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Title: Natalizumab-related anaphylactoid reactions in MS patients are associated with HLA class II alleles.
Authors: de la Hera, Belén
Urcelay, Elena
Brassat, David
Chan, Andrew
Vidal-Jordana, Angela
Salmen, Anke
Villar, Luisa Maria
Alvarez-Cermeño, José Carlos
Izquierdo, Guillermo
Fernández, Oscar
Oliver, Begoña
Saiz, Albert
Ara, Jose Ramón
Vigo, Ana G
Arroyo, Rafael
Meca, Virginia
Malhotra, Sunny
Fissolo, Nicolás
Horga, Alejandro
Montalban, Xavier
Comabella, Manuel
metadata.dc.contributor.authoraffiliation: [de la Hera,B; Urcelay,E; Vigo.AG] Department of Immunology, Hospital Clínico San Carlos (IdISSC), Madrid, Spain. [Arroyo,R] Department of Neurology, Multiple Sclerosis Unit, Hospital Clínico San Carlos (IdISSC), Madrid, Spain. [Brassat,D] Pole des neurosciences et INSERM U1043, Université de Toulouse III, Hopital Purpan, Toulouse, France. [Chan,A; Salmen,A] Department of Neurology, St. Josef-Hospital, Ruhr University, Bochum, Germany. [Vidal-Jordana,A; Malhotra,S; Horga,A; Montalban,X; Comabella,M] Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain. [Villar,LM; Alvarez-Cermeño,JC] Departments of Neurology and Immunology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigacion Sanitaria, Madrid, Spain. [Izquierdo,G] Hospital Universitario Virgen Macarena, Seville, Spain. [Fernández,O; Oliver,B] Unidad de Gestión Clínica de Neurociencias, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Regional de Málaga, Universidad de Málaga, Spain. [Saiz,A] Service of Neurology, Hospital Clínic, Universitat de Barcelona and Institut d´Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain. [Ara,JR] Department of Biochemistry, Molecular and Cellular Biology, Science Faculty, University of Zaragoza, Spain. [Meca,V] Fundación de Investigación Biomédica, Hospital Universitario de la Princesa, Madrid, Spain.
Keywords: Alelos;Anticuerpos monoclonales humanizados;Antígenos de histocompatibilidad clase I;Prueba de histocompatibilidad;Esclerosis múltiple
metadata.dc.subject.mesh: Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Genetic Structures::Genome::Genome Components::Genes::Alleles
Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal::Antibodies, Monoclonal, Humanized
Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Genotype
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Immunologic Tests::Histocompatibility Testing
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Respiratory Hypersensitivity
Medical Subject Headings::Diseases::Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Odds Ratio
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Confidence Intervals
Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Glycoproteins::Membrane Glycoproteins::Histocompatibility Antigens Class I
Issue Date: 11-Dec-2014
Publisher: Wolters Kluwer Health/LWW
American Academy of Neurology
Citation: de la Hera B, Urcelay E, Brassat D, Chan A, Vidal-Jordana A, Salmen A, et al. Natalizumab-related anaphylactoid reactions in MS patients are associated with HLA class II alleles. Neurol Neuroimmunol Neuroinflamm. 2014; 1(4):e47
Abstract: OBJECTIVES We aimed to investigate potential associations between human leukocyte antigen (HLA) class I and class II alleles and the development of anaphylactic/anaphylactoid reactions in patients with multiple sclerosis (MS) treated with natalizumab. METHODS HLA class I and II genotyping was performed in patients with MS who experienced anaphylactic/anaphylactoid reactions and in patients who did not develop infusion-related allergic reactions following natalizumab administration. RESULTS A total of 119 patients with MS from 3 different cohorts were included in the study: 54 with natalizumab-related anaphylactic/anaphylactoid reactions and 65 without allergic reactions. HLA-DRB1*13 and HLA-DRB1*14 alleles were significantly increased in patients who developed anaphylactic/anaphylactoid reactions (p M-H = 3 × 10(-7); odds ratio [OR]M-H = 8.96, 95% confidence interval [CI] = 3.40-23.64), with a positive predictive value (PPV) of 82%. In contrast, the HLA-DRB1*15 allele was significantly more represented in patients who did not develop anaphylactic/anaphylactoid reactions to natalizumab (p M-H = 6 × 10(-4); ORM-H = 0.2, 95% CI = 0.08-0.50), with a PPV of 81%. CONCLUSIONS HLA-DRB1 genotyping before natalizumab treatment may help neurologists to identify patients with MS at risk for developing serious systemic hypersensitivity reactions associated with natalizumab administration.
Description: Journal Article;
metadata.dc.identifier.doi: 10.1212/NXI.0000000000000047
ISSN: 2332-7812 (Online)
Appears in Collections:01- Artículos - Hospital Virgen Macarena
01- Artículos - IBIMA. Instituto de Investigación Biomédica de Málaga

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