Expansion of IL-10-producing CD4+ and CD8+ T cells in fixed drug eruption.
BACKGROUND
A severe form of fixed drug eruption (FDE) clinically and histologically mimics toxic epidermal necrolysis (TEN) but, unlike TEN, resolves spontaneously upon withdrawal of the causative drug.


OBJECTIVE
We reported a case of a severe FDE caused by mefenamic acid that spontaneously resolved without use of systemic corticosteroids. To clarify the phenotype of the T cells responsible for clinical resolution of FDE, we kinetically examined gamma-interferon (IFN-gamma), interleukin (IL)-2, IL-4 and IL-10 production by peripheral blood T cells of the patient before and after oral challenge with the causative drug using flow cytometry.


RESULTS
We found that the proportions of CD4+ and CD8+ T cells capable of producing IFN-gamma and IL-4 remained unchanged after challenge, while those of CD4+ and CD8+ T cells capable of producing IL-10 dramatically increased after challenge. The frequency of CD8+ T cells capable of producing IL-2 decreased after challenge.


CONCLUSIONS
These results suggest that expansion of IL-10-producing CD4+ and CD8+ T cells may be responsible for spontaneous resolution of a severe form of FDE.
Teraki
Yuichi
Y
Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan. teraki@saitama-med.ac.jp
Kokaji
Tomoko
T
Shiohara
Tetsuo
T
D000368:Aged; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism*; D003875:Drug Eruptions / Q000097:blood* / Q000276:immunology / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016753:Interleukin-10 / Q000096:biosynthesis*; D012720:Severity of Illness Index
D016753:Interleukin-10