Serum IL-17 in patients with erythema multiforme or Stevens-Johnson syndrome/toxic epidermal necrolysis drug reaction, and correlation with disease severity

Morsy, Hanan; Taha, Emad A.; Nigm, Dalia A; Shahin, Rasha Y; Youssef, Elza Youssef

doi:10.1111/ced.13213

Cited by 11 publications

(18 citation statements)

References 20 publications

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“…Przepiorka‐Kosinska et al showed that serum IL‐17 levels positively correlated with psoriasis severity and Elghandour et al reported a significant decreased in serum IL‐17 levels in psoriasis patients after narrow band ultraviolet B and methotrexate therapies 35,36 . Serum IL‐17 concentrations also correlated with disease severity in patients with HS, vitiligo, SJS/TEN, and acne vulgaris 37,38,41,43 . Our result did not report any association between serum IL‐17 levels and disease features including rosacea subtype, disease severity, age of disease onset, disease duration, and presence of family history of rosacea.…”

Section: Discussioncontrasting

confidence: 63%

Serum IL‐17 levels in patients with rosacea

Hayran

Şen

Oğuz

et al. 2021

J of Cosmetic Dermatology

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Background Rosacea is a chronic inflammatory skin disease characterized with increased serum and tissue inflammatory mediators. IL‐17 is a well‐known inflammatory mediator that plays important roles in pathogenesis of inflammatory skin diseases. Previous studies reported that Th17 pathway is activated in rosacea and IL‐17, one of Th17 signature cytokines, is elevated in tissue samples of rosacea patients. Objectives The aim of this study was to investigate serum IL‐17 levels in rosacea patients and to study its relationship with disease characteristics. Methods Sixty patients diagnosed with rosacea and 60 healthy controls were included in the study. Serum IL‐17 concentrations were measured using enzyme‐linked immunosorbent assay (ELISA). Results The mean serum IL‐17 level was 8.03 pg/mL (SD = 1.47) in rosacea patients and 7.37 pg/mL (Sd = 1.19) in controls. Serum IL‐17 levels were significantly higher in rosacea (p = 0.002). Serum IL‐17 levels were similar among patients with erythematotelangiectatic (ET) and papulopustular (PP) rosacea (8.02 vs 8.06, p = 0.83). Serum IL‐17 levels did not correlate with rosacea severity (p = 0.59, r = 0.07 in ET rosacea; p = 0.88, r = 0.02 in PP rosacea), age of onset (p = 0.58, r = −0.07), and disease duration (p = 0.37, r = −0.11). Primary features and global assessments did not correlate with serum IL‐17 levels (all p > 0.05). Among secondary features, edema showed a significant negative correlation with serum IL‐17 concentrations (p = 0.037, r = −0.26). Conclusions Our study showed increased serum IL‐17 levels in rosacea patients and a significant correlation between IL‐17 concentrations and secondary features of the disease suggesting IL‐17 may contribute to pathogenesis of rosacea and may be a new target for rosacea treatment.

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Section: Discussioncontrasting

confidence: 63%

Serum IL‐17 levels in patients with rosacea

Hayran

Şen

Oğuz

et al. 2021

J of Cosmetic Dermatology

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“…16 In addition, some inflammatory cytokines, like TNFα, interleukin (IL)-15, and IL-17, were also related to it. 17,18 Genetic factors and offending medications can result in activation of an inflammatory cascade, leading to keratinocyte apoptosis, blistering, and systemic inflammation. 9 The traditional inflammatory parameters such as CRP and PCT have been used to evaluate systemic inflammatory status and prognosis in some hyper-inflammatory immune responses.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil : lymphocyte ratio is associated with disease severity and mortality in patients with Stevens–Johnson syndrome/toxic epidermal necrolysis

Wang

Lan

et al. 2021

The Journal of Dermatology

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The neutrophil : lymphocyte ratio (NLR), platelet : lymphocyte ratio (PLR), C-reactive protein : albumin ratio (CAR), and albumin : fibrinogen ratio (AFR) have been considered as useful inflammatory biomarkers. However, their roles in Stevens-Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN) still remain unclear. This study aimed to test whether NLR, PLR, CAR, and AFR serve as predictive markers of disease severity and systemic inflammation in patients with SJS/TEN. This retrospective study included 40 patients with SJS/TEN and 60 healthy controls. The correlation between these markers and severity-of-illness score for toxic epidermal necrolysis (SCORTEN), ABCD-10, procalcitonin (PCT), C-reactive protein (CRP) were analyzed and compared. Univariable and multivariable analysis were used to assess associations of variables with mortality. The receiver-operator curves (ROC) were used to evaluate the predictive value of variables for mortality in SJS/TEN patients. The results demonstrated that the NLR and PLR of SJS/TEN patients were significantly higher and the AFR was significantly lower when compared with healthy controls (p < 0.05). The NLR and CAR were positively correlated with SCORTEN, ABCD-10, PCT, and CRP. The NLR in SCORTEN of ≥3 group was significantly higher than that in SCORTEN <3 group (p < 0.05) and there were no significant differences between PLR, CAR, and AFR between the two groups. The univariate analysis suggested that NLR of >5.79 was a risk factor for mortality (odds ratio, 10.5; p < 0.05), but the association was no longer statistically significant in multivariable analysis. The ROC showed that NLR had a sensitivity of 85.7% and specificity of 63.6% for predicting death with a cut-off value of 5.79 (p < 0.05) in SJS/TEN patients. In conclusion, among the four markers, NLR and CAR can partially reflect severity and inflammatory status in patients with SJS/TEN. NLR was also a predictor of death.

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“…These findings are favorable to the key role of granulysin, a product of CTLs and NK cells, in the pathogenesis of SJS/TEN. EM is a cutaneous reaction characterized by typical or atypical target lesions that mimic cutaneous manifestations of SJS/TEN in the early phase [2], [22], [23]. The causes of EM may be a viral infection or drug reaction [22], [23], [32].…”

Section: Discussionmentioning

confidence: 99%

“…EM is a cutaneous reaction characterized by typical or atypical target lesions that mimic cutaneous manifestations of SJS/TEN in the early phase [2], [22], [23]. The causes of EM may be a viral infection or drug reaction [22], [23], [32]. Serum granulysin can be also elevated in viral infected conditions [33] such as virus-associated EM.…”

Section: Discussionmentioning

confidence: 99%

“…Erythema multiforme (EM) may have skin manifestation similar to SJS/TEN [2], [22], [23], but they can be distinguished immunopathologically. In cases of SJS/TEN, the inflammatory infiltrates expressing granulysin, granzyme B, and perforin accumulated predominantly in the lower epidermal and subepidermal bulla, in contrast, they were relatively sparse in EM [24].…”

Section: Introductionmentioning

confidence: 99%

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Serum Granulysin in Differentiation of Stevens-Johnson Syndrome/toxic Epidermal Necrolysis and Erythema Multiforme

Huyền¹,

Hoa²,

Trang³

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening drug reactions, which lead to massive epidermal necrolysis. Granulysin plays an important role as a key mediator for keratinocyte apoptosis in these conditions. Erythema multiforme (EM) may have skin manifestation similar to SJS/TEN. AIMS: The aim of the study was to compare serum granulysin levels in patients with SJS/TEN and EM as well as to investigate a possible association between serum granulysin levels and the severity of SJS/TEN. METHODS: In total, 48 patients with SJS/TEN, 43 patients with EM, and 20 health controls (HCs) were enrolled. We measured serum granulysin levels using enzyme-linked immunosorbent assay. RESULTS: The average level of serum granulysin in the SJS/TEN patients was 23.0 ng/ml (range 1.2–144.6 ng/ml), significantly higher than that of EM group (20.1 ng/ml; range 8.5–121 ng/ml, p < 0.05) and HCs group (20.8 ng/ml; range 10.1–46.7 ng/ml, p < 0.05). Of 48 SJS/TEN patients, the 25 samples collected <6 days after onset showed higher level of serum granulysin (27.7 ng/ml; range 2.5–144.6 ng/ml) than those collected ≥6 days after onset (17.9 ng/ml; range 1.2–59 ng/ml; p > 0.05). No significant correlation was found between serum granulysin levels and the body surface area affected and the modified-SCORTEN. At the day of re-epithelialization, serum granulysin levels were not different compared with those at the day of hospitalization. CONCLUSIONS: Serum granulysin levels are significantly higher in SJS/TEN group than in EM group. After the onset, serum granulysin levels in patients with SJS/TEN are not a good biomarker to evaluate the severity of the diseases.

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Serum IL-17 in patients with erythema multiforme or Stevens-Johnson syndrome/toxic epidermal necrolysis drug reaction, and correlation with disease severity

Abstract: Serum IL-17 levels may have prognostic and diagnostic value in patients with EM or SJS/TEN reactions, and can provide a valuable approach in managment.

Cited by 11 publications

References 20 publications

Serum IL‐17 levels in patients with rosacea

Serum IL‐17 levels in patients with rosacea

Neutrophil : lymphocyte ratio is associated with disease severity and mortality in patients with Stevens–Johnson syndrome/toxic epidermal necrolysis

Serum Granulysin in Differentiation of Stevens-Johnson Syndrome/toxic Epidermal Necrolysis and Erythema Multiforme

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