Serum IFN-γ-inducible chemokines CXCL9 and CXCL10 are elevated in nonimmediate drug hypersensitivity reactions.

Background: The recruitment to the skin of drug-responsive T cells is responsible for inflammatory profiles of nonimmediate drug hypersensitivity reactions (niDHRs). Maculopapular exanthema (MPE) and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) have quite distinct T cell infiltrating patterns. Objective: To investigate serum levels of CXCL9, CXCL10 and IFN-γ in patients with niDHRs, including MPE and SJS/TEN, evaluate correlations between the cytokines, and determine whether the inflammatory factors correlate with clinical severity in patients with SJS/TEN. Methods: 24 patients with SJS/TEN and 24 patients with MPE, and 24 healthy donors with good tolerance to the drugs involved in the drug reactions, were recruited into the study. The modified severity-of-illness score for TEN (SCORTEN) and detachment of body surface area (dBSA) were used to assess clinical severity of SJS/TEN. Serum levels of CXCL9, CXCL10 and IFN-γ were determined by ELISA. Results: niDHRs group, SJS/TEN and MPE subgroups all exhibited significantly higher levels of CXCL9, CXCL10 and IFN-γ compared with control group ( P < 0.001). Serum IFN-γ levels were positively correlated with CXCL9 levels and CXCL10 levels in patients with niDHRs ( r s = 0.576, r s = 0.449, P < 0.05). None of the levels of CXCL9, CXCL10 and IFN-γ had any correlation with modified SCOTEN index or dBSA in SJS/TEN group. Conclusion: The results suggest Th1 cytokine INF-γ and chemokines CXCL9 and CXCL10 may play roles in the pathogenesis of niDHRs. DOI 10.12932/AP0679