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. 2000 Jan;119(1):225-30.
doi: 10.1046/j.1365-2249.2000.01119.x.

Blister fluid T lymphocytes during toxic epidermal necrolysis are functional cytotoxic cells which express human natural killer (NK) inhibitory receptors

L Le Cleach  1 , S Delaire, L Boumsell, M Bagot, I Bourgault-Villada, A Bensussan, J C Roujeau
Affiliations

Blister fluid T lymphocytes during toxic epidermal necrolysis are functional cytotoxic cells which express human natural killer (NK) inhibitory receptors

L Le Cleach et al. Clin Exp Immunol. 2000 Jan.

Abstract

Toxic epidermal necrolysis (TEN) is a rare life-threatening adverse drug reaction characterized by a massive destruction of the epidermis. Immunohistological studies of skin biopsies of TEN showed infiltrates of predominantly CD8+ T lymphocytes even though other authors reported a prominent involvement of cells of the monocyte-macrophage lineage. The aim of this study was to characterize phenotypically and functionally the cells present in the cutaneous blister fluid of four patients with TEN. We first determined that lymphocytes were predominant in blister fluid obtained early, while monocytes/macrophages later became the most important population. We then showed that this lymphocyte population, mainly CD3+CD8+, corresponded to a peculiar cell subset as they expressed cutaneous leucocyte antigen, killer inhibitory receptors KIR/KAR and failed to express CD28 molecule. Functionally, we determined that blister T lymphocytes had a cytotoxic T lymphocyte (CTL)- and NK-like cytotoxicity. The role of this cytotoxic lymphocyte population present at the site of lesions during TEN remains to be understood.

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Figures

Fig. 1
Fig. 1
Flow cytometric analysis of toxic epidermal necrolysis (TEN) blister fluid cells on the basis of size and granulosity. A, morphologic characteristics of lymphocytes; N, morphologic characteristics of monocytes-macrophages.
Fig. 2
Fig. 2
Cytotoxicity of blister fluid cells (▪) and of a positive control T cell clone (TC7) (•) evaluated in a 4-h 51Cr release assay. Assays were done in triplicate. The percentage specific lysis was calculated as described in Patients and Methods.
Fig. 3
Fig. 3
Cytotoxicity of two different patient blister fluid cells against the NK-sensitive cell line K562 evaluated in a 4-h 51Cr release assay. Assays were done in triplicate. The percentage specific lysis was calculated as described in Patients and Methods.
Fig. 4
Fig. 4
Flow cytometric analysis results after double staining of blister fluid cells (a) and peripheral blood lymphocytes (PBL) (b) of patient 1, using a CD3 antibody directly coated and a mixture of the four anti-KIR/KAR antibodies (all of them directly labelled with the same fluorochrome).
See this image and copyright information in PMC

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