title: Increased circulating Th17 frequencies and serum IL-22 levels in patients with acute generalized exanthematous pustulosis.
abstract: OBJECTIVE
  Acute generalized exanthematous pustulosis (AGEP) is a diffuse pustular disorder that usually begins in intertriginous folds with widespread erythema. The causes in the majority of the cases are drugs. T cells and interleukin (IL)-8 play roles in the development of AGEP, but the mechanism remains to be elucidated. We investigated the involvement of Th17 cells and their cytokine IL-22 in the pathogenesis.
  
  
  METHODS
  Three patients with AGEP were enrolled in this study. The percentages of IL-17(+) Th17 cells, interferon γ(+) T cells and IL-4(+) T cells were measured in the patients' peripheral blood lymphocytes by intracellular cytokine staining and flow cytometry. The concentration of IL-22 in the sera was measured by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The percentages of Th17 cells were markedly higher in all three patients than healthy control individuals. The frequencies of interferon γ(+) T cells were slightly high in the patients compared with the control, and there was no definite tendency in IL-4(+) T-cell frequencies. The concentration of IL-22 was remarkably high in all patients when compared with normal subjects with levels under detection.
  
  
  CONCLUSIONS
  Th17 cells and their produced cytokine IL-22 were elevated in the peripheral blood of patients with AGEP. As IL-17 and IL-22 cooperatively stimulate keratinocytes to produce IL-8, IL-8 may contribute to the accumulation of neutrophils in the lesional epidermis of AGEP.
authors.affiliation: Department of Dermatology, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kabashima
authors.forename: K
authors.initials: K
authors.lastname: Sugita
authors.forename: Y
authors.initials: Y
authors.lastname: Sawada
authors.forename: R
authors.initials: R
authors.lastname: Hino
authors.forename: M
authors.initials: M
authors.lastname: Nakamura
authors.forename: Y
authors.initials: Y
authors.lastname: Tokura
mesh_terms: D000328:Adult; D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay; D005076:Exanthema / Q000097:blood*; D005260:Female; D006801:Humans; D007378:Interleukins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D058504:Th17 Cells / Q000166:cytology*; D000097043:Interleukin-22
chemical_list: D007378:Interleukins; D000097043:Interleukin-22