Soluble interleukin 2 receptor and interleukin 1alpha in toxic epidermal necrolysis: a comparative analysis of serum and blister fluid samples.
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.
Correia
Osvaldo
O
Department of Dermatology, Instituto Português Oncologia, 4200 Porto, Portugal. osvaldo.correia@netc.pt
Delgado
Luis
L
Roujeau
Jean-Claude
JC
Le Cleach
Laurence
L
Fleming-Torrinha
José A
JA
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*
D015415:Biomarkers; D007375:Interleukin-1; D015375:Receptors, Interleukin-2