muramidase and Stevens-Johnson-Syndrome

Topics: Humans; Immunoglobulins; Muramidase; Prealbumin; Proteins; Sjogren's Syndrome; Stevens-Johnson Syndrome; Tears

Topics: Actins; Adult; Antigens, CD20; Biomarkers; Conjunctival Diseases; Dry Eye Syndromes; Humans; Lacrimal Apparatus Diseases; Lactoferrin; Muramidase; Prospective Studies; S100 Proteins; Stevens-Johnson Syndrome

To detect the immunohistochemical changes in the main lacrimal glands of patients suffering from chronic ocular sequelae of Stevens-Johnson syndrome (SJS).. Histological sections of biopsies from the lacrimal gland of three chronic SJS patients (mean age, 33 years; 2 males) with severe dry eye disease (Schirmer = 0 mm) were assessed using double immunofluorescence techniques. Changes in the expression of secretory proteins lactoferrin (Lf), lysozyme (Ly), aquaporin 5 (AQP5), S-100, and early apoptosis marker (Annexin V) were studied.. Different morphological expressions of secretory proteins were present in the three samples. One sample had maintained the immunoreactivity for Lf, Ly, S-100, similar to healthy controls. Two samples had significantly reduced immunoreactivity for anti-Lf, anti-Ly, and S-100, the weakest being in the sample with distorted lobular architecture and mild interlobular fibrosis. AQP5 had a distinct vesicular intracytoplasmic immunoreactivity suggesting defective trafficking and integration of the protein to the apical membrane. There was no S-100 immunostaining in the acinar or ductal epithelium, whereas interstitial nerve fibers scattered in the periacinar region showed reduced immunoreactivity for S-100. There was strong Annexin V immunoreactivity in the nuclei of epithelial cells in the majority of acinar and ductal epithelia of all the samples, with distorted nuclear morphology in one sample.. Defective trafficking of AQP5 and variable expression of Ly, Lf, S-100 are the notable findings in the lacrimal glands of chronic SJS patients along with signs of early apoptosis. It suggests that the palpebral lobe of the lacrimal gland is involved in the pathological processes occurring in the conjunctiva of SJS patients.

Topics: Adult; Annexin A5; Apoptosis; Aquaporin 5; Biomarkers; Chronic Disease; Dry Eye Syndromes; Eye Proteins; Female; Fluorescent Antibody Technique, Indirect; Humans; Lacrimal Apparatus; Lactoferrin; Male; Muramidase; S100 Proteins; Stevens-Johnson Syndrome; Young Adult

Dry eye is a multifactorial disease comprising a wide spectrum of ocular surface alterations and symptoms of discomfort. In most patients with aqueous-deficient dry eye, pharmaceutical tear substitutes are used to control symptoms and prevent ocular surface damage. However, in severe dry eye conditions caused by cicatricial disorders, such as Stevens-Johnson syndrome and ocular cicatricial mucous membrane pemphigoid, noninvasive treatments are insufficient, and patients are at risk of developing complications that can lead to blindness. The use of salivary glands as a source of lubrication to treat severe cases of dry eye has been proposed by different authors. The first reports proposed parotid or submandibular gland duct transplantation into the conjunctival fornix. However, complications limited the functional outcomes. Minor salivary gland autotransplantation together with labial mucosa has been used as a complex graft to the conjunctival fornix in severe dry eye with a good outcome. Our group demonstrated significant improvements in best-corrected visual acuity, Schirmer I test score, corneal transparency, and neovascularization after using this technique. A symptoms questionnaire applied to these patients revealed improvements in foreign body sensation, photophobia, and pain. Similar to tears, saliva has a complex final composition comprising electrolytes, immunoglobulins, proteins, enzymes, and mucins. We demonstrated the viability of minor salivary glands transplanted into the fornix of patients with dry eye by performing immunohistochemistry on graft biopsies with antibodies against lactoferrin, lysozyme, MUC1, and MUC16. The findings revealed the presence of functional salivary gland units, indicating local production of proteins, enzymes, and mucins.

Topics: Adult; Biomarkers; CA-125 Antigen; Caspase 3; Female; Graft Survival; Humans; Immunohistochemistry; Lactoferrin; Male; Membrane Proteins; Middle Aged; Mucin-1; Muramidase; Ophthalmologic Surgical Procedures; Salivary Glands, Minor; Stevens-Johnson Syndrome; Visual Acuity; Young Adult

We report a case of toxic epidermal necrolysis-type drug eruption. A 23-year-old man took an oral over-the-counter preparation for the common cold. A few days later, generalized erythema developed with systemic malaise and pain. A multiple blister formation followed, and Nikolsky's sign was noted on each blister. A lymphocyte stimulation test (LST) with the patient's peripheral lymphocytes strongly suggested that the eruption was attributable to lysozyme chloride which was included in the preparation taken. Following an intravenous drip of betamethasone for two weeks, the eruptions improved favorably.

Topics: Acetaminophen; Administration, Oral; Adult; Anti-Inflammatory Agents; Betamethasone; Biopsy, Needle; Caffeine; Common Cold; Drug Combinations; Follow-Up Studies; Guaiacol; Humans; Male; Muramidase; Nonprescription Drugs; Stevens-Johnson Syndrome; Urticaria

Topics: Adolescent; Adult; Aged; Animals; Cats; Child; Child, Preschool; Eye Proteins; Guinea Pigs; Haplorhini; Humans; Infant; Middle Aged; Muramidase; Prealbumin; Sjogren's Syndrome; Stevens-Johnson Syndrome; Tears