Increased ratio of FoxP3+ regulatory T cells/CD3+ T cells in skin lesions in drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms

Clin Exp Dermatol. 2014 Apr;39(3):284-91. doi: 10.1111/ced.12246.

Abstract

Background: Drug-induced hypersensitivity syndrome/drug rash with eosinophilia with systemic symptoms (DIHS/DRESS) is a severe drug eruption accompanied by multiorgan disorders. Several unique aspects of DIHS/DRESS, including herpesvirus reactivation, liver dysfunction and hypogammaglobulinaemia, have similarities to graft-versus-host disease (GVHD).

Aim: In this study, we focused on the dynamics of regulatory T cells (Tregs) infiltrating into the skin lesions of DIHS/DRESS and GVHD.

Methods: Skin biopsies were taken from patients with DIHS/DRESS, GVHD, or maculopapular drug eruption. Tregs were detected using immunostaining with anti-FoxP3.

Results: The ratio of FoxP3+ T cells to CD3+ T cells was significantly higher in the skin lesions of patients with DIHS/DRESS than in those of patients with GVHD, and was positively correlated with the number of days from disease onset in the acute phase.

Conclusions: The dynamics of Tregs in skin lesions are different between DIHS/DRESS and GVHD, despite there being many similarities between these conditions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Drug Eruptions / immunology
  • Drug Eruptions / pathology*
  • Eosinophilia / pathology
  • Exanthema / pathology
  • Female
  • Forkhead Transcription Factors / metabolism*
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / pathology*
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • T-Lymphocytes, Regulatory / metabolism
  • T-Lymphocytes, Regulatory / pathology*
  • Young Adult

Substances

  • FOXP3 protein, human
  • Forkhead Transcription Factors