Soluble Interleukin 2 Receptor and Interleukin 1α in Toxic Epidermal Necrolysis: A Comparative Analysis of Serum and Blister Fluid Samples | Allergy and Clinical Immunology | JAMA Dermatology | JAMA Network
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January 2002

Soluble Interleukin 2 Receptor and Interleukin 1α in Toxic Epidermal Necrolysis: A Comparative Analysis of Serum and Blister Fluid Samples

Author Affiliations

From the Department of Dermatology, Instituto Português Oncologia (Dr Correia), and Department of Immunology, Faculty of Medicine (Drs Correia, Delgado, and Fleming-Torrinha), Porto, Portugal; and Department of Dermatology, Hôpital Henri Mondor, Université Paris XII, Créteil, France (Drs Roujeau and Le Cleach).

Arch Dermatol. 2002;138(1):29-32. doi:10.1001/archderm.138.1.29

Background  Toxic epidermal necrolysis (TEN) is a rare but severe adverse drug disease, characterized by extensive skin and mucosal detachment with participation of different immunoinflammatory pathways, in particular with early participation of activated CD8+ T lymphocytes.

Objective  To further study the potential role of T lymphocytes in the early phase of keratinocyte necrosis.

Design  Prospective study.

Setting  University hospitals.

Patients  Thirteen patients with clinical and histopathologic criteria of TEN and 6 patients with second-degree burns.

Main Outcome Measures  Measurement of soluble interleukin (IL) 2 receptor (sIL-2R) and IL-1α in serum samples and fluid of recent blisters.

Results  In the blister fluid of patients with TEN, we found significantly higher levels of sIL-2R than in patients with burns, whereas IL-1α levels were higher in the blister fluid of burned patients. No significant differences were found in serum samples of patients with TEN and burns, in either sIL-2R or IL-1α. In TEN we also found significantly higher levels of sIL-2R in the blister fluid compared with serum samples, pointing to a predominantly local production contrasting with the low concentration of sIL-2R in the blister fluid of burned patients.

Conclusions  Our findings of elevated sIL-2R levels in blister fluid of patients with TEN are probably related to a local down-regulation of an immunologically mediated cytotoxic reaction and further support the involvement of activated T lymphocytes in the early blisters of TEN.