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Association of Reduced CD4 T Cell Responses Specific to Varicella Zoster Virus with High Incidence of Herpes Zoster in Patients with Systemic Lupus Erythematosus
HYUNG-BAE PARK, KI-CHAN KIM, JAE-HONG PARK, TAE-YOUNG KANG, HYE-SOON LEE, TAE-HWAN KIM, JAE-BUM JUN, SANG-CHEOL BAE, DAE-HYUN YOO, JOE CRAFT, and SUNGSOO JUNG
ABSTRACT. 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-g (IFN-g), tumor necrosis factor-a (TNF-a), 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-g-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-a-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. (J Rheumatol 2004;31:2151-5) Key Indexing Terms:
HERPES ZOSTER
From the Department of Internal Medicine, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea; and the Sections of Rheumatology and Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA. H-B. Park, MEng, Research Associate; K-C. Kim, MD, PhD, Fellow of Rheumatology; J-H. Park, MD, PhD, Fellow of Rheumatology; T-Y. Kang, MD, PhD, Fellow of Rheumatology; H-S. Lee, MD, Instructor of Medicine; T-H. Kim, MD, PhD, Assistant Professor; J-B. Jun, MD, PhD, Associate Professor; S-C. Bae, MD, PhD, MPH, Associate Professor; D-H. Yoo, MD, PhD, Professor; S. Jung, MD, PhD, Associate Professor, Hanyang University College of Medicine; J. Craft, MD, Professor, Yale University School of Medicine. Address reprint requests to Dr. S. Jung, Department of Internal Medicine, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine, 17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Republic of Korea. E-mail: ssjung@hanyang.ac.kr Submitted August 7, 2003; revision accepted May 28, 2004. |