title: Soluble interleukin 2 receptor and interleukin 1alpha in toxic epidermal necrolysis: a comparative analysis of serum and blister fluid samples.
abstract: 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.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospitals.
  
  
  METHODS
  Thirteen patients with clinical and histopathologic criteria of TEN and 6 patients with second-degree burns.
  
  
  METHODS
  Measurement of soluble interleukin (IL) 2 receptor (sIL-2R) and IL-1alpha 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-1alpha 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-1alpha. 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.
authors.affiliation: Department of Dermatology, Instituto Português Oncologia, 4200 Porto, Portugal. osvaldo.correia@netc.pt
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Correia
authors.forename: Luis
authors.initials: L
authors.lastname: Delgado
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Roujeau
authors.forename: Laurence
authors.initials: L
authors.lastname: Le Cleach
authors.forename: José A
authors.initials: JA
authors.lastname: Fleming-Torrinha
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001768:Blister; D002056:Burns / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000097:blood / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D007375:Interleukin-1; D015375:Receptors, Interleukin-2