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- Title
Granulysin is a key mediator for disseminated keratinocyte death in Stevens-Johnson syndrome and toxic epidermal necrolysis.
- Authors
Wen-Hung Chung; Shuen-Iu Hung; Jui-Yung Yang; Shih-Chi Su; Shien-Ping Huang; Chun-Yu Wei; See-Wen Chin; Chien-Chun Chiou; Sung-Chao Chu; Hsin-Chun Ho; Chih-Hsun Yang; Chi-Fang Lu; Jer-Yuarn Wu; You-Di Liao; Yuan-Tsong Chen
- Abstract
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening adverse drug reactions characterized by massive epidermal necrosis, in which the specific danger signals involved remain unclear. Here we show that blister cells from skin lesions of SJS-TEN primarily consist of cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells, and both blister fluids and cells were cytotoxic. Gene expression profiling identified granulysin as the most highly expressed cytotoxic molecule, confirmed by quantitative PCR and immunohistochemistry. Granulysin concentrations in the blister fluids were two to four orders of magnitude higher than perforin, granzyme B or soluble Fas ligand concentrations, and depleting granulysin reduced the cytotoxicity. Granulysin in the blister fluids was a 15-kDa secretory form, and injection of it into mouse skin resulted in features mimicking SJS-TEN. Our findings demonstrate that secretory granulysin is a key molecule responsible for the disseminated keratinocyte death in SJS-TEN and highlight a mechanism for CTL- or NK cell—mediated cytotoxicity that does not require direct cellular contact.
- Publication
Nature Medicine, 2008, Vol 14, Issue 12, p1343
- ISSN
1078-8956
- Publication type
Academic Journal
- DOI
10.1038/nm.1884