title: Chemokine expression in diverse nonimmediate drug hypersensitivity reactions: focus on thymus activation-regulated chemokine, cutaneous T-cell-attracting chemokine, and interleukin-10.
abstract: BACKGROUND
  Skin infiltration of different types of T lymphocytes is responsible for inflammatory profiles of nonimmediate drug hypersensitivity reactions (niDHRs). Important chemokines attracting skin-specific homing T cells include thymus activation-regulated chemokine (TARC) and cutaneous T-cell-attracting chemokine (CTACK). Interleukin-10 (IL-10) is a potent chemokine attracting CD8(+) T cells.
  
  
  OBJECTIVE
  To investigate serum levels of TARC, CTACK, and IL-10 in patients with niDHRs and evaluate the correlation among these 3 chemokines.
  
  
  METHODS
  Forty patients, including 19 patients with Stevens-Johnson syndrome and toxic epidermal necrolysis and 21 patients with maculopapular exanthema, and 21 healthy donors were recruited into the study. Clinical data of patients were obtained. Serum TARC, CTACK, and IL-10 levels were determined by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Serum levels of TARC, CTACK, and IL-10 were significantly elevated in patients with niDHRs compared with those in normal controls (P < .05, P < .001, P < .001, respectively). The CTACK and IL-10 levels were significantly higher (P < .05, P < .001) in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis than in normal controls. Patients with maculopapular exanthema exhibited higher levels of TARC, CTACK, and IL-10 compared with normal controls (P < .001, P < .001, P < .05). Serum CTACK levels were positively correlated with TARC levels in all 40 patients (rs = 0.3422, P < .05). Serum CTACK levels positively correlated with detachment of body surface area in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis (rs = 0.510, P < .05).
  
  
  CONCLUSIONS
  These results support a role for TARC, CTACK, and IL-10 in the pathogenesis of niDHRs for their chemotactic ability to attract different T-cell subtypes and different functional severities in niDHRs.
authors.affiliation: Department of Dermatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Dermatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Dingyang
authors.initials: D
authors.lastname: He
authors.affiliation: Department of Dermatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Xuhua
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Dermatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China. Electronic address: xingqizhang@hotmail.com.
authors.forename: Xingqi
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D054414:Chemokine CCL17 / Q000097:blood*; D054425:Chemokine CCL27 / Q000097:blood*; D002633:Chemotaxis; D003876:Dermatitis, Atopic / Q000139:chemically induced / Q000276:immunology; D003875:Drug Eruptions / Q000097:blood / Q000150:complications; D004342:Drug Hypersensitivity / Q000097:blood / Q000276:immunology* / Q000401:mortality; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D013262:Stevens-Johnson Syndrome / Q000097:blood / Q000150:complications; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D055815:Young Adult
chemical_list: D054414:Chemokine CCL17; D054425:Chemokine CCL27; C508609:IL10 protein, human; D016753:Interleukin-10