Polymorphisms in the interleukin 4 receptor and interleukin 13 genes in immediate allergic reactions to beta-lactam antibiotics: A case-control study.

BACKGROUND: Immediate hypersensitivity reactions to beta-lactams are IgE-mediated and constitute the most common adverse reactions to antibiotics mediated by a specific immunologic mechanism.

OBJECTIVE: We investigated the association between four functional polymorphisms of IL13 (R130Q variant) and IL4RA (I50V, S478P and Q551R variants) genes and susceptibility to immediate allergic reactions to beta-lactams in the Algerian population.

METHODS: We determined these gene variants in 199 patients and 99 healthy controls from Algeria. In a case-control study using the TaqMan method, we genotyped four single nucleotide polymorphisms (SNPs) including Arg130Gln in IL13, and Ile50Val, Ser478Pro as well as Gln551Arg in IL4RA.

RESULTS: IL4RA I50V variant was more significantly connected with the risk of beta-lactam allergy (P = 0.0144) and the total serum IgE level in patients (P = 0.0136). A significant correlation was observed between IL13 R130Q and beta- lactam allergy (P = 0.0384). Also, a significant gene-gene interaction was detected between the predominant allele of the IL13 R130Q polymorphism and the three polymorphisms of IL4RA (P < 0.0001, P = 0.0163, and 0.0301, respectively). Haplotype analysis of IL4RA revealed that GTA haplotype had a significant correlation in patients with beta-lactam allergy (P = 0.0123).

CONCLUSIONS: Our results indicate that IL4RA (I50V) and IL13 R130Q are associated with beta-lactam allergy. The combination of IL13 and IL4RA variants markedly increases an individual's susceptibility to beta-lactam allergy in the Algerian population.