Association of reduced CD4 T cell responses specific to varicella zoster virus with high incidence of herpes zoster in patients with systemic lupus erythematosus

• Published in: Journal of rheumatology 2004-11, Vol.31 (11), p.2151-2155
• Main Authors: PARK, Hyung-Bae, KIM, Ki-Chan, JUNG, Sungsoo, PARK, Jae-Hong, KANG, Tae-Young, LEE, Hye-Soon, KIM, Tae-Hwan, JUN, Jae-Bum, BAE, Sang-Cheol, YOO, Dae-Hyun, CRAFT, Joe
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antigens, Viral - pharmacology; Arthritis, Rheumatoid - epidemiology; Arthritis, Rheumatoid - immunology; Arthritis, Rheumatoid - virology; Biological and medical sciences; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes - immunology; CD4-Positive T-Lymphocytes - metabolism; CD8-Positive T-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - metabolism; Cytokines - metabolism; Diseases of the osteoarticular system; Flow Cytometry; Herpes Zoster - complications; Herpes Zoster - epidemiology; Herpes Zoster - immunology; Herpesvirus 3, Human - immunology; Human viral diseases; Humans; Immunologic Memory; Infectious diseases; Inflammatory joint diseases; Korea - epidemiology; Lupus Erythematosus, Systemic - epidemiology; Lupus Erythematosus, Systemic - immunology; Lupus Erythematosus, Systemic - virology; Medical sciences; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Seroepidemiologic Studies; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Viral Envelope Proteins - immunology
• ISSN: 0315-162X; 1499-2752

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). CONCLUSION: 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.