title: Association of reduced CD4 T cell responses specific to varicella zoster virus with high incidence of herpes zoster in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  To examine whether the high incidence of herpes zoster in patients with systemic lupus erythematosus (SLE) is associated with the frequency of memory T cells specific to varicella zoster virus (VZV).
  
  
  METHODS
  Whole blood samples from 47 subjects [24 patients with SLE, 11 with rheumatoid arthritis (RA) as a disease control, and 12 healthy negative controls] were stimulated with VZV antigen, stained for surface CD4 and CD8 and intracellularly stained for the cytokines interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), interleukin 4 (IL-4), and IL-10, followed by flow cytometry analyses. Correlations of VZV-specific T cell frequencies with the clinical status of patients were analyzed.
  
  
  RESULTS
  Percentage of IFN-gamma-positive CD4 T cells was significantly lower in patients with SLE (0.043 +/- 0.009%) than in RA (0.102 +/- 0.019%) and healthy controls (0.126 +/- 0.025%) upon VZV stimulation. A similar pattern was seen in TNF-alpha-positive CD4 T cell responses. These low frequencies of VZV-specific CD4 T cells in patients with SLE were significantly related with disease activity (r = -0.435, p = 0.043).
  
  
  CONCLUSIONS
  These data suggest that the high incidence of herpes zoster in patients with SLE was related to the intrinsic defects in controlling VZV reactivation, and thus VZV-specific CD4 T cell frequency could be another practical risk factor of herpes zoster in patients with SLE.
authors.affiliation: Department of Internal Medicine, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Hyung-Bae
authors.initials: HB
authors.lastname: Park
authors.forename: Ki-Chan
authors.initials: KC
authors.lastname: Kim
authors.forename: Jae-Hong
authors.initials: JH
authors.lastname: Park
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Kang
authors.forename: Hye-Soon
authors.initials: HS
authors.lastname: Lee
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim
authors.forename: Jae-Bum
authors.initials: JB
authors.lastname: Jun
authors.forename: Sang-Cheol
authors.initials: SC
authors.lastname: Bae
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Yoo
authors.forename: Joe
authors.initials: J
authors.lastname: Craft
authors.forename: Sungsoo
authors.initials: S
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D000328:Adult; D000956:Antigens, Viral / Q000494:pharmacology; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D005434:Flow Cytometry; D006562:Herpes Zoster / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007156:Immunologic Memory; D007723:Korea / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology / Q000276:immunology* / Q000821:virology*; D016036:Seroepidemiologic Studies; D014759:Viral Envelope Proteins / Q000276:immunology
chemical_list: D000956:Antigens, Viral; D016207:Cytokines; D014759:Viral Envelope Proteins; C056913:glycoprotein E, varicella-zoster virus