Immune-mediated pathogenesis of Stevens Johnson Syndrome/Toxic Epidermal Necrolysis - An imminent need for stricter and more effective pharmacovigilance strategies

2^nd International Congress on DERMATOLOGY RESEARCH

December 05-06, 2022 | Dubai, UAE

Omer Iqbal, Hanin El-Khateeb, Joseph Lewis and Charles Bouchard

Loyola University, USA

Scientific Tracks Abstracts: J Dermatol Dis

Abstract :

Albert Stevens, a surgeon and Frank Johnson, a paediatrician first published a paper “A New Eruptive Fever Associated with Stomatitis and Ophthalmia” in 1922, which was later known as Stevens Johnson Syndrome (SJS). Even a century after its first identification, the pathophysiology of Stevens Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) is not completely understood. Despite significant advances the incidence, prevalence and severe mucocutaneous involvement with long-term ocular sequelae continue to remain unabated. SJS/TEN are drug-induced severe cutaneous adverse reactions with increased morbidity and mortality. It often involves the eyes causing corneal blindness. Patients die because of infections, multiorgan failure and sepsis. HLA-E-specific activating receptor CD94/NKG2C is reported to trigger T-cell receptor-independent cytotoxicity in cytotoxic T cells. Various cytokines are known to play a role in the pathogenesis of this condition. Our laboratories earlier reported on the potential roles of IL-13, IL-15, IL-33, TGFβ1 and Endocan in the pathogenesis of SJS/TEN. The potential roles of IL- 6 and NKG2C in SJS/TEN in causing keratinocyte apoptosis are not fully explored. Determination of the expression of IL-6 and NKG2C in skin biopsies of patients with SJS/TEN as studied by immunofluorescence microscopy will enable better understanding of their potential roles in the pathogenesis of SJS/TEN. Increased expression of IL-6 and NKG2C suggests the potential roles in the pathogenesis of SJS/TEN. This presentation will discuss the current understanding of pathogenesis and management of SJS/TEN. Given the severe adverse reactions and long-term sequelae, there is an emergent need for pharmacovigilance to predict these catastrophic complications and to save lives. Increased expression of IL-6 and NKG2C in skin biopsy slides from patients with confirmed SJS/TEN, when compared with Lichen Planus as controls, as studied by immunofluorescence microscopy suggests the potential roles of IL-6 and NKG2C in the pathogenesis of SJS/TEN. Recent Publications 1. Iqbal O. A New Eruptive Fever Associated with Stomatitis and Ophthalmia, Editorial International Journal of Ophthalmology and Eye Science (IJOES), 2021 July 9(1e):1-2 2. Iqbal O. Precision Medicine and Immunomodulatory Therapy for Stevens Johnson Syndrome/Toxic Epidermal Necrolysis. Personalized & Medicine International Conference, Paris, France, 2018. OS2b-A,Personalized Therapies, (15:15-Tuesday 26th, June, 2018). 3. Michael Sadek, Iqbal O, et al. The Role of IL-13, IL-15 and granulysin in the pathogenesis of Stevens Johnson Syndrome/ Toxic Epidermal Necrolysis. Clin and Applied Thrombosis/ Hemostasis. Vol 27:1-8, 2021.

Biography :

Omer Iqbal is currently a research professor in the departments of Ophthalmology and Pathology at Loyola University Stritch School of Medicine in Maywood, Illinois, USA. He is an elected fellow of the American College of Cardiology and European Society of Cardiology. For a little over three decades, he has been involved in research in the fields of Haemostasis & Thrombosis, and Stevens Johnson Syndrome/ Toxic Epidermal Necrolysis. He has a wide and varied interests in the fields of new oral anticoagulants, precision and personalized medicine, pharmacogenomics, pharmacovigilance, nanotechnology, ocular manifestations of systemic diseases, ocular toxicities in patients with cancer, artificial intelligence and spatial biology. He has participated as an invited speaker in several national and international conferences. He serves on editorial boards of several journals including World Journal of Ophthalmology & Vision Research. He is a professional member of various international societies including ARVO, ISTH, ACC, ESC, AHA, ASCO etc.