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Soluble Interleukin 2 Receptor and Interleukin 1 in Toxic Epidermal Necrolysis
A Comparative Analysis of Serum and Blister Fluid Samples
Osvaldo Correia, MD;
Luis Delgado, MD, PhD;
Jean-Claude Roujeau, MD, PhD;
Laurence Le Cleach, MD;
José A. Fleming-Torrinha, MD, PhD
Arch Dermatol. 2002;138:29-32.
Background Toxic epidermal necrolysis (TEN) is a rare but severe adverse drug disease,
characterized by extensive skin and mucosal detachment with participation
of different immunoinflammatory pathways, in particular with early participation
of activated CD8+ T lymphocytes.
Objective To further study the potential role of T lymphocytes in the early phase
of keratinocyte necrosis.
Design Prospective study.
Setting University hospitals.
Patients Thirteen patients with clinical and histopathologic criteria of TEN
and 6 patients with second-degree burns.
Main Outcome Measures Measurement of soluble interleukin (IL) 2 receptor (sIL-2R) and IL-1
in serum samples and fluid of recent blisters.
Results In the blister fluid of patients with TEN, we found significantly higher
levels of sIL-2R than in patients with burns, whereas IL-1 levels were
higher in the blister fluid of burned patients. No significant differences
were found in serum samples of patients with TEN and burns, in either sIL-2R
or IL-1. In TEN we also found significantly higher levels of sIL-2R
in the blister fluid compared with serum samples, pointing to a predominantly
local production contrasting with the low concentration of sIL-2R in the blister
fluid of burned patients.
Conclusions Our findings of elevated sIL-2R levels in blister fluid of patients
with TEN are probably related to a local down-regulation of an immunologically
mediated cytotoxic reaction and further support the involvement of activated
T lymphocytes in the early blisters of TEN.
From the Department of Dermatology, Instituto Português Oncologia
(Dr Correia), and Department of Immunology, Faculty of Medicine (Drs Correia,
Delgado, and Fleming-Torrinha), Porto, Portugal; and Department of Dermatology,
Hôpital Henri Mondor, Université Paris XII, Créteil, France
(Drs Roujeau and Le Cleach).
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