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多形性红斑或史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症药物反应患者的血清白介素 17 及其与疾病严重程度的相关性。

Serum IL-17 in patients with erythema multiforme or Stevens-Johnson syndrome/toxic epidermal necrolysis drug reaction, and correlation with disease severity.

机构信息

Department of Dermatology, Venereology and Andrology , Assiut University, Egypt.

Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt.

出版信息

Clin Exp Dermatol. 2017 Dec;42(8):868-873. doi: 10.1111/ced.13213. Epub 2017 Sep 20.

Abstract

BACKGROUND

There is strong evidence that drug-induced cutaneous eruptions have an immunological component. Interleukin (IL)-17, a proinflammatory cytokine that is predominantly produced by T helper 17 cells, has been linked to various autoimmune and inflammatory diseases.

AIM

To measure serum IL-17 levels in patients with cutaneous drug reactions [erythema multiforme (EM) and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN)] in order to study the associations between IL-17 and disease severity.

METHODS

In total, 32 patients (13 with EM and 19 with SJS/TEN) and 15 age- and sex-matched healthy controls (HCs) were enrolled. Patients with SJS/TEN were assessed clinically using the SCORe of Toxic Epidermal Necrosis (SCORTEN) scale. Serum IL-17 levels were determined by ELISA.

RESULTS

Serum IL-17 levels were significantly higher compared with HCs (16.46 ± 5.21 pg/mL) in the EM (35.1 ± 23.89 pg/mL, P < 0.02) and SJS/TEN (68.19 ± 35.42 pg/mL, P = 0.001) groups. IL-17 levels were also significantly higher in the SJS/TEN group than in the EM group (P = 0.004). Mean affected body surface area percentage was 0.9 ± 0.21 in the EM group and 22.8 ± 10.67 in the SJS/TEN group. The SJS/TEN SCORTEN ranged from 1 to 5, with a mean of 2.5 ± 1. Serum IL-17 level correlated positively with both percentage surface area of detached skin and SCORTEN.

CONCLUSIONS

Serum IL-17 levels may have prognostic and diagnostic value in patients with EM or SJS/TEN reactions, and can provide a valuable approach in managment.

摘要

背景

有强有力的证据表明,药物引起的皮肤疹具有免疫学成分。白细胞介素(IL)-17 是一种促炎细胞因子,主要由辅助性 T 细胞 17 产生,与各种自身免疫和炎症性疾病有关。

目的

测量药物性皮肤反应(多形红斑(EM)和史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症(SJS/TEN))患者的血清 IL-17 水平,以研究 IL-17 与疾病严重程度之间的关系。

方法

共纳入 32 名患者(13 名 EM 和 19 名 SJS/TEN)和 15 名年龄和性别匹配的健康对照者(HCs)。使用毒性表皮坏死评分(SCORTEN)量表对 SJS/TEN 患者进行临床评估。通过 ELISA 测定血清 IL-17 水平。

结果

与 HCs(16.46±5.21pg/mL)相比,EM(35.1±23.89pg/mL,P<0.02)和 SJS/TEN(68.19±35.42pg/mL,P=0.001)组的血清 IL-17 水平显著升高。SJS/TEN 组的 IL-17 水平也明显高于 EM 组(P=0.004)。EM 组的平均受累体表面积百分比为 0.9±0.21,SJS/TEN 组为 22.8±10.67。SJS/TEN 的 SCORTEN 评分范围为 1 至 5,平均为 2.5±1。血清 IL-17 水平与脱落皮肤的面积百分比和 SCORTEN 均呈正相关。

结论

血清 IL-17 水平可能对 EM 或 SJS/TEN 反应患者具有预后和诊断价值,并为治疗提供有价值的方法。

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