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Soluble Interleukin 2 Receptor and Interleukin 1α in Toxic Epidermal Necrolysis: A Comparative Analysis of Serum and Blister Fluid Samples

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TLDR
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.
Abstract
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.

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Journal ArticleDOI

Toxic epidermal necrolysis

TL;DR: Recent data concerning clinical presentation, pathogenesis and treatment of TEN is reviewed, with evidence suggesting that combination therapies may be of value and anecdotal or based on observational or retrospective studies.
Journal ArticleDOI

Toxic epidermal necrolysis: current evidence, practical management and future directions.

TL;DR: A composite model of T EN is presented, based on previous work and suggested pathogeneses of TEN, mechanisms of drug reactions and reported cytotoxic lymphocyte (CTL) cytolytic pathways, which suggests a multifaceted regimen appears indicated, targeting various likely intermediary mechanisms.
Journal ArticleDOI

Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

TL;DR: The understanding of the pathogenesis of SJS/TEN has improved: drug-specific T cell-mediated cytotoxicity, genetic linkage with HLA- and non-HLA-genes, TCR restriction, and cytot toxicity mechanisms were clarified.
Journal ArticleDOI

Multiplex bead array assay for detection of 25 soluble cytokines in blister fluid of patients with complex regional pain syndrome type 1.

TL;DR: Investigation of the involvement of mediators by measurement of several other cytokines using new detection techniques that enable multiple cytokine measurement in small samples of CRPS1 finds minimal detection levels are significantly higher in the bead array system than those in common ELISA assays.
References
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Journal ArticleDOI

Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme

TL;DR: This study suggests that an illustrated atlas is a useful tool for standardizing the diagnosis of acute severe bullous disorders that are attributed to drugs or infectious agents.
Journal ArticleDOI

Severe Adverse Cutaneous Reactions to Drugs

TL;DR: Adverse cutaneous reactions to drugs are frequent, affecting 2 to 3 percent of hospitalized patients, and prompt withdrawal of the offending drug is often the most important action to minimize morbidity.
Journal Article

Soluble interleukin 2 receptors are released from activated human lymphoid cells in vitro.

TL;DR: The release of soluble IL 2R appears to be a characteristic marker of T lymphocyte activation and might serve an immunoregulatory function during both normal and abnormal cell growth and differentiation.
Journal ArticleDOI

Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin.

TL;DR: Antibodies present in pooled human intravenous immunoglobulins (IVIG) blocked Fas-mediated keratinocyte death in vitro and indicated that IVIG may be an effective treatment for toxic epidermal necrolysis of TEN.
Journal ArticleDOI

Biology and clinical relevance of human natural killer cells.

TL;DR: Information about subscriptions and ASH membership may be found online at: reserved.org.
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