Genetic variants of the arachidonic acid pathway in non-steroidal anti-inflammatory drug-induced acute urticaria

Clin Exp Allergy. 2012 Dec;42(12):1772-81. doi: 10.1111/j.1365-2222.2012.04078.x.

Abstract

Background: To date, genetic studies of hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) have been carried out mainly in aspirin-induced asthma and to a lesser extent in chronic urticaria, with no studies in patients with acute urticaria (AU), the most common entity induced by these drugs.

Objective: In this work, we analysed the association of common variants of 15 relevant genes encoding both enzymes and receptors from the arachidonic acid (AA) pathway with NSAID-induced AU.

Methods: Patients were recruited in several Allergy Services that are integrated into the Spanish network RIRAAF, and diagnosed of AU induced by cross-intolerance (CRI) to NSAIDs. Genotyping was carried out by TaqMan allelic discrimination assays.

Results: A total of 486 patients with AU induced by CRI to NSAIDs and 536 unrelated controls were included in this large Spanish case-control study. Seven variants from 31 tested in six genes were associated in a discovery study population from Malaga (0.0003 ≤ p-value ≤ 0.041). A follow-up analysis in an independent sample from Madrid replicated three of the SNPs from the ALOX15 (rs7220870), PTGDR (rs8004654) and CYSLTR1 (rs320095) genes (1.055x10(-6) ≤meta-analysis p-value ≤ 0.003).

Conclusions and clinical relevance: Genetic variants of the AA pathway may play an important role in NSAID-induced AU. These data may help understand the mechanism underlying this disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Arachidonate 15-Lipoxygenase / genetics*
  • Arachidonate 15-Lipoxygenase / metabolism
  • Arachidonic Acid / metabolism*
  • Case-Control Studies
  • Drug Hypersensitivity / etiology
  • Drug Hypersensitivity / genetics*
  • Female
  • Genotype
  • Humans
  • Leukotrienes / metabolism
  • Male
  • Mast Cells / metabolism
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Prostaglandins / metabolism
  • Receptors, Immunologic / genetics*
  • Receptors, Immunologic / metabolism
  • Receptors, Leukotriene / genetics*
  • Receptors, Leukotriene / metabolism
  • Receptors, Prostaglandin / genetics*
  • Receptors, Prostaglandin / metabolism
  • Urticaria / chemically induced
  • Urticaria / genetics*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Leukotrienes
  • Prostaglandins
  • Receptors, Immunologic
  • Receptors, Leukotriene
  • Receptors, Prostaglandin
  • Arachidonic Acid
  • ALOX15 protein, human
  • Arachidonate 15-Lipoxygenase
  • leukotriene D4 receptor
  • prostaglandin D2 receptor