Disseminated Varicella Infection Caused by Varicella Vaccine Strain in a Child With Low Invariant Natural Killer T Cells and Diminished CD1d Expression
Disseminated Varicella Infection Caused by Varicella Vaccine Strain in a Child With Low Invariant Natural Killer T Cells and Diminished CD1d Expression
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DOI：
10.1093/infdis/jir660
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发表时间：
2011-12-15
影响因子：
6.4
通讯作者：
Nourse, Clare B.
中科院分区：
文献类型：
--
作者：
Banovic, Tatjana;Yanilla, Mayonelo;Nourse, Clare B.
方法与结果。聚合酶链反应（PCR）分析囊泡拭子样品证实水痘带状疱疹病毒（VZV）。PCR产物经测序证实与人疱疹病毒3株VZV-Oka ORF62基因同源性100%。常规免疫检查未发现任何异常。总白细胞、淋巴细胞、中性粒细胞计数和淋巴细胞亚群正常。免疫球蛋白、C3、C4和CH50完好无损。对蛋白质和多糖抗原、eb病毒和巨细胞病毒存在特异性IgG。检测正常淋巴细胞对植物血凝素和VZV抗原的增殖。中性粒细胞功能和NK细胞活性正常。对不变NKT （iNKT）细胞数量和功能的分析显示iNKT细胞减少，同源受体cd1表达不足，这是我们患者所独有的。该报告提供了iNKT/CD1d通路缺陷与水痘疫苗病毒易感性增加之间的进一步联系，表明这一先天通路在宿主防御另一种疱疹病毒家族成员方面发挥重要作用。
Methods and Results. Polymerase chain reaction (PCR) analysis of vesicle swab samples demonstrated varicella zoster virus (VZV). Sequencing of the PCR product demonstrated 100% homology with human herpesvirus 3 strain VZV-Oka ORF62 gene. Routine immunologic investigations failed to demonstrate any abnormality. Total leukocyte, lymphocyte, and neutrophil counts and lymphocyte subsets were normal. Immunoglobulins, C3, C4, and CH50 were intact. Specific IgG to protein and polysaccharide antigens and to Epstein-Barr virus and cytomegalovirus were present. Normal lymphocyte proliferation to phytohemagglutinin and VZV antigens was detected. Neutrophil function and natural killer (NK) cell activity were normal. The analysis of invariant NK T (iNKT) cell numbers and function revealed diminished iNKT cells, reported once previously and unique to our patient, deficient expression of the cognate receptor, CD1d.Conclusions. This report provides a further link between deficiency of the iNKT/CD1d pathway and increased susceptibility to varicella vaccine virus, suggesting an important role of this innate pathway in host defense against yet another member of the herpesvirus family.