mediated or hypersensitivity reactions, including immediate (type I) reactions mediated by antigen-specific IgE.Objective: We sought to identify genetic predisposing factors for immediate reactions to β-lactam antibiotics.Methods: Patients with a clinical history of immediate hypersensitivity reactions to either penicillins or cephalosporins, which were immunologically confirmed, were recruited from allergy clinics. A genome-wide association study was conducted on 662 patients (the discovery cohort) with a diagnosis of immediate hypersensitivity and the main finding was replicated in a cohort of 98 Spanish cases, recruited using the same diagnostic criteria as the discovery cohort.Results: Genome-wide association study identified rs71542416 within the Class II HLA region as the top hit (P = 2 × 10-14); this was in linkage disequilibrium with HLA-DRB1∗10:01 (odds ratio, 2.93; P = 5.4 × 10-7) and HLA-DQA1∗01:05 (odds ratio, 2.93, P = 5.4 × 10-7). Haplotype analysis identified that HLA-DRB1∗10:01 was a risk factor even without the HLA-DQA1∗01:05 allele. The association with HLA-DRB1∗10:01 was replicated in another cohort, with the meta-analysis of the discovery and replication cohorts showing that HLA-DRB1∗10:01 increased the risk of immediate hypersensitivity at a genome-wide level (odds ratio, 2.96; P = 4.1 × 10-9). No association with HLA-DRB1∗10:01 was identified in 268 patients with delayed hypersensitivity reactions to β-lactams.Conclusions: HLA-DRB1∗10:01 predisposed to immediate hypersensitivity reactions to penicillins. Further work to identify other predisposing HLA and non-HLA loci is required.