Kitamura Kana, Asada Hideo, Iida Hideyuki, Fukumoto Takaya, Kobayashi Nobuhiko, Niizeki Hironori, Morii Takeshi, Kimura Hiroshi, Miyagawa Sachiko
Department of Dermatology, Nara Medical University, Nara, Japan.
J Am Acad Dermatol. 2008 May;58(5):802-9. doi: 10.1016/j.jaad.2008.01.005. Epub 2008 Mar 25.
The relationship between herpesvirus reactivation and graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) is unclear.
We sought to examine the relationship between human herpesvirus (HHV) reactivation and rash/GVHD after allo-SCT by prospective evaluation.
Fifteen patients who had received allo-SCT underwent prospective serial examinations for human herpesvirus 6 (HHV-6), HHV-7, cytomegalovirus, and Epstein-Barr virus DNA in the blood by polymerase chain reaction and real-time polymerase chain reaction. Serum interferon gamma, interleukins 4 and 10, tumor necrosis factor alpha, and soluble interleukin 2 receptor (sIL-2R) were also measured.
In 10 of 15 patients, macular/papular eruptions were seen after allo-SCT and GVHD was diagnosed. In 8 patients with rash, HHV-6 DNA levels correlated with the cutaneous manifestation. Interleukin 10 and sIL-2R also increased in association with rash.
The number of patients in our study was relatively small. Not all patients were examined for cytokines and sIL-2R.
HHV-6 reactivation may be involved in the pathogenesis of rash/GVHD after allo-SCT.
异基因造血干细胞移植(allo-SCT)后疱疹病毒再激活与移植物抗宿主病(GVHD)之间的关系尚不清楚。
我们试图通过前瞻性评估来研究异基因造血干细胞移植后人类疱疹病毒(HHV)再激活与皮疹/移植物抗宿主病之间的关系。
15例接受异基因造血干细胞移植的患者通过聚合酶链反应和实时聚合酶链反应对血液中的人类疱疹病毒6型(HHV-6)、HHV-7、巨细胞病毒和EB病毒DNA进行前瞻性系列检测。还检测了血清干扰素γ、白细胞介素4和10、肿瘤坏死因子α以及可溶性白细胞介素2受体(sIL-2R)。
15例患者中有10例在异基因造血干细胞移植后出现斑丘疹,诊断为移植物抗宿主病。在8例有皮疹的患者中,HHV-6 DNA水平与皮肤表现相关。白细胞介素10和sIL-2R也随着皮疹而升高。
我们研究中的患者数量相对较少。并非所有患者都检测了细胞因子和sIL-2R。
HHV-6再激活可能参与异基因造血干细胞移植后皮疹/移植物抗宿主病的发病机制。