Prolonged elevation of serum granulysin in drug-induced hypersensitivity syndrome

Monitoring the acute response in severe hypersensitivity reactions to drugs

“…Importantly, serum sFas L levels at the initial presentation were the highest in TEN patients who subsequently progressed to TEN, but not to SJS. Although sFas L [18][19][20][21][22] and granulysin [23,24] have been implicated in the pathological process of SJS/ TEN, these findings suggest that sFas L represents a useful early biomarker that can predict the subsequent progression to TEN, but not SJS, particularly when combined with the increase in serum IL-6 and IP-10 levels (Fig. 2).…”

“…Although numerous previous studies [15][16][17][18][19][20][21][22][23][24] demonstrated the pathogenic role of soluble mediators including cytokines/chemokines secreted by different immune cells including TNF-a, IFN-g, IL-10, perforin/granzyme B, Fas L and granulysin, there are few biomarkers or prognostic tests available to predict disease progression that can be used in clinical routine for diagnosis and to monitor patients with ADRs. In this regard, the simultaneous use of these biomarkers may increase specificity and sensitivity as a diagnostic tool.…”

Severe Cutaneous Adverse Reactions: The Pharmacogenomics from Research to Clinical Implementation

“…Granulysin levels were quantitatively associated with the disease severity of SJS/TEN [67] and clinically relevant to DRESS [68,69]. For these particular SCARs, measurement of granulysin using the ELISpot, intracellular cytokine staining, and ELISA may be useful to determine the causative drug, which would be another instance of successful translation from the findings of SCAR research to clinical settings.…”

Cytotoxic Proteins and Therapeutic Targets in Severe Cutaneous Adverse Reactions

“…It is reported that granulysin is a vital mediator of damage in a number of cutaneous diseases, including folliculitis [32], psoriasis [33], acne [34], lichen planus [35], and other forms of cutaneous ADRs [36,37]. Noteworthily, numbers of granulysin-positive cells in fixed drug eruptions were similar to those observed in SJS/TEN [36], and serum granulysin levels were elevated in DRESS patients [37]. Furthermore, serum levels of granulysin are markedly heightened and correlated with the severity of graft vs .…”