Correia O, Delgado L, Ramos J P, Resende C, Torrinha J A
Department of Immunology, Faculty of Medicine, Hospital S João, Porto, Portugal.
Arch Dermatol. 1993 Apr;129(4):466-8.
Toxic epidermal necrolysis (TEN) is a life-threatening disease with severe mucocutaneous shedding. Although it is widely accepted that immune mechanisms are at play, the pathophysiology of TEN is still unknown. We studied the blister fluid inflammatory cells in three drug-related cases to further define the suspected T-cell involvement in TEN.
A peripheral blood lymphopenia, especially of CD4+ T lymphocytes, was associated with a high lymphocytic cellularity of the blister fluid. In two cases, immunophenotyping of blister fluid lymphocytes showed a predominance of the CD8 phenotype. Furthermore, using two-color flow cytometry in one patient, we could show the predominance of CD8+ CD29+ lymphocytes and CD45RA- negative cells.
Our findings point to a cutaneous recruitment of antigen-primed and cytotoxic T cells in TEN, further supporting the involvement of CD8+ lymphocytes in TEN pathogenesis and its immune mediation.
中毒性表皮坏死松解症（TEN）是一种伴有严重黏膜皮肤脱落的危及生命的疾病。尽管免疫机制在其中起作用已被广泛认可，但TEN的病理生理学仍不清楚。我们研究了3例药物相关病例中的水疱液炎症细胞，以进一步明确TEN中疑似的T细胞参与情况。
外周血淋巴细胞减少，尤其是CD4 + T淋巴细胞减少，与水疱液中淋巴细胞细胞密度高有关。在2例病例中，水疱液淋巴细胞的免疫表型分析显示CD8表型占优势。此外，在1例患者中使用双色流式细胞术，我们能够显示CD8 + CD29 +淋巴细胞和CD45RA阴性细胞占优势。
我们的研究结果表明，TEN中存在抗原致敏和细胞毒性T细胞的皮肤募集，进一步支持CD8 +淋巴细胞参与TEN发病机制及其免疫介导作用。
