PDF(Pubmed)
Abstract：
The varicella-zoster virus (VZV) is a human neurotropic herpes virus responsible for varicella and herpes zoster (HZ). Following primary infection in childhood, VZV manifests as varicella (chickenpox) and enters a period of latency within the dorsal root ganglion. A compromised cellular immune response due to aging or immunosuppression triggers viral reactivation and the development of HZ (shingles). Patients with autoimmune diseases have a higher risk of developing HZ owing to the immunodeficiency associated with the disease itself and/or the use of immunosuppressive agents. The introduction of new immunosuppressive agents with unique mechanisms has expanded the treatment options for autoimmune diseases but has also increased the risk of HZ. Specifically, Janus kinase (JAK) inhibitors and anifrolumab have raised concerns regarding HZ. Despite treatment advances, a substantial number of patients suffer from complications such as postherpetic neuralgia for prolonged periods. The adjuvanted recombinant zoster vaccine (RZV) is considered safe and effective even in immunocompromised patients. The widespread adoption of RZV may reduce the health and socioeconomic burdens of HZ patients. This review covers the link between VZV and autoimmune diseases, assesses the risk of HZ associated with immunosuppressant use, and discusses the benefits and risks of using RZV in patients with autoimmune diseases.
摘要：
水痘-带状疱疹病毒(VZV)是负责水痘和带状疱疹(HZ)的人亲神经疱疹病毒。在儿童期的原发性感染之后，VZV表现为水痘（水痘），并在背根神经节内进入潜伏期。由于老化或免疫抑制引起的细胞免疫应答受损触发病毒再激活和HZ(带状疱疹)的发展。由于与疾病本身相关的免疫缺陷和/或使用免疫抑制剂，患有自身免疫性疾病的患者患HZ的风险更高。具有独特机制的新型免疫抑制剂的引入扩大了自身免疫性疾病的治疗选择，但也增加了HZ的风险。具体来说,Janus激酶（JAK）抑制剂和anifrolumab引起了对HZ的关注。尽管治疗进展，相当多的患者长期患有并发症，如带状疱疹后神经痛。佐剂化重组带状疱疹疫苗(RZV)被认为即使在免疫受损的患者中也是安全和有效的。RZV的广泛采用可以减轻HZ患者的健康和社会经济负担。这篇综述涵盖了VZV与自身免疫性疾病之间的联系，评估与使用免疫抑制剂相关的HZ风险，并讨论了在自身免疫性疾病患者中使用RZV的益处和风险。
