RT Journal Article
T1 Anticonvulsant-induced Toxic Epidermal Necrolysis: Monitoring the Immunologic Response.
A1 Leyva-Fernández, Laura
A1 Torres-Jaén, María Josefa
A1 Posadas, Sinforiano Jose
A1 Blanca, Miguel
A1 Besso, Guillermo
A1 O'Valle, Francisco
A1 García del Moral, Raimundo
A1 Santamaría, Luis F
A1 Juárez, Carlos
K1 Piel
K1 Piel - Enfermedades
AB Background Toxic epidermal necrolysis is a severe reaction with skin involvement induced by different drugs and other agents. The mechanisms implicated in the induction of the reaction are poorly understood.Objective To study the involvement of T lymphocytes and other immunocompetent cells in the peripheral blood, blister fluid, and affected skin of 3 patients who developed a severe reaction after receiving anticonvulsant medication.Methods Quantification of T lymphocytes expressing the skin homing receptor (cutaneous lymphocyte-associated antigen [CLA]) in peripheral blood, skin and skin blister fluid and assessment of other adhesion molecules, activation markers and inflammatory interleukins by flow cytometry, immunohistochemistry and RT-PCR.Results An increase in CD3+CLA+ cells paralleling the severity of the disease was observed in both peripheral blood and skin, tending to normalize as soon as patient’s condition improved. E-selectin was detected in endothelial vessels in parallel with CLA expression on lymphocytes. An overexpression of TNF-, IFN- and IL-2 was also observed in peripheral blood mononuclear cells. The expression of the different markers changed over the course of the disease.Conclusions. These data show an increase in activated T cells expressing the skin-homing receptor in both tissue and peripheral blood accompanying clinical symptoms, with a recruitment of macrophages and an overexpression of cytokines. All these results suggest an important role for T cells in the production of toxic epidermal necrolysis.
PB Elsevier BV
YR 2000
FD 2000
LK https://hdl.handle.net/10630/32376
UL https://hdl.handle.net/10630/32376
LA eng
NO Leyva L, Torres MJ, Posadas S, Blanca M, Besso G, O'Valle F, del Moral RG, Santamaría LF, Juárez C. Anticonvulsant-induced toxic epidermal necrolysis: monitoring the immunologic response. J Allergy Clin Immunol. 2000 Jan;105(1 Pt 1):157-65
NO This work was supported in part by Grants CICYT SAF 96/0240 from the Consejería de Salud de la Junta de Andalucía and FIS 98/0861. Laura Leyva has a FIS fellowship 98/5061.
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 21 ene 2026