title: An inverse correlation of VZV skin-test reaction, but not antibody, with severity of herpes zoster skin symptoms and zoster-associated pain.
abstract: BACKGROUND
  Cell-mediated immunity (CMI) has been considered to be related to the development of herpes zoster (HZ). However, there have been no large-scale prospective studies on the relationship between VZV-specific CMI and severity of HZ.
  
  
  OBJECTIVE
  We carried out a large-scale prospective cohort study to clarify the relationship between immunological factors for varicella-zoster virus (VZV) and the clinical severity of HZ.
  
  
  METHODS
  We carried out a cohort study on VZV immunity in a population living on an island cluster, Shozu County in Japan, and examined the people who developed HZ during a median follow-up period of 2 years, with a focus on the relationship between cell-mediated and humoral immunity and the severity of skin lesions and zoster-associated pain. A total of 12,522 people over the age of 50 were enrolled in this study, and 258 registrants were diagnosed as HZ. CMI was measured by VZV skin test, and humoral immunity was assessed with serological tests (neutralization test, immunoadherence hemagglutination test, and gpELISA test) for VZV-specific antibodies.
  
  
  RESULTS
  CMI to VZV assessed by VZV skin test showed a significant inverse relationship to the severity of HZ skin lesions, and also to the severity of acute and subacute pain. Furthermore, weak response to the VZV skin test was associated with a high risk of post-herpetic neuralgia. In contrast, VZV-specific antibody titer was not associated with the severity of skin lesions and zoster-associated pain.
  
  
  CONCLUSIONS
  VZV-specific CMI, but not humoral immunity, may play a key role in controlling the severity of HZ skin lesions and zoster-associated pain.
authors.affiliation: Department of Dermatology, Nara Medical University School of Medicine, Nara, Japan. asadah@naramed-u.ac.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Asada
authors.forename: Kousuke
authors.initials: K
authors.lastname: Nagayama
authors.forename: Aiko
authors.initials: A
authors.lastname: Okazaki
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Mori
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Okuno
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Takao
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Fumitake
authors.initials: F
authors.lastname: Onishi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Okeda
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Yano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kumihashi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Gomi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Maeda
authors.forename: Toyokazu
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamanishi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood*; D005260:Female; D006562:Herpes Zoster / Q000175:diagnosis / Q000276:immunology*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D056724:Immunity, Humoral; D007564:Japan; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000175:diagnosis* / Q000276:immunology; D010146:Pain; D011446:Prospective Studies; D012737:Sex Factors; D012882:Skin Tests / Q000379:methods; D013997:Time Factors
chemical_list: D000906:Antibodies