{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:49:34Z","timestamp":1777592974142,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T00:00:00Z","timestamp":1730505600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002873","name":"Chulalongkorn University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002873","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Dermatology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Drug reactions with eosinophilia and systemic symptoms (DRESS) and Stevens\u2010Johnson syndrome\/toxic epidermal necrolysis (SJS\/TEN) are severe cutaneous adverse hypersensitivity reactions with distinct clinical manifestations. Regulatory T (Treg) cells may behave differently in these syndromes, contributing to their diverse clinical features and outcomes. This study compared Treg dynamics between DRESS and SJS\/TEN patients during the acute and recovery phases. Flow cytometry quantitatively analysed and defined the immunophenotype of CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup>CD127<jats:sup>\u2212<\/jats:sup>FoxP3<jats:sup>+<\/jats:sup> Tregs in blood from DRESS and SJS\/TEN patients indicated that Treg percentages were lowest in DRESS patients during the acute phase compared to those in the recovery phase in DRESS patients and the acute phase in SJS\/TEN patients. During the acute phase, CTLA\u20104 expression in Tregs in both DRESS patients with and without autoimmune sequelae was significantly increased, while only DRESS patients without autoimmune sequelae had elevated OX40 expression compared to the healthy controls. High IL\u201010 expression in Tregs during the acute phase in SJS\/TEN patients was also observed. The suppressive function of Tregs was lower in DRESS compared to SJS\/TEN, which was determined using a suppression assay by co\u2010culturing autologous Treg and effector T cells. Furthermore, NanoString technology explored mRNA profiles in Tregs. Genes associated with the JAK\/STAT pathway were found to be downregulated during the acute phase in DRESS patients who later developed autoimmune sequelae. Our findings evidenced impaired Treg function in DRESS compared to SJS\/TEN. The early disturbance of the JAK\/STAT pathway may serve as a prognostic marker for autoimmune development in DRESS patients.<\/jats:p>","DOI":"10.1111\/exd.70007","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T09:48:56Z","timestamp":1730540936000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dysregulation of Regulatory T Cells and Autoimmune Sequelae in <scp>DRESS<\/scp>: Insights From Flow Cytometry and NanoString Analysis"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5577-2660","authenticated-orcid":false,"given":"Suparada","family":"Khanaruksombat","sequence":"first","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Medical Sciences Program, Faculty of Medicine Chulalongkorn University  Bangkok 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