Plasma cytokine and chemokine profile in patients who are hospitalized with toxic epidermal necrolysis

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 analysed plasma cytokine/chemokine profiles during the first week of hospitalization. In total, 12 patients with SJS/TEN and 24 with burns 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 tumour necrosis factor-α on the first day of hospitalization were 147-, 36.8-, 10.7- and 5.9-fold higher, respectively, in the SJS/TEN group compared with the burns group (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 cytokines/chemokines.