Occupational trichloroethylene hypersensitivity syndrome: human herpesvirus 6 reactivation and rash phenotypes - PubMed (original) (raw)

doi: 10.1016/j.jdermsci.2013.07.003. Epub 2013 Jul 16.

Hailan Wang, Osamu Yamanoshita, Yuki Ito, Lihua Xia, Yukie Yanagiba, Cishan Chen, Ai Okamura, Zhenlie Huang, Xinxiang Qiu, Xiangrong Song, Tingfeng Cai, Lili Liu, Yichen Ge, Yingyu Deng, Hisao Naito, Tetsushi Yoshikawa, Mikiko Tohyama, Laiyu Li, Hanlin Huang, Tamie Nakajima

Affiliations

Occupational trichloroethylene hypersensitivity syndrome: human herpesvirus 6 reactivation and rash phenotypes

Michihiro Kamijima et al. J Dermatol Sci. 2013 Dec.

Abstract

Background: Trichloroethylene (TCE) is an industrial solvent which can cause severe generalized dermatitis, i.e., occupational TCE hypersensitivity syndrome. Reactivation of latent human herpesvirus 6 (HHV6) can occur in such patients, which has made TCE known as a causative chemical of drug-induced hypersensitivity syndrome (DIHS).

Objective: This study aimed to clarify HHV6 status, cytokine profiles and their association with rash phenotypes in patients with TCE hypersensitivity syndrome.

Methods: HHV6 DNA copy numbers, anti-HHV6 antibody titers, and cytokines were measured in blood prospectively sampled 5-7 times from 28 hospitalized patients with the disease.

Results: The patients (19 had exfoliative dermatitis (ED) and 9 had non-ED type rash) generally met the diagnostic criteria for DIHS. Viral reactivation defined as increases in either HHV6 DNA (≥100 genomic copies/10(6) peripheral blood mononuclear cells) or antibody titers was identified in 24 (89%) patients. HHV6 DNA, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-5, IL-6 and IL-10 concentrations were remarkably higher in the patients than in the healthy workers (p<0.01). Positive correlations between HHV6 DNA, TNF-α, IFN-γ, IL-6 and IL-10 were significant (p<0.05) except for that between HHV6 DNA and IFN-γ. An increase in HHV6 DNA was positively associated with an increase in TNF-α on admission (p<0.01). HHV6 DNA, the antibody titers, TNF-α and IL-10 concentrations were significantly higher in ED than in the non-ED type (p<0.05).

Conclusion: Reactivated HHV6 and the increased cytokines could be biomarkers of TCE hypersensitivity syndrome. The higher-level reactivation and stronger humoral responses were associated with ED-type rash.

Keywords: Biomarker; Cytokine; DIHS; DRESS; Drug-induced hypersensitivity syndrome (DIHS); ED; EM; HHV6; Human herpesvirus 6; IFN-γ; IL; LOQ; PBMC; Reactivation; SD; TCA; TCE; TEN; TNF-α; Trichloroethylene; drug reaction with eosinophilia and systemic symptoms; drug-induced hypersensitivity syndrome; erythema multiforme; exfoliative dermatitis; human herpesvirus 6; interferon gamma; interleukin; limit of quantification; peripheral blood mononuculear cell; standard deviation; toxic epidermal necrolysis; trichloroacetic acid; trichloroethylene; tumor necrosis factor alpha.

Copyright © 2013 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

PubMed Disclaimer

Similar articles

Cited by

Publication types

MeSH terms

Substances

LinkOut - more resources