2026-05-28T12:20:19Zhttps://riuma.uma.es/rest/oai/request

oai:riuma.uma.es:10630/323762026-02-03T11:01:37Zcom_10630_2254col_10630_37953

Anticonvulsant-induced Toxic Epidermal Necrolysis: Monitoring the Immunologic Response. Leyva-Fernández, Laura Torres-Jaén, María Josefa Posadas, Sinforiano Jose Blanca, Miguel Besso, Guillermo O'Valle, Francisco García del Moral, Raimundo Santamaría, Luis F Juárez, Carlos Piel Piel - Enfermedades 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. 2024-07-31T09:00:45Z 2024-07-31T09:00:45Z 2024-07-31T09:00:45Z 2000 journal article 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 https://hdl.handle.net/10630/32376 10.1016/s0091-6749(00)90191-x eng http://creativecommons.org/licenses/by-nc-nd/4.0/ open access Attribution-NonCommercial-NoDerivatives 4.0 Internacional Elsevier BV