Rand K H, Rasmussen L E, Pollard R B, Arvin A, Merigan T C
N Engl J Med. 1977 Jun 16;296(24):1372-7. doi: 10.1056/NEJM197706162962402.
We observed severe infection with herpes simplex virus in cardiac-transplant patients despite their high serum antibody levels to this virus. Therefore, we sought to correlate clinical susceptibility to two herpesvirus (simplex and zoster) infections with specific cellular immunity, assessed by the transformation and interferon responses of peripheral blood mononuclear cells to heat-inactivated antigens. Transformation and interferon response to herps simplex virus was maximally depressed immediately after transplantation, the time when severe and prolonged infection with herps simplex virus occurred. Six months to six years after transplantation, both clinical susceptibility and cellular immunity to herpes simplex virus were normal. Herpes zoster infections were more frequent than normal at all times after cardiac transplantation; depressed or absent cellular responses to the varicella zoster virus paralleled that susceptibility. In these patients the risk of severe herpesvirus infections correlated with depressed cellular immune responses to the specific viral agent involved.
我们观察到，心脏移植患者尽管血清中针对单纯疱疹病毒的抗体水平很高，但仍发生了严重的单纯疱疹病毒感染。因此，我们试图将对两种疱疹病毒（单纯疱疹病毒和带状疱疹病毒）感染的临床易感性与特定的细胞免疫相关联，通过外周血单核细胞对热灭活抗原的转化反应和干扰素反应来评估细胞免疫。移植后即刻，对单纯疱疹病毒的转化反应和干扰素反应受到最大程度的抑制，而此时正是发生严重且迁延的单纯疱疹病毒感染的时期。移植后6个月至6年，对单纯疱疹病毒的临床易感性和细胞免疫均恢复正常。心脏移植后的任何时候，带状疱疹感染都比正常情况更为频繁；对水痘-带状疱疹病毒的细胞反应降低或缺失与这种易感性呈平行关系。在这些患者中，严重疱疹病毒感染的风险与针对相关特定病毒病原体的细胞免疫反应降低相关。
