Stevens-Johnson综合征和中毒性表皮坏死松解患者血清中thelper2来源的细胞因子浓度

Open Access Macedonian Journal of Medical Sciences Pub Date : 2023-05-04 DOI:10.3889/oamjms.2023.11645

T. Tran, Nguyen Thi Ha Vinh

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引用次数: 0

摘要

背景:Stevens-Johnson综合征(SJS)和中毒性表皮坏死松解(TEN)是严重的皮肤药物不良反应。一些免疫和遗传因素被认为参与了SJS/TEN的发病机制，包括辅助性T 1和辅助性T 2 (Th2)衍生的细胞因子。目的:本研究旨在评价SJS/TEN患者血清中th2源性细胞因子水平，并与多形性红斑(EM)患者进行比较，探讨其与SJS/TEN进展的关系。方法:这是一项分段描述性研究，于2017年10月至2019年9月在越南河内国立皮肤性病医院进行。48例SJS/TEN患者、43例EM患者和20例健康对照(hc)参与研究。采用荧光共价微珠免疫吸附法(FCMIA) (ProcartaPlex Immunoassay Panels kit, Thermo Fisher Scientific, USA)检测血清白细胞介素(IL)-4、IL-5和IL-13水平。采用Mann-Whitney U检验比较两组血清IL水平。采用Wilcoxon检验比较治疗前后的定量变量。p < 0.05认为差异有统计学意义。结果:19例SJS患者(39.5%)和29例TEN患者(60.5%)参加了我们的研究。平均年龄49.3岁，年龄范围19 ~ 77岁，男性占47.9%;52.1%的女性)。最常见的致病药物为传统药物(29.1%)和别嘌呤醇(12.5%)。入院当日，SJS/TEN组血清IL-4水平为3±7.5 pg/mL，高于hc组(p < 0.05)，但不高于EM组(p < 0.05);SJS/TEN组血清IL-5和IL-13水平分别为4.5±9.8 pg/mL和1.6±0.6 pg/mL，与EM和hc组相似。再上皮当日，SJS/TEN患者血清IL-5水平为1±2.8 pg/ml，低于住院当日(3±7.5 pg/ml)，差异有统计学意义(p < 0.05)。关于血清IL-4和IL-13水平，两个时间点之间没有差异。结论:SJS/TEN组血清中th2源性细胞因子(IL-4、IL-5、IL-13)浓度均不高于EM组，除血清IL-5水平外，SJS/TEN的临床进展无明显变化。

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Serum Concentrations of Thelper2-derived Cytokines in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Some immunological and genetic factors are believed to be involved in the pathogenesis of SJS/TEN, including T helper 1 and T helper 2 (Th2)-derived cytokines. AIM: This study aims to evaluate the serum levels of Th2-derived cytokines in SJS/TEN, compare to those of erythema multiforme (EM) patients, and the relation between them and the progress of SJS/TEN. METHODS: This was a sectional descriptive study conducted at the National Hospital of Dermatology and Venereology, in Hanoi, Vietnam, from October 2017 to September 2019. 48 SJS/TEN patients, 43 EM patients, and 20 healthy controls (HCs) participated. Serum interleukin (IL)-4, IL-5, and IL-13 levels were measured by using the fluorescence covalent microbead immunosorbent assay (FCMIA) (ProcartaPlex Immunoassay Panels kit, Thermo Fisher Scientific, USA). The Mann-Whitney U test was used to compare the serum IL levels of the two groups. The Wilcoxon tests were used to compare quantitative variables before and after the treatment. Differences were considered to be statistically significant at p < 0.05. RESULTS: 19 SJS patients (39.5%) and 29 TEN patients (60.5%) participated in our study. The mean age was 49.3, range of 19–77 years (47.9% males; 52.1% females). The most common causative drugs were traditional medicine (29.1%), and allopurinol (12.5%). On the day of hospitalization, the serum level of IL-4 in the SJS/TEN group was 3 ± 7.5 pg/mL, statistically significantly higher than that in the HCs group (p < 0.05), but not higher than that in the EM group (p > 0.05); serum levels of IL-5 and IL-13 in the SJS/TEN group were 4.5 ± 9.8 pg/mL and 1.6 ± 0.6 pg/mL, respectively, similar to those in the EM and HCs groups. On the day of re-epithelialization, in SJS/TEN patients, the serum level of IL-5 was 1 ± 2.8 pg/ml, statistically significantly lower than that on the day of hospitalization (3 ± 7.5 pg/mL) with p < 0.05. Regarding serum levels of IL-4 and IL-13, there was no difference between the two- time points. CONCLUSION: The serum concentrations of Th2-derived cytokines (IL-4, IL-5, and IL-13) were not higher in the SJS/TEN group than in the EM group and there was no significant change in the clinical progression of SJS/TEN, except the serum level of IL-5.

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来源期刊

Open Access Macedonian Journal of Medical Sciences Medicine-Medicine (all)

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1225

期刊介绍： Open Access Macedonian Journal of Medical Sciences (OAMJMS) [formerly known as Macedonian Journal of Medical Sciences] is a top-tier open access medical science journal published by the ID Design 2012/DOOEL Skopje, Rajko Zhinzifov No 48, 1000 Skopje, Republic of Macedonia. OAMJMS is an international, modern, general medical journal covering all areas in the medical sciences, from basic studies to large clinical trials and cost-effectiveness analyses. We publish mostly human studies that substantially enhance our understanding of disease epidemiology, etiology, and physiology; the development of prognostic and diagnostic technologies; trials that test the efficacy of specific interventions and those that compare different treatments; and systematic reviews. We aim to promote translation of basic research into clinical investigation, and of clinical evidence into practice. We publish occasional studies in animal models when they report outstanding research findings that are highly clinically relevant. Our audience is the international medical community as well as educators, policy makers, patient advocacy groups, and interested members of the public around the world. OAMJMS is published quarterly online version. The Open Access Macedonian Journal of Medical Sciences (OAMJMS) publishes Medical Informatics, Basic Science, Clinical Science, Case Report, Brief Communication, Public Health, Public Policy, and Review Article from all fields of medicine and related fields. This journal also publishes, continuously or occasionally, the bibliographies of the members of the Society, medical history, medical publications, thesis abstracts, book reviews, reports on meetings, information on future meetings, important events and dates, and various headings which contribute to the development of the corresponding scientific field.