Hsia Shao-Chung V, Chen Lie Hong, Tseng Hung-Fu
Department of Pharmaceutical Sciences, School of Pharmacy and Health Professions, University of Maryland, Eastern Shore, Princess Anne, MD 21853, USA.
Department of Research and Evaluation, Kaiser Permanente Research, 100 S. Los Robles Ave, 2nd Floor, Pasadena, CA 91101, USA.
Int J Infect Dis. 2017 Jun;59:90-95. doi: 10.1016/j.ijid.2017.04.016. Epub 2017 Apr 24.
Thyroid hormone (TH) has been suggested to control herpes virus gene expression and replication in neurons via epigenetics through its nuclear receptors. It has previously been shown that patients with hypothyroidism are predisposed to herpes zoster (HZ), suggesting that the TH deficiency may be a risk factor for varicella zoster virus (VZV) reactivation. The aim of this study was to test the hypothesis that TH treatment will ameliorate the complication of HZ.
This study investigated the hypothesis by enquiring into a comprehensive medical database at Kaiser Permanente Southern California (KPSC) to verify whether patients taking TH medication experience a reduction in HZ occurrence.
It was shown by Kaplan-Meier analysis that hypothyroidism patients taking TH medicines had a lower risk of HZ. The fully adjusted analysis indicated that patients receiving medication for the treatment of TH deficiency exhibited a reduced risk of HZ (hazard ratio 0.60, 95% confidence interval 0.51-0.71). This lower risk of HZ was significant in all age groups except the 18-39 years cohort. In addition, female patients taking TH treatment exhibited a lower risk than their male counterparts.
Together these findings support the hypothesis that a constant level of TH will provide a degree of protection from contracting HZ. More studies are underway to evaluate the laboratory data for an analysis of hormonal effects on individuals.
甲状腺激素(TH)被认为可通过其核受体经由表观遗传学机制控制神经元中疱疹病毒的基因表达和复制。此前已有研究表明,甲状腺功能减退患者易患带状疱疹(HZ),这表明甲状腺激素缺乏可能是水痘带状疱疹病毒(VZV)再激活的一个危险因素。本研究的目的是检验甲状腺激素治疗可改善HZ并发症这一假说。
本研究通过查询南加州凯撒医疗集团(KPSC)的综合医学数据库来验证服用甲状腺激素药物的患者HZ发病率是否降低,以此对该假说进行调查。
Kaplan-Meier分析表明,服用甲状腺激素药物的甲状腺功能减退患者患HZ的风险较低。完全校正分析表明,接受甲状腺激素缺乏治疗的患者患HZ的风险降低(风险比0.60,95%置信区间0.51 - 0.71)。除18 - 39岁年龄组外,所有年龄组中这种较低的HZ风险均具有统计学意义。此外,接受甲状腺激素治疗的女性患者患HZ的风险低于男性患者。
这些研究结果共同支持了这样一种假说,即维持恒定水平的甲状腺激素可为预防HZ提供一定程度的保护。目前正在进行更多研究以评估实验室数据,从而分析激素对个体的影响。