Yuan Yanrong, Zhang Yan, Wang Jun, Liu Huili, Zhang Hua, Yan Yongxing
Department of Neurology, The Third People's Hospital of Hangzhou Hangzhou, Zhejiang, China.
Department of Anesthesiology and Pain Management, The Third People's Hospital of Hangzhou Hangzhou, Zhejiang, China.
Am J Transl Res. 2023 Feb 15;15(2):1421-1429. eCollection 2023.
This study aimed to investigate the immune changes in patients with varicella-zoster virus (VZV) encephalitis/meningitis and explored their relationships with prognosis.
A total of 129 patients with herpes zoster (HZ), 32 patients with VZV encephalitis/meningitis and 31 non-HZ and non-VZV people as healthy controls were included into the present study. The numbers of peripheral T lymphocytes and the serum levels of complements 3 (C3), complements 4 (C4) and immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) were detected and compared among groups. In 32 patients with VZV encephalitis/meningitis, the immune related variables were compared between the favorable and the unfavorable prognosis group and their relationships with prognosis were further evaluated.
There were marked differences in the peripheral CD3+, CD4+ and CD8+ cells and CD4+/CD8+ ratio in the three groups (P<0.05). As compared with HZ and control groups, the peripheral CD3+ and CD4+ cells were reduced dramatically in patients with VZV encephalitis/meningitis (P<0.05). In 32 patients with VZV encephalitis/meningitis, the absolute CD3+ and CD4+ cells in patients with favorable prognosis were significantly higher than in patients with unfavorable prognosis (P<0.05), and they were positively related to the prognosis of these patients (r=0.3852, P=0.0295; r=0.3719, P=0.0361).
These immune changes were compromised in VZV encephalitis/meningitis. The peripheral CD3+ and CD4+ levels may be employed to predict prognosis.
本研究旨在调查水痘-带状疱疹病毒（VZV）脑炎/脑膜炎患者的免疫变化，并探讨其与预后的关系。
本研究共纳入129例带状疱疹（HZ）患者、32例VZV脑炎/脑膜炎患者以及31例非HZ且非VZV的健康对照者。检测并比较各组外周血T淋巴细胞数量以及补体3（C3）、补体4（C4）、免疫球蛋白A（IgA）、免疫球蛋白G（IgG）和免疫球蛋白M（IgM）的血清水平。在32例VZV脑炎/脑膜炎患者中，比较预后良好组和预后不良组的免疫相关变量，并进一步评估它们与预后的关系。
三组外周血CD3⁺、CD4⁺和CD8⁺细胞及CD4⁺/CD8⁺比值存在显著差异（P<0.05）。与HZ组和对照组相比，VZV脑炎/脑膜炎患者外周血CD3⁺和CD4⁺细胞显著减少（P<0.05）。在32例VZV脑炎/脑膜炎患者中，预后良好患者的绝对CD3⁺和CD4⁺细胞显著高于预后不良患者（P<0.05），且它们与这些患者的预后呈正相关（r=0.3852，P=0.0295；r=0.3719，P=0.0361）。
VZV脑炎/脑膜炎患者存在免疫功能受损。外周血CD3⁺和CD4⁺水平可用于预测预后。
