New insights into the diagnosis and management of Stevens-Johnson syndrome and toxic epidermal necrolysis.

IF 3 4区医学 Q2 ALLERGY

Current Opinion in Allergy and Clinical Immunology Pub Date : 2023-08-01 DOI:10.1097/ACI.0000000000000914

Yuki Saito, Riichiro Abe

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引用次数: 0

Abstract

Purpose of review: Recent studies have been clarifying the pathogenesis and early diagnostic markers of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Additionally, the efficacy of tumor necrosis factor alpha inhibitors is attracting attention. This review provides) recent evidence for the diagnosis and management of SJS/TEN.

Recent findings: Risk factors for the development of SJS/TEN have been identified, particularly the association between HLA and the onset of SJS/TEN with specific drugs, which has been intensively studied. Research on the pathogenesis of keratinocyte cell death in SJS/TEN has also progressed, revealing the involvement of necroptosis, an inflammatory cell death, in addition to apoptosis. Diagnostic biomarkers associated with these studies have also been identified.

Summary: The pathogenesis of SJS/TEN remains unclear and effective therapeutic agents have not yet been established. As the involvement of innate immunity, such as monocytes and neutrophils, in addition to T cells, has become clear, a more complex pathogenesis is predicted. Further elucidation of the pathogenesis of SJS/TEN is expected to lead to the development of new diagnostic and therapeutic agents.

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史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症的诊断和治疗的新见解。

综述目的:最近的研究阐明了Stevens-Johnson综合征(SJS)和中毒性表皮坏死松解症(TEN)的发病机制和早期诊断指标。此外，肿瘤坏死因子α抑制剂的疗效也引起了人们的关注。本文综述了SJS/TEN的诊断和治疗的最新证据。最近的研究发现:SJS/TEN发生的危险因素已经确定，特别是HLA与SJS/TEN发病与特定药物之间的关系已经得到了深入的研究。对SJS/TEN中角质形成细胞死亡的发病机制的研究也取得了进展，揭示了除了细胞凋亡外，还涉及坏死下垂，一种炎症细胞死亡。与这些研究相关的诊断性生物标志物也已被确定。摘要:SJS/TEN的发病机制尚不清楚，有效的治疗药物尚未确定。随着先天免疫的参与，如单核细胞和中性粒细胞，除了T细胞，已经变得清楚，预测一个更复杂的发病机制。进一步阐明SJS/TEN的发病机制有望导致新的诊断和治疗药物的开发。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Allergy and Clinical Immunology 医学-过敏

CiteScore

5.90

自引率

3.60%

发文量

109

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on one to three topics, every issue of Current Opinion in Allergy and Clinical Immunology delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as upper airway disease; mechanisms of allergy and adult asthma; paediatric asthma and development of atopy; food and drug allergies; and immunotherapy.