Koto Serina, Umeda Masataka, Kawano Hiroaki, Endo Yushiro, Shimizu Toshimasa, Koga Tomohiro, Ichinose Kunihiro, Nakamura Hideki, Mukaino Akihiro, Higuchi Osamu, Nakane Shunya, Kawakami Atsushi
Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Department of Rheumatology, Sasebo City General Hospital, Japan.
Intern Med. 2020 Apr 15;59(8):1099-1104. doi: 10.2169/internalmedicine.3954-19. Epub 2020 Feb 1.
A 58-year-old Japanese woman with herpes zoster developed Behçet's disease (BD) with symptoms including orthostatic intolerance as an autonomic disorder. Multiple immune-suppressive therapies and a β-blocker successfully controlled both the disease activity of BD and the autonomic disorders. A cytokine multiplex analysis of her serum revealed the elevation of proinflammatory cytokines [interleukin (IL)-1, IL-6, IL-12, tumor necrosis factor alfa (TNFα), and interferon gamma (IFN-γ)] and a low IL-10 concentration. IL-10 production is reported to be important for defense against herpes zoster virus (VZV). Insufficient IL-10 production is reported in BD. The reactivation of VZV with this cytokine profile suggests that BD will develop with various symptoms, including severe autonomic disorders.
一名58岁患有带状疱疹的日本女性患上了白塞病（BD），症状包括作为自主神经功能障碍的直立性不耐受。多种免疫抑制疗法和一种β受体阻滞剂成功控制了BD的疾病活动和自主神经功能障碍。对她的血清进行的细胞因子多重分析显示促炎细胞因子[白细胞介素（IL）-1、IL-6、IL-12、肿瘤坏死因子α（TNFα）和干扰素γ（IFN-γ）]升高，而IL-10浓度较低。据报道，IL-10的产生对于抵御带状疱疹病毒（VZV）很重要。BD患者中据报道存在IL-10产生不足的情况。具有这种细胞因子谱的VZV再激活表明BD会出现包括严重自主神经功能障碍在内的各种症状。
