Supplementary Material for: Skin-Homing IL-13-Producing T Cells Expand in the Circulation of Patients with Drug Rash with Eosinophilia and Systemic Symptoms
<p><b><i>Background:</i></b> Drug rash with eosinophilia and systemic
symptoms (DRESS), also known as drug-induced hypersensitivity syndrome,
is characterized by severe drug-induced reactions with extensive
cutaneous lesions and visceral involvement. Although T cell-mediated
hypersensitivity reactions to drugs may be involved in the pathogenesis
of DRESS, there is limited data regarding the T-cell phenotypes
responsible for the pathogenesis of DRESS. <b><i>Objective and Methods:</i></b>
Using flow cytometry, we investigated the cytokine profiles and
cutaneous lymphocyte antigen (CLA) expression in circulating T cells in
patients with DRESS. <b><i>Results:</i></b> The proportions of
circulating IL-4- and IL-13-producing CD4+ T cells, but not CD8+ T
cells, were significantly higher in patients with DRESS during the
active stage of the disease than in healthy subjects, and these
proportions declined during the recovery stage. No differences in the
proportions of circulating IFN-γ-, IL-17-, and IL-22-producing CD4+ and
CD8+ T cells were observed between patients with DRESS and healthy
subjects. A strong correlation between the proportion of IL-13-producing
CD4+ T cells and serum levels of thymus and activation-regulated
chemokine was observed. The proportion of CLA-expressing CD4+ T cells
was significantly higher during the active stage of the disease.
Moreover, the proportion of IL-13-producing CD4+ T cells was higher in
the CLA+ subset than in the CLA- subset. <b><i>Conclusions:</i></b> Skin-homing IL-13-producing CD4+ T cells may be involved in the pathogenesis of DRESS.</p
