Significance of HLA-B*15 in three pemphigus patients with rituximab-triggered severe cutaneous drug reactions.

IF 1.4 4区医学 Q3 ALLERGY

Postepy Dermatologii I Alergologii Pub Date : 2024-12-01 Epub Date: 2024-12-02 DOI:10.5114/ada.2024.145439

Tang Jun-Ting, Tu Ying, Sun Dong-Jie, Nong Xiang, Cao Can, Du Si-Cheng, Cun Yue-Ting, He Li

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Abstract

Introduction: Rituximab, a CD20 inhibitor, has swiftly become the primary treatment for pemphigus patients.

Aim: We present 3 cases of pemphigus patients who had undergone rituximab treatment.

Material and methods: After the second intravenous administration of rituximab, the primary rash developed into severe cutaneous drug reactions. Peripheral blood was collected from the aforementioned 3 patients for the detection of susceptibility genes by using second-generation sequencing.

Results: Notably, a significant resemblance was observed in the HLA profiles of these 3 patients, particularly regarding high-risk alleles associated with rituximab-induced severe cutaneous drug reactions (CDRs). This rare occurrence of severe CDRs post-rituximab administration may be HLA-dependent and linked to HLA-B*15:02:01, HLA-B*15:12 and HLA-B*15:27:01. This pioneering laboratory trial shows the pathological background of rituximab-induced severe cutaneous drug reactions.

Conclusions: Our findings contribute to the expanding catalogue of potential HLA-B*15 linked to severe CDRs and underscore the importance of vigilance regarding such reactions in pemphigus patients undergoing rituximab therapy.

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HLA-B*15在3例利妥昔单抗引发严重皮肤药物反应的天疱疮患者中的意义

美罗华（Rituximab）是一种CD20抑制剂，已迅速成为天疱疮患者的主要治疗药物。目的：报告3例接受利妥昔单抗治疗的天疱疮患者。材料与方法：第二次静脉给予利妥昔单抗后，原发皮疹发展为严重的皮肤药物反应。采集上述3例患者外周血，采用二代测序检测易感基因。结果：值得注意的是，在这3例患者的HLA谱中观察到显著的相似性，特别是与利妥昔单抗诱导的严重皮肤药物反应（CDRs）相关的高危等位基因。这种罕见的利妥昔单抗给药后发生的严重cdr可能是hla依赖性的，与HLA-B*15:02:01、HLA-B*15:12和HLA-B*15:27:01有关。这项开创性的实验室试验显示了利妥昔单抗诱导的严重皮肤药物反应的病理背景。结论：我们的研究结果有助于扩大与严重cdr相关的潜在HLA-B*15的目录，并强调了在接受利妥昔单抗治疗的天疱疮患者对此类反应保持警惕的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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