title: Reduction of interleukin-10 production by B cells in intractable toxic epidermal necrolysis.
abstract: Several interleukin (IL)-10 producing B-cell subsets have been identified recently. However, few studies have examined the role of them in toxic epidermal necrolysis (TEN). We describe a 41-year-old woman with TEN who had B-cell lymphoma and a history of treatments including B-cell depletion therapy. Her re-epithelization was still ongoing after 7 months, despite treatments. To investigate her immune system, we compared cytokine and chemokine production from B cells and non-B cells isolated from the patient and another non-lymphoma TEN patient. IL-10 production from B cells decreased in the patient compared with the control TEN-only patient. Cytokine and chemokine levels from non-B cells involved in inflammation were elevated in the patient compared with the control patient. In conclusion, this study demonstrates that IL-10 from B cells as well as regulatory T cells is critical in the pathogenesis of TEN, and that B-cell dysfunction based on B-cell lymphoma and B-cell depletion therapy may be involved in the intractability of TEN.
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Amiko
authors.initials: A
authors.lastname: Hakuta
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujita
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Kanaoka
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Izumi
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Komitsu
authors.affiliation: Department of Dermatology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Munenari
authors.initials: M
authors.lastname: Itoh
authors.affiliation: Department of Dermatology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Tanito
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Aihara
mesh_terms: D000328:Adult; D001402:B-Lymphocytes / Q000378:metabolism; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D047589:Leukocyte Reduction Procedures; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000628:therapy; D013262:Stevens-Johnson Syndrome / Q000276:immunology*
chemical_list: D016753:Interleukin-10
keywords: B-cell depletion therapy; anti-CD20 antibody; interleukin-10; regulatory B cell; toxic epidermal necrolysis