Plasma Cytokine and Chemokine Profile in Hospitalized Toxic Epidermal Necrolysis Patients

Abstract Clinical management of Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and other immune mediated cutaneous reactions can benefit from early diagnosis and novel therapeutics. To identify reliable and potential pathogenic biomarkers of SJS/TEN, we analyzed plasma cytokine/chemokine profiles during the first week of hospitalization. A total of 12 SJS/TEN and 24 burn patients participated in the study. The SJS/TEN group showed a significant increase in four cytokines throughout the study period. Median concentrations of CXCL10, CXCL9, CXCL11 and TNFα on the first day of hospitalization were 147, 36.8, 10.7 and 5.9-fold higher in SJS/TEN group compared to the burn group, respectively (P 0.01). Receiver operating characteristic analysis of these cytokines showed the highest areas under the curve with values of 0.962, 0.955, 1.000 and 0.972, respectively. The early appearance, and a sustained large magnitude of changes in these cytokines indicate potential diagnostic and therapeutic utility of the identified cytokine/chemokines.