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416 results on '"Yang, Chih-Hsun"'

4. Randomized, controlled trial of TNF-[alpha] antagonist in CTL-mediated severe cutaneous adverse reactions

Author

Wang, Chuang-Wei, Yang, Lan-Yan, Chen, Chun-Bing, Ho, Hsin-Chun, Hung, Shuen-Iu, Yang, Chih-Hsun, Chang, Chee-Jen, Su, Shih-Chi, Hui, Rosaline Chung-Yee, Chin, See-Wen, Huang, Li-Fang, Lin, Yang Yu-Wei, Chang, Wei-Yang, Fan, Wen-Lang, Yang, Chin-Yi, Ho, Ji-Chen, Chang, Ya-Ching, Lu, Chun-Wei, and Chung, Wen-Hung

Subjects
Care and treatment, Development and progression, Genetic aspects, Health aspects, Tumor necrosis factor -- Health aspects, Lymphocytes -- Genetic aspects -- Health aspects, Skin diseases -- Genetic aspects -- Development and progression -- Care and treatment
Abstract

Introduction Stevens-Johnson syndrome (SJS) and its related disease, toxic epidermal necrolysis (TEN), are severe cutaneous adverse reactions (SCARs) involving keratinocyte apoptosis and detachment of the epidermis. Allopurinol and carbamazepine are [...], BACKGROUND. Cytotoxic T lymphocyte-mediated (CTL-mediated) severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), are rare but life-threatening adverse reactions commonly induced by drugs. Although high levels of CTL-associated cytokines, chemokines, or cytotoxic proteins, including TNF-[alpha] and granulysin, were observed in SJS-TEN patients in recent studies, the optimal treatment for these diseases remains controversial. We aimed to evaluate the efficacy, safety, and therapeutic mechanism of a TNF-[alpha] antagonist in CTL-mediated SCARs. METHODS. We enrolled 96 patients with SJS-TEN in a randomized trial to compare the effects of the TNF-[alpha] antagonist etanercept versus traditional corticosteroids. RESULTS. Etanercept improved clinical outcomes in patients with SJS-TEN. Etanercept decreased the SCORTEN-based predicted mortality rate (predicted and observed rates, 17.7% and 8.3%, respectively). Compared with corticosteroids, etanercept further reduced the skin-healing time in moderate-to-severe SJS-TEN patients (median time for skin healing was 14 and 19 days for etanercept and corticosteroids, respectively; P = 0.010), with a lower incidence of gastrointestinal hemorrhage in all SJS-TEN patients (2.6% for etanercept and 18.2% for corticosteroids; P = 0.03). In the therapeutic mechanism study, etanercept decreased the TNF-[alpha] and granulysin secretions in blister fluids and plasma (45.7%-62.5% decrease after treatment; all P < 0.05) and increased the Treg population (2-fold percentage increase after treatment; P = 0.002), which was related to mortality in severe SJS-TEN. CONCLUSIONS. The anti-TNF-[alpha] biologic agent etanercept serves as an effective alternative for the treatment of CTL-mediated SCARs. TRIAL REGISTRATION. ClinicalTrials.gov NCT01276314. FUNDING. Ministry of Science and Technology of Taiwan.

Published
2018
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19. Patients with inhibitory and neutralizing auto-antibodies to interferon-γ resemble the sporadic adult-onset phenotype of Mendelian Susceptibility to Mycobacterial Disease (MSMD) lacking Bacille Calmette–Guerin (BCG)-induced diseases

Author

Lee, Wen-I., Huang, Jing-Long, Wu, Ting-Shu, Lee, Ming-Hsun, Chen, I.-Jung, Yu, Kuang-Hiu, Liu, Chien-Ying, Yang, Chih-Hsun, Hsieh, Meng-Ying, Lin, Yi-Ling, Shih, Ying-Fan, Jaing, Tang-Her, Huang, Shih-Chiang, Kuo, Tseng-Tong, and Ku, Cheng-Lung

Published
2013
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24. Risk and association of HLA with oxcarbazepine-induced cutaneous adverse reactions in Asians

Author

Chen, Chun-Bing, Hsiao, Yi-Hsin, Wu, Tony, Hsih, Mo-Song, Tassaneeyakul, Wichittra, Jorns, Teekayu P., Sukasem, Chonlaphat, Hsu, Chien-Ning, Su, Shih-Chi, Chang, Wan-Chun, Hui, Rosaline Chung-Yee, Chu, Chia-Yu, Chen, Yi-Ju, Wu, Ching-Ying, Hsu, Chao-Kai, Chiu, Tsu-Man, Sun, Pei-Lun, Lee, Hua-En, Yang, Chin-Yi, Kao, Pei-han, Yang, Chih-Hsun, Ho, Hsin-Chun, Lin, Jing-Yi, Chang, Ya-Ching, Chen, Ming-Jing, Lu, Chun-Wei, Ng, Chau Yee, Kuo, Kang-Ling, Lin, Chien-yio, Yang, Ching-Sheng, Chen, Ding-Ping, Chang, Pi-Yueh, Wu, Tsu-Lan, Lin, Yu-Jr, Weng, Yi-Ching, Kuo, Tseng-tong, Hung, Shuen-Iu, and Chung, Wen-Hung

Published
2017
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32. Genetic Variants Associated With Phenytoin-Related Severe Cutaneous Adverse Reactions

Author

Chung, Wen-Hung, Chang, Wan-Chun, Lee, Yun-Shien, Wu, Ying-Ying, Yang, Chih-Hsun, Ho, Hsin-Chun, Chen, Ming-Jing, Lin, Jing-Yi, Hui, Rosaline Chung-Yee, Ho, Ji-Chen, Wu, Wei-Ming, Chen, Ting-Jui, Wu, Tony, Wu, Yih-Ru, Hsih, Mo-Song, Tu, Po-Hsun, Chang, Chen-Nen, Hsu, Chien-Ning, Wu, Tsu-Lan, Choon, Siew-Eng, Hsu, Chao-Kai, Chen, Der-Yuan, Liu, Chin-San, Lin, Ching-Yuang, Kaniwa, Nahoko, Saito, Yoshiro, Takahashi, Yukitoshi, Nakamura, Ryosuke, Azukizawa, Hiroaki, Shi, Yongyong, Wang, Tzu-Hao, Chuang, Shiow-Shuh, Tsai, Shih-Feng, Chang, Chee-Jen, Chang, Yu-Sun, and Hung, Shuen-Iu

Published
2014
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33. Granulysin is a key mediator for disseminated keratinocyte death in Stevens-Johnson syndrome and toxic epidermal necrolysis

Author

Chung, Wen-Hung, Hung, Shuen-Iu, Yang, Jui-Yung, Su, Shih-Chi, Huang, Shien-Ping, Wei, Chun-Yu, Chin, See-Wen, Chiou, Chien-Chun, Chu, Sung-Chao, Ho, Hsin-Chun, Yang, Chih-Hsun, Lu, Chi-Fang, Wu, Jer-Yuarn, Liao, You-Di, and Chen, Yuan-Tsong

Subjects
Care and treatment, Physiological aspects, Development and progression, Research, Genetic aspects, Health aspects, Causes of, CD8 lymphocytes -- Physiological aspects -- Health aspects -- Genetic aspects -- Research, Immunologic factors -- Physiological aspects -- Health aspects -- Research, Stevens-Johnson syndrome -- Development and progression -- Care and treatment -- Research -- Genetic aspects, Cell death -- Causes of -- Genetic aspects -- Research -- Health aspects -- Physiological aspects, Immunity -- Physiological aspects -- Health aspects -- Research
Abstract

Adverse drug reactions (ADRs) account for 6-7% of all hospital admissions and remain a major clinical problems. Among them, SJS and TEN are two of the most serious and life-threatening [...], Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening adverse drug reactions characterized by massive epidermal necrosis, in which the specific danger signals involved remain unclear. Here we show that blister cells from skin lesions of SJS-TEN primarily consist of cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells, and both blister fluids and cells were cytotoxic. Gene expression profiling identified granulysin as the most highly expressed cytotoxic molecule, confirmed by quantitative PCR and immunohistochemistry. Granulysin concentrations in the blister fluids were two to four orders of magnitude higher than perforin, granzyme B or soluble Fas ligand concentrations, and depleting granulysin reduced the cytotoxicity. Granulysin in the blister fluids was a 15-kDa secretory form, and injection of it into mouse skin resulted in features mimicking SJS-TEN. Our findings demonstrate that secretory granulysin is a key molecule responsible for the disseminated keratinocyte death in SJS-TEN and highlight a mechanism for CTL- or NK cell--mediated cytotoxicity that does not require direct cellular contact.

Published
2008

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