Rapid detection of HLA-A *31:01 allele in DNA and blood samples using loop-mediated isothermal amplification

Y. K. Cheung, M. Kwok, E. Chan, P. Kwan

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7 Citations (Scopus)

Abstract

Background The human leucocyte antigen (HLA) allele, HLA-A*31:01, is a biomarker for adverse cutaneous reactions to carbamazepine, a first-line antiepileptic drug. Objectives To develop a platform that can rapidly detect the HLA-A*31:01 allele in blood samples to facilitate pretreatment screening. Methods A novel protocol based on loop-mediated isothermal amplification (LAMP) was designed and optimized. It was applied to purified genomic DNA samples derived from B-cell lines with known HLA genotypes, and to DNA and whole blood samples collected from patients with epilepsy, in whom HLA-A genotypes were determined by sequence-based typing. Results The turnaround time for the LAMP-based protocol was < 45 min. In the DNA samples derived from B-cell lines (n = 66), the sensitivity, specificity, positive predictive value and negative predictive value of the LAMP-based protocol for detecting HLA-A*31:01 were 1·00 [95% confidence interval (CI) 0·88-1·00], 0·95 (95% CI 0·82-0·99), 0·94 and 1·00, respectively. The LAMP-based protocol produced the same results in the DNA and whole blood samples collected from patients (n = 34). Its sensitivity, specificity, positive predictive value and negative predictive value in detecting HLA-A*31:01 in the patient samples were 1·00 (95% CI 0·57-1·00), 0·97 (95% CI 0·83-0·99), 0·83 and 1·00, respectively. Conclusions The findings demonstrated the feasibility of accurately detecting HLA-A*31:01 in DNA and whole blood samples using a LAMP-based protocol. Given its rapid turnaround time, this novel platform has the potential to be adapted into a point-of-care screening test. What's already known about this topic? Screening for the human leucocyte antigen (HLA) allele, HLA-A*31:01, a biomarker for adverse cutaneous reactions to carbamazepine, is recommended prior to commencing the medication. Conventional HLA genotyping relies on polymerase chain reaction or sequencing, which are time consuming, leading to delayed treatment. What does this study add? A novel protocol based on loop-mediated isothermal amplification was developed. It detected HLA-A*31:01 in DNA and whole blood samples within 45 min. This protocol may be adapted into a point-of-care screening test.

Original languageEnglish
Pages (from-to)90-96
Number of pages7
JournalBritish Journal of Dermatology
Volume171
Issue number1
DOIs
Publication statusPublished - 1 Jan 2014
Externally publishedYes

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