Revisiting HLA-DQA1*05 in Asian inflammatory bowel disease cohorts: Ethnic variations in genetic susceptibility to immunogenicity

Core Tip

Core Tip: This letter builds upon Weng et al’s study in Taiwan that incorporated comparative evidence from Asia and Europe toward the investigation of racial disparities in human leukocyte antigen (HLA)-related immunogenicity of anti-tumor necrosis factor therapy. Although Weng et al did not identify an association between HLA-DQA1*05 and the development of anti-drug antibody against infliximab and adalimumab, other larger-scale studies across Chinese and European cohorts demonstrated a significant correlation between HLA-DQA1*05 and anti-drug antibody formation, particularly with infliximab, highlighting the genetic diversity within Asia. The novel alleles reported by Weng et al warrant further validation. Until further comprehensive, large-scale racial cohort data becomes available, clinicians should prioritize therapeutic drug monitoring and individualized treatment approaches. Furthermore, HLA allele screening for inflammatory bowel disease treatment decisions requires support from larger, genetically diverse cohort studies.