Absence of circulating natural killer and primed CD8+ cells in life-threatening varicella.
Five pediatric patients with no history of immunodeficiency had a life-threatening course of varicella. Strikingly, natural killer (NK) cells were absent from the circulation in all children, and, despite active viral infection, up to 98% of the CD8(+) cells were naive. Primary immunodeficiencies were excluded--NK cells and primed CD8(+) cells reappeared in the circulation, granzymes were detectable in plasma early during infection, and no abnormalities could be detected in interleukin-15 receptor function. Our data indicate that varicella-zoster virus (VZV) has a unique capability to seclude primed CD8(+) cells and NK cells from the circulating lymphocyte pool. This may be the consequence of an overwhelming immune response to VZV that is influenced by factors such as infectious dose, age, and the presence of maternal antibodies during infancy. Because both homozygous twin sisters in the study had a severe course of varicella, particular genetic factors may contribute to severe varicella.
Vossen
Mireille T M
MT
Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands. m.t.vossen@amc.uva.nl
Biezeveld
Maarten H
MH
de Jong
Menno D
MD
Gent
Mi-Ran
MR
Baars
Paul A
PA
von Rosenstiel
Ines A
IA
van Lier
René A W
RA
Kuijpers
Taco W
TW
D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002644:Chickenpox / Q000276:immunology*; D002675:Child, Preschool; D005260:Female; D014645:Herpesvirus 3, Human / Q000472:pathogenicity*; D006801:Humans; D007121:Immunocompetence / Q000276:immunology*; D007223:Infant; D007694:Killer Cells, Natural / Q000276:immunology*; D008297:Male