Plasma Cytokine and Chemokine Profile in Hospitalized Toxic Epidermal Necrolysis Patients

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.