Chen Po-Ku, Chen Yi-Ming, Chen Hsin-Hua, Liao Tsai-Ling, Chang Shih-Hsin, Yeo Kai-Jieh, Huang Po-Hao, Chen Der-Yuan
Rheumatology and Immunology Center, China Medical University Hospital, Taichung 404, Taiwan.
College of Medicine, China Medical University, Taichung 404, Taiwan.
Microorganisms. 2024 May 12;12(5):974. doi: 10.3390/microorganisms12050974.
Anti-interferon (IFN)-γ autoantibodies are linked to varicella zoster virus (VZV) infection. Given the elevated risks of herpes zoster (HZ) in rheumatoid arthritis (RA) patients treated with Janus kinase inhibitors (JAKis), we aimed to examine the relationship between anti-IFN-γ autoantibodies with HZ development in JAKi-treated patients. Serum titers of anti-IFN-γ autoantibodies, plasma levels of IFN-γ, monocyte chemoattractant protein-1 (MCP-1), and IFN-γ-inducible protein-10 (IP-10) were measured by ELISA. Among the 66 enrolled RA patients, 24 developed new-onset HZ. Significantly lower MCP-1 levels were observed in patients with HZ compared to those without (median, 98.21 pg/mL, interquartile range (IQR) 77.63-150.30 pg/mL versus 142.3 pg/mL, IQR 106.7-175.6 pg/mL, < 0.05). There was no significant difference in anti-IFN-γ titers, IFN-γ levels, or IP-10 levels between patients with and without HZ. Three of 24 patients with HZ had severe HZ with multi-dermatomal involvement. Anti-IFN-γ titers were significantly higher in patients with severe HZ than in those with non-severe HZ (median 24.8 ng/mL, IQR 21.0-38.2 ng/mL versus 10.5 ng/mL, IQR 9.9-15.0 ng/mL, < 0.005). Our results suggest an association between reduced MCP-1 levels and HZ development in JAKi-treated RA patients. High-titer anti-IFN-γ autoantibodies may be related to severe HZ in these patients.
抗干扰素（IFN）-γ自身抗体与水痘带状疱疹病毒（VZV）感染有关。鉴于接受Janus激酶抑制剂（JAKi）治疗的类风湿关节炎（RA）患者发生带状疱疹（HZ）的风险升高，我们旨在研究抗IFN-γ自身抗体与接受JAKi治疗患者发生HZ之间的关系。通过酶联免疫吸附测定（ELISA）测量抗IFN-γ自身抗体的血清滴度、IFN-γ的血浆水平、单核细胞趋化蛋白-1（MCP-1）和IFN-γ诱导蛋白10（IP-10）。在66名纳入研究的RA患者中，24人出现新发HZ。与未发生HZ的患者相比，发生HZ的患者MCP-1水平显著降低（中位数分别为98.21 pg/mL，四分位间距（IQR）77.63 - 150.30 pg/mL与142.3 pg/mL，IQR 106.7 - 175.6 pg/mL，P<0.05）。发生HZ和未发生HZ的患者之间抗IFN-γ滴度、IFN-γ水平或IP-10水平无显著差异。24例发生HZ的患者中有3例出现严重HZ且累及多个皮区。严重HZ患者的抗IFN-γ滴度显著高于非严重HZ患者（中位数分别为24.8 ng/mL，IQR 21.0 - 38.2 ng/mL与10.5 ng/mL，IQR 9.9 - 15.0 ng/mL，P<0.005）。我们的结果表明，在接受JAKi治疗的RA患者中，MCP-1水平降低与HZ发生有关。高滴度抗IFN-γ自身抗体可能与这些患者的严重HZ有关。
