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

Michihiro Kamijima, 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 HuangTamie Nakajima

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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/106 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.

Original languageEnglish
Pages (from-to)218-224
Number of pages7
JournalJournal of Dermatological Science
Volume72
Issue number3
DOIs
Publication statusPublished - 01-12-2013

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All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Molecular Biology
  • Dermatology

Cite this

Kamijima, M., Wang, H., Yamanoshita, O., Ito, Y., Xia, L., Yanagiba, Y., Chen, C., Okamura, A., Huang, Z., Qiu, X., Song, X., Cai, T., Liu, L., Ge, Y., Deng, Y., Naito, H., Yoshikawa, T., Tohyama, M., Li, L., ... Nakajima, T. (2013). Occupational trichloroethylene hypersensitivity syndrome: Human herpesvirus 6 reactivation and rash phenotypes. Journal of Dermatological Science, 72(3), 218-224. https://doi.org/10.1016/j.jdermsci.2013.07.003