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Immunity against Varicella Zoster virus in patients with systemic lupus erythematosus or rheumatoid arthritis

Newling, M (2012) Immunity against Varicella Zoster virus in patients with systemic lupus erythematosus or rheumatoid arthritis. Bachelor's Thesis, Biology.

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Abstract

Patients with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) are at high risk for developing herpes zoster. Herpes zoster is a disease which is characterized by a skin rash and is often associated with a lot of pain. Herpes zoster occurs in patients who have a normal or even a better antibody response in comparison to healthy subjects. So, it has been suggested that suppressed cellular immunity is implicated in the pathogenesis of herpes zoster. In previous studies it was shown that VZV-specific IFN-γ and TNF-α positive CD4 T lymphocytes are reduced in patients with SLE, and that in general, Treg (regulatory T) cells, NK (natural killer) and NKT (natural killer T) cells are also reduced in these patients in comparison to healthy controls. There was no significant difference in CD8 T cells in comparison to healthy subjects. In general, patients with RA showed an increase in CD4 T cells, specifically Th17 cells. The IL-17 production was also enhanced in patients with RA. However, like patients with SLE, patients with RA also showed a decrease in Treg cells. It depends on the given treatment whether a live-attenuated varicella vaccine might be an option for patients with SLE or RA. However, in most treatments it is probably not advisable to give a live-attenuated varicella vaccine to patients with SLE or RA, because there is a high risk that the vaccine will trigger the development of herpes zoster. This is because these patients have a suppressed cellular immunity. There are no studies yet that investigated if a herpes zoster vaccine can be used in patients with SLE or RA. So, future studies are necessary to know what level of immunosuppression makes patients at risk for infections caused by vaccination and to get a better understanding of the risks and benefits associated with varicella vaccination in patients with SLE or RA.

Item Type: Thesis (Bachelor's Thesis)
Degree programme: Biology
Thesis type: Bachelor's Thesis
Language: English
Date Deposited: 15 Feb 2018 07:48
Last Modified: 15 Feb 2018 07:48
URI: http://fse.studenttheses.ub.rug.nl/id/eprint/10091

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