中毒性表皮坏死松解
医学
颗粒溶素
优势比
置信区间
内科学
免疫学
胃肠病学
皮肤病科
免疫系统
穿孔素
CD8型
作者
Shih‐Chi Su,Maja Mockenhaupt,Pierre Wolkenstein,Ariane Dunant,Sabine Le Gouvello,Chun‐Bing Chen,Olivier Chosidow,Laurence Valeyrie‐Allanore,Teresa Bellón,Peggy Sekula,Chuang‐Wei Wang,Martin Schumacher,Sylvia H. Kardaun,Shuen‐Iu Hung,Jean‐Claude Roujeau,Wen‐Hung Chung
标识
DOI:10.1016/j.jid.2016.11.034
摘要
Early diagnosis and prognosis monitoring for Stevens-Johnson syndrome/toxic epidermal necrolysis (TEN) still remain a challenge. This study aims to explore any cytokine/chemokine with prognostic potential in Stevens-Johnson syndrome/TEN. Through screening a panel of 28 serological factors, IL-6, IL-8, IL-15, tumor necrosis factor-α, and granulysin were upregulated in patients with Stevens-Johnson syndrome/TEN and selected for the further validation in total 155 patients with Stevens-Johnson syndrome/TEN, including 77 from Taiwan and 78 from the Registry of Severe Cutaneous Adverse Reactions. Among these factors evaluated, the levels of IL-15 (r = 0.401; P < 0.001) and granulysin (r = 0.223; P = 0.026) were significantly correlated with the disease severity in 112 samples after excluding patients with insufficient data to calculate the score of TEN. In addition, IL-15 was also associated with mortality (P = 0.002; odds ratio, 1.09; 95% confidence interval, 1.03-1.14; P = 0.001; adjusted odds ratio, 1.10; 95% confidence interval, 1.04-1.16). Consistent results were obtained after the exclusion of Taiwanese patients with sepsis to rule out possible confounders. Moreover, IL-15 was shown to enhance cytotoxicity of cultured natural killer cells and blister cells from patients with TEN. Our findings highlight a usefulness of IL-15 in prognosis monitoring and therapeutic intervention of this devastating condition.
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