Association of reduced CD4 T cell responses specific to varicella zoster virus with high incidence of herpes zoster in patients with systemic lupus erythematosus.
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.
Park
Hyung-Bae
HB
Department of Internal Medicine, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.
Kim
Ki-Chan
KC
Park
Jae-Hong
JH
Kang
Tae-Young
TY
Lee
Hye-Soon
HS
Kim
Tae-Hwan
TH
Jun
Jae-Bum
JB
Bae
Sang-Cheol
SC
Yoo
Dae-Hyun
DH
Craft
Joe
J
Jung
Sungsoo
S
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
D000956:Antigens, Viral; D016207:Cytokines; D014759:Viral Envelope Proteins; C056913:glycoprotein E, varicella-zoster virus