Granulysine

Cytolytic cytokine that is produced in the cytolytic granules of activated cytotoxic T cells (CD8) and NK cells. It is active together with the cytokine perforin. Perforin is integrated into the cell membrane of the target cell, where it forms a pore-like structure. Certain serine proteases (e.g. granzymes) penetrate the target cell through this pore and trigger apoptosis. Granulysin has a broad antimicrobial effect. It leads to the destruction of keratinocytes in certain inflammatory processes of the skin, such as Stevens-Johnson syndrome or toxic epidermal necrolysis. The concentration of granulysin in the blister contents is directly correlated with the severity of the disease. Large quantities of granulysin can also be detected in the blisters of erythema multiforme.

1. Chung WH et al (2015) Oxypurinol-Specific T Cells Possess Preferential TCR Clonotypes and Express Granulysin in Allopurinol-Induced Severe Cutaneous Adverse Reactions. J Invest Dermatol doi: 10.1038/yid.2015.165.
2. Chung WH et al (2014) Insights into the poor prognosis of allopurinol-induced severe cutaneous adverse reactions: the impact of renal insufficiency, high plasma levels of oxypurinol and granulysin. Ann Rheum Dis PubMed PMID: 25115449.
3. Su SC et al (2013) Update on pathobiology in Stevens-Johnson syndrome and toxic erpidermal necrolysis. Dermatol Sinica 31: 174-180
4. Su SC, Chung WH (2014). Cytotoxic proteins and therapeutic targets in severe cutaneous adverse reactions. Toxins (Basel) 6:194-210
5. Cho YT et al (2013) Generalized bullous fixed drug eruption is distinct from Stevens-Johnson syndrome/toxic epidermal necrolysis by immunohistopathological features. J Am Acad Dermatol 70:539-548