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J Invest Dermatol. 2016 Dec 20. pii: S0022-202X(16)32797-X. doi: 10.1016/j.jid.2016.11.034. [Epub ahead of print]

Interleukin-15 is associated with severity and mortality in Stevens-Johnson syndrome/toxic epidermal necrolysis.

Author information

  • 1Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou Keelung, Taiwan.
  • 2Dokumentationszentrum schwerer Hautreaktionen, Department of Dermatology, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.
  • 3Department of Dermatology, Hospital Henri Mondor, Créteil, France.
  • 4Biostatistics and Epidemiology Unit, Gustave Roussy, Villejuif, France.
  • 5University Medical Center Henri Mondor, ImmunoBiology Department & Inserm U955, France.
  • 6Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou Keelung, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
  • 7Research Unit, Hospital La Paz Health Research Institute (IdiPAZ), Madrid, Spain.
  • 8Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany.
  • 9Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou Keelung, Taiwan.
  • 10Department of Dermatology, Reference Center for Cutaneous Adverse Reactions, University Medical Center Groningen, University of Groningen, The Netherlands.
  • 11Institute of Pharmacology, School of Medicine, Infection and Immunity Research Center, National Yang-Ming University, Taipei, Taiwan.
  • 12Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. Electronic address: chung1@cgmh.org.tw.

Abstract

Early diagnosis and prognosis monitoring for Stevens-Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) still remain a challenge. This study aims to explore any cytokine/chemokine with prognostic potential in SJS/TEN. Through screening a panel of 28 serological factors, IL-6, IL-8, IL-15, TNF-α, and granulysin were upregulated in SJS/TEN patients and selected for the further validation in total 155 SJS/TEN patients, including 77 from Taiwan and 78 from RegiSCAR (the Registry of Severe Cutaneous Adverse Reactions). Among these factors evaluated, the levels of IL-15 (r = 0.401; p < 0.001) and granulysin (r = 0.223; p = 0.026) were significantly correlated with the disease severity in 112 samples after excluding patients with insufficient data to calculate the SCORTEN (score of toxic epidermal necrolysis). In addition, IL-15 was also associated with mortality (p = 0.002; OR, 1.09; 95% CI, 1.03-1.14; p = 0.001; AOR, 1.10; 95% CI, 1.04-1.16). Consistent results were obtained after the exclusion of Taiwanese patients with sepsis to rule out possible confounders. Moreover, IL-15 was shown to enhance cytotoxicity of cultured NK cells and blister cells from TEN patients. Our findings highlight a usefulness of IL-15 in prognosis monitoring and therapeutic intervention of this devastating condition.

KEYWORDS:

Stevens-Johnson syndrome; cytokine; granulysin; interleukin-15; prognostic factor; toxic epidermal necrolysis

PMID:
28011147
DOI:
10.1016/j.jid.2016.11.034
[PubMed - as supplied by publisher]
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