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               <mods:identifier type="citation">Lucena MI, Molokhia M, Shen Y, Urban TJ, Aithal GP, Andrade RJ, Day CP, Ruiz-Cabello F, Donaldson PT, Stephens C, Pirmohamed M, Romero-Gomez M, Navarro JM, Fontana RJ, Miller M, Groome M, Bondon-Guitton E, Conforti A, Stricker BHC, Carvajal A, Ibanez L, Yue QY, Eichelbaum M, Floratos A, Pe'er I, Daly MJ, Goldstein DB, Dillon JF, Nelson MR, Watkins PB, Daly AK; Spanish DILI Registry; EUDRAGENE; DILIN; DILIGEN; International SAEC. Susceptibility to Amoxicillin-Clavulanate-Induced Liver Injury is Influenced by Multiple HLA Class I and II Alleles. Gastroenterology 2011 Jul;41(1):338-347</mods:identifier>
               <mods:identifier type="uri">https://hdl.handle.net/10630/40269</mods:identifier>
               <mods:identifier type="doi">10.1053/j.gastro.2011.04.001</mods:identifier>
               <mods:abstract>Background &amp; Aims: Drug-induced liver injury (DILI), especially from antimicrobial&#xd;
agents, is an important cause of serious liver disease. Amoxicillin-clavulanate (AC) is a&#xd;
leading cause of idiosyncratic DILI, but little is understood about genetic susceptibility&#xd;
to this adverse reaction.&#xd;
Methods: We performed a genome-wide association study using 822,927 singlenucleotide polymorphism (SNP) markers from 201 White European and US cases of ACDILI and 532 population controls, matched for genetic background.Results: AC-DILI was associated with many loci in the major histocompatibility&#xd;
complex. The strongest effect was with a human leukocyte antigen (HLA) class II SNP&#xd;
(rs9274407, P=4.8×10−14), which correlated with rs3135388, a tag SNP of HLADRB1*1501-DQB1*0602 that was previously associated with AC-DILI. Conditioned on&#xd;
rs3135388, rs9274407 is still significant (P=1.1×10−4). An independent association was&#xd;
observed in the class I region (rs2523822, P=1.8×10−10), related to HLA-A*0201. The&#xd;
most significant class I and II SNPs showed statistical interaction (P=0.0015). Highresolution HLA genotyping (177 cases and 219 controls) confirmed associations of HLAA*0201 (P=2×10−6) and HLA-DQB1*0602 (P=5×10−10), and their interaction&#xd;
(P=0.005). Additional, population-dependent effects were observed in HLA alleles with&#xd;
nominal significance. In an analysis of auto-immunerelated genes, rs2476601 in the gene&#xd;
PTPN22 was associated (P=1.3×10−4).Conclusions: Class I and II HLA genotypes affect susceptibility to AC-DILI, indicating&#xd;
the importance of the adaptive immune response in pathogenesis. The HLA genotypes&#xd;
identified will be useful in studies of the pathogenesis of AC-DILI, but have limited utility&#xd;
as predictive or diagnostic biomarkers because of the low positive-predictive values</mods:abstract>
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               <mods:accessCondition type="useAndReproduction">Attribution-NonCommercial-NoDerivatives 4.0 Internacional</mods:accessCondition>
               <mods:subject>
                  <mods:topic>Hepatotoxicidad</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Medicamentos - Efectos secundarios</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Farmacogenética</mods:topic>
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                  <mods:title>Susceptibility to Amoxicillin-Clavulanate-Induced Liver Injury is Influenced by Multiple HLA Class I and II Alleles</mods:title>
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