The gene that turns epilepsy treatment deadly

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Drug-induced Hyper sensitivity reactions (DIHRs) are serious and life-threatening complications post drug administration.

A common example: Antiepileptic drug carbamazepine, however the mechanisms that trigger it are unclear.

Current scientific consensus holds that people who have a specific variation of the HLA-B gene (Human leukocyte antigen B) which codes for the protein that plays a crucial role in immune system are more at risk of DIHR. Although the mechanism linking this gene to DIHR is currently not known, the specific variation called HLA-B 15:02, is common in South-East Asian descent, this poses a serious problem for clinicians in the region.

Carbamazepine and another eight out of 26 antiepileptic drugs (AEDs) that were tested were found to bind strongly to the HLA complex in the simulation model. The team believes this strong binding is behind DIHRs in patients who carry the variant gene.

The remaining AEDs that did not show strong binding interactions with the HLA-B*15:02 complex, including clonazepam, nitrazepam and stiripentol, could be safer options for patients that have already developed adverse reactions to other antiepileptic drugs.