史蒂文斯-约翰逊综合征和中毒性表皮坏死症患者水疱液和皮肤组织中细胞因子病例对照研究的系统回顾。

IF 2.2 4区 医学 Q2 DERMATOLOGY
Thomas Jonathan Stewart BBioMedSci, MBBS, MMed, MS, FRACGP, FACD, Joshua Farrell BA, MBBS, MMed, John Walter Frew MBBS, MMed, MS, PhD, FACD
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引用次数: 0

摘要

史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死(TEN)是以角质细胞凋亡、坏死和表皮脱落为特征的严重皮肤不良反应。有研究表明,SJS/TEN 患者的血液和皮肤中多种细胞因子和细胞毒性蛋白升高,静脉注射免疫球蛋白和肿瘤坏死因子(TNF)-α 抑制剂等生物制剂已显示出良好的治疗潜力。然而,SJS/TEN 的确切致病模式仍然难以捉摸。本系统综述旨在评估有关史蒂文斯-约翰逊综合征和/或中毒性表皮坏死症成人水疱液和皮肤中细胞因子和细胞毒性蛋白的病例对照研究。本综述已在 INPLASY 注册,并按照 PRISMA 报告指南进行。采用 NIH 标准对潜在偏倚进行了评估。共纳入了 11 篇文章,描述了 96 例病例和 170 例对照的结果。与健康对照组相比,SJS/TEN水疱液和皮肤组织中的Fas、Fas配体、白细胞介素(IL)-8和B细胞淋巴瘤(Bcl)-2均升高。与病变对照组相比,SJS/TEN 大疱液中的 IL-2、IL-6、TNF-α、肿瘤坏死因子相关凋亡诱导配体(TRAIL)、γ 干扰素和基质金属蛋白酶-2 均升高。SJS/TEN皮肤组织中的粒细胞素、IL-33、TGF-beta-1和IL-13与扁平苔藓组织相比有所升高,IL-13、IFN-γ、IL-2和IL-5与多形性红斑组织相比也有所升高。与健康对照组和皮损对照组相比,SJS/TEN 患者的水疱液和皮肤组织中细胞因子和细胞毒性蛋白的浓度更高。我们的研究结果表明,这些蛋白质可能是致病因子,也可能是诊断、疾病严重程度和病程的标志物。它们也可能被证明是有用的治疗目标。还需要更多的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A systematic review of case–control studies of cytokines in blister fluid and skin tissue of patients with Stevens Johnson syndrome and toxic epidermal necrolysis

A systematic review of case–control studies of cytokines in blister fluid and skin tissue of patients with Stevens Johnson syndrome and toxic epidermal necrolysis

Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions characterised by keratinocyte apoptosis, necroptosis and epidermal detachment. Several cytokines and cytotoxic proteins have been shown to be elevated in the blood and skin of SJS/TEN sufferers and biologics such as intravenous immune globulin and tumour necrosis factor (TNF)-alpha inhibitors have demonstrated good therapeutic potential. The exact pathogenic model of SJS/TEN however remains elusive. This systematic review aimed to evaluate the case–control studies of cytokines and cytotoxic proteins in the blister fluid and skin of adults with Stevens Johnson syndrome and/or toxic epidermal necrolysis. This review was registered with INPLASY and conducted in accordance with the PRISMA reporting guidelines. Potential bias was assessed using the NIH criteria. Eleven articles describing results from 96 cases and 170 controls were included. Fas, Fas ligand, Interleukin (IL)-8 and B-cell lymphoma (Bcl)-2 were elevated in SJS/TEN blister fluid and skin tissue, compared with healthy controls. IL-2, IL-6, TNF-alpha, tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon-gamma and matrix metalloproteinase-2 were elevated in SJS/TEN blister fluid compared with fluid sampled from lesional controls. Granulysin, IL-33, TGF-beta-1 and IL-13 were elevated in SJS/TEN skin tissue compared with lesional lichen planus tissue, as was IL-13, IFN-gamma, IL-2 and IL-5, when compared with erythema multiforme tissue. A wide array of cytokines and cytotoxic proteins are present at higher concentrations in the blister fluid and skin tissue of SJS/TEN patients compared with healthy and lesional controls. Our findings suggest that these proteins may be pathogenic, as well as possibly markers for diagnosis, disease severity and course. They may also prove to be useful therapeutic targets. More research is needed.

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来源期刊
CiteScore
3.20
自引率
5.00%
发文量
186
审稿时长
6-12 weeks
期刊介绍: Australasian Journal of Dermatology is the official journal of the Australasian College of Dermatologists and the New Zealand Dermatological Society, publishing peer-reviewed, original research articles, reviews and case reports dealing with all aspects of clinical practice and research in dermatology. Clinical presentations, medical and physical therapies and investigations, including dermatopathology and mycology, are covered. Short articles may be published under the headings ‘Signs, Syndromes and Diagnoses’, ‘Dermatopathology Presentation’, ‘Vignettes in Contact Dermatology’, ‘Surgery Corner’ or ‘Letters to the Editor’.
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