Human herpes virus reactivations and dynamic cytokine profiles in patients with cutaneous adverse drug reactions - a prospective comparative study
Human herpes virus reactivations and dynamic cytokine profiles in patients with cutaneous adverse drug reactions - a prospective comparative study
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DOI：
10.1111/all.12602
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发表时间：
2015-05-01
期刊：
影响因子：
12.4
通讯作者：
Chu, C. -Y.
中科院分区：
文献类型：
--
作者：
Chen, Y. -C.;Chiang, H. -H.;Chu, C. -Y.
研究背景人疱疹病毒（human herpes virus，HHV）在伴有嗜酸性粒细胞增多和全身症状的药物反应（drug reaction with eosinophilia and systemic symptoms，DRESS）中的再激活现象是众所周知的，但在其他类型的皮肤药物不良反应（drug adverse reactions，cADR）中，HHV的再激活现象却鲜有研究。此外，病毒再活化与细胞因子或趋化因子变化之间的关联在很大程度上是未知的。我们的目的是评估不同cADR中HHV-6、HHV-7、EB病毒（EBV）和巨细胞病毒（CMV）的病毒再激活率及其对临床预后的影响。细胞因子和趋化因子的变化与病毒reactivations.MethodsA前瞻性研究进行了监测不同的cADR患者的病毒状态的聚合酶链反应和血清特异性抗体滴度。血浆细胞因子和趋化因子水平的变化也进行了评价，通过连续的血液samples. ResultsAmong各种cADR，HHV-6的再激活，只观察到在DRESS，但EBV和CMV可以检测到在其他cADR。HHV-6再激活的DRESS患者的许多促炎细胞因子和趋化因子，包括白细胞介素（IL）-1，IL-2，IL-6，干扰素-，肿瘤坏死因子-，与没有HHV-6再激活的患者相比，显著降低。此外，这些介质显着降低之前和过程中HHV-6再激活，HHV-6再激活后在同一patient.ConclusionHHV-6再激活后的细胞因子水平相比，只观察到在DRESS患者，而不是在任何其他cADR。在DRESS患者中，一些促炎细胞因子在HHV-6再激活之前或期间显著降低。
BackgroundSequential human herpes virus (HHV) reactivation is well known in drug reaction with eosinophilia and systemic symptom (DRESS), but such a phenomenon has seldom studied in other types of cutaneous adverse drug reactions (cADRs). Moreover, the association between viral reactivations and cytokine or chemokine changes is largely unknown. We aimed to evaluate the viral reactivation rates of HHV-6, HHV-7, Epstein-Barr virus (EBV), and cytomegalovirus (CMV) in different cADRs and their impacts on clinical prognosis. Cytokine and chemokine changes with viral reactivations were also examined.MethodsA prospective study was conducted to monitor the viral statuses of patients with different cADRs by polymerase chain reaction and serum-specific antibody titers. Changes in plasma cytokine and chemokine levels were also evaluated by sequential blood samples.ResultsAmong the various cADRs, HHV-6 reactivation was only observed in DRESS, but EBV and CMV could be detected in other cADRs. Many proinflammatory cytokines and chemokines, including interleukin (IL)-1, IL-2, IL-6, interferon-, tumor necrosis factor-, were significantly lower in DRESS patients with HHV-6 reactivation when compared to those without HHV-6 reactivation. In addition, these mediators were significantly lower before and during HHV-6 reactivation, compared to cytokine levels after HHV-6 reactivation in the same patient.ConclusionHHV-6 reactivation was only observed in DRESS patients, not in any other cADR. In DRESS patients, some proinflammatory cytokines were significantly lower before or during HHV-6 reactivation.