Department of Dermatology, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Japan.
J Eur Acad Dermatol Venereol. 2011 Apr;25(4):485-8. doi: 10.1111/j.1468-3083.2010.03771.x.
BACKGROUND/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.
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.
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.
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.
背景/目的：急性泛发性发疹性脓疱病（AGEP）是一种弥漫性脓疱性疾病，通常始于间擦部位的广泛红斑。在大多数情况下，其病因是药物。T 细胞和白细胞介素（IL）-8 在 AGEP 的发病机制中发挥作用，但机制仍有待阐明。我们研究了 Th17 细胞及其细胞因子 IL-22 在发病机制中的作用。
本研究纳入了 3 名 AGEP 患者。通过细胞内细胞因子染色和流式细胞术测量了患者外周血淋巴细胞中 IL-17（+）Th17 细胞、干扰素 γ（+）T 细胞和 IL-4（+）T 细胞的百分比。通过酶联免疫吸附试验测量了血清中 IL-22 的浓度。
所有 3 名患者的 Th17 细胞百分比均明显高于健康对照者。与对照组相比，患者的干扰素 γ（+）T 细胞频率略高，而 IL-4（+）T 细胞频率无明显趋势。与正常对照者相比，所有患者的 IL-22 浓度均明显升高，而正常对照者的 IL-22 浓度低于检测下限。
AGEP 患者外周血中 Th17 细胞及其产生的细胞因子 IL-22 升高。由于 IL-17 和 IL-22 协同刺激角质形成细胞产生 IL-8，IL-8 可能有助于 AGEP 皮损表皮中中性粒细胞的积聚。
