Risk-conferring HLA variants in an epilepsy cohort: Benefits of multifaceted use of whole genome sequencing in clinical practice


Vakrinou A., Bellampalli R., Gulcebi M., Martins Custodio H., Research Consortium G. E., Balestrini S., ...Daha Fazla

Journal of Neurology, Neurosurgery and Psychiatry, cilt.94, sa.11, ss.887-892, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 94 Sayı: 11
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1136/jnnp-2023-331419
  • Dergi Adı: Journal of Neurology, Neurosurgery and Psychiatry
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, Psycinfo, Veterinary Science Database
  • Sayfa Sayıları: ss.887-892
  • Anahtar Kelimeler: ALLERGY, ANTICONVULSANTS, EPILEPSY, GENETICS, HLA
  • Marmara Üniversitesi Adresli: Hayır

Özet

Background Whole genome sequencing is increasingly used in healthcare, particularly for diagnostics. However, its clinically multifaceted potential for individually customised diagnostic and therapeutic care remains largely unexploited. We used existing whole genome sequencing data to screen for pharmacogenomic risk factors related to antiseizure medication-induced cutaneous adverse drug reactions (cADRs), such as human leucocyte antigen HLA-B∗15:02, HLA-A∗31:01 variants. Methods Genotyping results, generated from the Genomics England UK 100 000 Genomes Project primarily for identification of disease-causing variants, were used to additionally screen for relevant HLA variants and other pharmacogenomic variants. Medical records were retrospectively reviewed for clinical and cADR phenotypes for HLA variant carriers. Descriptive statistics and the χ 2 test were used to analyse phenotype/genotype data for HLA carriers and compare frequencies of additional pharmacogenomic variants between HLA carriers with and without cADRs, respectively. Results 1043 people with epilepsy were included. Four HLA-B∗15:02 and 86 HLA-A∗31:01 carriers were identified. One out of the four identified HLA-B∗15:02 carriers had suffered antiseizure medication-induced cADRs; the point prevalence of cADRs was 16.9% for HLA-A∗31:01 carriers of European origin (n=46) and 14.4% for HLA-A∗31:01 carriers irrespective of ancestry (n=83). Conclusions Comprehensive utilisation of genetic data spreads beyond the search for causal variants alone and can be extended to additional clinical benefits such as identifying pharmacogenomic biomarkers, which can guide pharmacotherapy for genetically-susceptible individuals.