The utility ofHLA-DQB302as a genetic marker to predict the effect of aspirin desensitization on lung function of patients with aspirin exacerbated respiratory disease

Abstract

Background: Previous studies demonstrated different HLA genotypes in patients with aspirin exacerbated respiratory disease (AERD) compared to aspirin tolerant individuals. Objective: To investigate the effect of HLA DRB1, DQA1 and DQB1 on lung function improvement following aspirin desensitization (AD). Methods:This cohort study was conducted on patients with AERD who participated in AD trial ([NCT01867281][1]). Forced expiratory volume in 1 second (FEV1), medication and symptom scores and Sino-Nasal Outcome Test-22 (SNOT-22) of the participants were investigated at baseline and 6 months after AD. Polymerase chain reaction was used to genotype HLA DRB1, DQA1 and DQB1. The association of each genotype with the clinical response to AD was investigated. Those with more than 12% increase in percent of predicted value of FEV1 were considered responder to AD. Results: A total of 16 patients with AERD (81.3% were female) with median age of 29 ± 4.3 years were included in this study. Following 6 months, mean FEV1 (87.1 ± 1.7 vs. 79.1 ± 1.9, p<0.001) improved significantly. Similarly mean SNOT-22, medication and symptom scores of participants improved significantly. However, only 7 patients (43.7%) had 12% improvement in FEV%. HLADQB1*0302 was significantly higher in responders to AD rather non-responders (8.33(1.38-50.00), p=0.022). Sensitivity and specificity of HLA-DQB1*0302 to predict response to AD was (71.4%, 95%CI(35.8-91.7)) and (81.8%, 95%CI(52.3-94.8)), respectively. Conclusion: This study introduces HLA-DQB1*0302 as a genetic marker to predict improvement in lung function following AD in patients with AERD. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01867281&atom=%2Ferj%2F46%2Fsuppl_59%2FPA3611.atom