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Variable levels of apoptotic signal‐associated cytokines in the disease course of patients with Stevens–Johnson syndrome and toxic epidermal necrolysis
Author(s) -
Yang Yongsheng,
Li Feng,
Du Juan,
Shen Yanyun,
Lin Jinran,
Zhu Xiaohua,
Luo Xiaoqun,
Liang Jun,
Xu Jinhua
Publication year - 2017
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/ajd.12462
Subject(s) - toxic epidermal necrolysis , granulysin , medicine , cd16 , cytokine , immunology , cd14 , cd8 , apoptosis , tumor necrosis factor alpha , keratinocyte , flow cytometry , cd3 , immune system , biology , dermatology , cell culture , biochemistry , genetics , perforin
Abstract Background/Objectives Keratinocyte death is a hallmark of Stevens–Johnson syndrome and toxic epidermal necrolysis (SJS/TEN). Apoptotic signal‐associated cytokines, such as TNF‐α, sFasL, granulysin, sTRAIL and IFN‐γ have been reported to participate in keratinocyte apoptosis. However, their levels are variable, which hampers the elucidation of the role of these cytokines. We sought to determine whether cytokine levels vary with disease course. Methods The serum cytokine levels of 24 patients and blister fluid of 10 were analysed by enzyme‐linked immunosorbent assay on the first day of their admission to hospital and were evaluated at different time points in the disease course. Meanwhile, surface markers (CD3, CD4, CD8, CD1a, CD14, CD16+56 and CD68) of blister fluid cells were measured by flow cytometry. Results The concentrations of all cytokines in the serum and blister fluid were higher than those in the controls and were more elevated in the blister fluid than in the serum. Moreover, sTRAIL, IFN‐γ and TNF‐α quantities were relatively stable, while those of sFasL and granulysin decreased rapidly in the disease course. On the first day, CD8+ T and natural killer cells were predominant in the blister fluid but their relative percentage diminished gradually, while that of CD14+ cells increased. Conclusion Our study confirmed there are high but variable levels of these cytokines in SJS/TEN, especially in the early phase and different tendencies are manifested in the disease course.