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Study of patients with persistent HHV-6 infection after DIHS

Research Project

Project/Area Number 19K17811
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 53050:Dermatology-related
Research InstitutionNara Medical University

Principal Investigator

Nishimura Yuki  奈良県立医科大学, 医学部, 助教 (90812420)

Project Period (FY) 2019-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Keywords薬剤性過敏症症候群 / DIHS / ヒトヘルペスウイルス / HHV-6 / 再活性化 / 持続感染 / 自己免疫疾患 / 薬疹 / ヒトヘルペスウイルス6 / 合併症
Outline of Research at the Start

薬剤性過敏症症候群(DIHS)は、抗けいれん薬など比較的限られた薬剤投与開始から3週間以上たって遅発性に発症し、発熱、多臓器障害を伴う重症薬疹の1つである。発症2~3週間後にヒトヘルペスウイルス6(HHV-6)の再活性化を生じる。われわれはDIHS軽快後も、血液からHHV-6 DNAが長期に検出される症例が少なからず存在し、持続感染例では急性期の皮膚症状が重症であることを見出した。本研究は、HHV-6持続感染と臨床症状や血液検査所見、サイトカインやケモカインの発現、合併症との関連を検討する。さらにHHV-6持続感染のメカニズムを明らかにし、予後予測やその治療に重要な知見を得ることを目的とする。

Outline of Final Research Achievements

Involvement of human herpesvirus (HHV)-6 in the pathogenesis of drug-induced hypersensitivity syndrome (DIHS) has been suggested, but remains unclear. In this study, we investigated clinical and immunological characteristics of the patients with persistent HHV-6 reactivation after DIHS. We found that the patients with persistent HHV-6 reactivation were characterized by (1) severe cutaneous and mucosal symptoms in the acute phase, (2) high levels of HHV-6 and CMV DNA, (3) high levels of IL-4 and IL-5 in the acute phase and soluble IL-2 receptors in the acute and chronic phases, and (4) a high complication rate of chronic inflammatory complications such as interstitial nephritis, arthritis, and thyroiditis. These results suggest that persistent HHV-6 reactivation is associated with the severity of the acute phase of DIHS and the development of chronic inflammatory complications.

Academic Significance and Societal Importance of the Research Achievements

本研究の結果、DIHSが軽快した後もHHV-6の感染が持続している症例が少なからず存在すること、HHV-6持続感染はDIHSの重症度および慢性期の自己免疫性疾患の合併と関連していることが明らかになった。また、HHV-6持続感染例ではDIHS急性期に単球/マクロファージ分画が低下していたことより、持続感染例では抗ウイルス免疫における自然免疫応答が不十分であり、このことによりHHV-6の持続感染を生じる可能性が示唆された。

Report

(4 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (5 results)

All 2022 2021 2020 2019

All Journal Article (1 results) (of which Peer Reviewed: 1 results) Presentation (4 results) (of which Invited: 1 results)

  • [Journal Article] Serum Soluble OX40 as a Diagnostic and Prognostic Biomarker for Drug-Induced Hypersensitivity Syndrome/Drug Reaction with Eosinophilia and Systemic Symptoms2022

    • Author(s)
      Mitsui Y, Shinkuma S, Nakamura-Nishimura Y, Ommori R, Ogawa K, Miyagawa F, Mori Y, Tohyama M, Asada H
    • Journal Title

      J Allergy Clin Immunol Pract

      Volume: 10 Issue: 2 Pages: 585-565

    • DOI

      10.1016/j.jaip.2021.10.042

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Presentation] DIHSの病態形成におけるHHV-6の役割2021

    • Author(s)
      西村友紀、浅田秀夫
    • Organizer
      第72回日本皮膚科学会中部支部学術大会
    • Related Report
      2021 Annual Research Report
    • Invited
  • [Presentation] Persistent HHV-6 infection has an increased risk of autoimmune disorders in patients with DIHS2021

    • Author(s)
      Nishimura Y, Shobatake C, Miyagawa F, Shinkuma S, Watanabe H, Kira M, Nakajima S, Higashi Y, Asada H
    • Organizer
      日本研究皮膚科学会 第46回年次学術大会・総会
    • Related Report
      2021 Annual Research Report
  • [Presentation] Persistent HHV-6 infection has an increased risk of more severe complications in patients with DIHS2020

    • Author(s)
      Yuki Nishimura, Fumi Miyagawa, Hideaki Watanabe, Masahiro Kira, Saeko Nakajima, Yuko Higashi, Hideo Asada
    • Organizer
      日本研究皮膚科学会 第45回年次学術大会・総会
    • Related Report
      2020 Research-status Report
  • [Presentation] The characteristics of patients with persistent HHV-6 infection after DIHS/DRESS2019

    • Author(s)
      Yuki Nishimura, Fumi Miyagawa, Kazuya Miyashita, Rie Ommori, Chinatsu Shobatake, Hiroaki Azukizawa, Hideo Asada
    • Organizer
      日本研究皮膚科学会 第44回年次学術大会・総会
    • Related Report
      2019 Research-status Report

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Published: 2019-04-18   Modified: 2023-01-30  

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