Prevention strategy of Herpes zoster based on analysis of reconstruction of cell-mediated immunity after hematopoietic cell transplantation

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K08320
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 54010:Hematology and medical oncology-related
• Research Institution: Shinshu University
• Principal Investigator: Tanaka Miyuki 信州大学, 学術研究院医学系(医学部附属病院), 講師 (10550478)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 移植後感染症 / T細胞性免疫 / 感染症予防

Outline of Final Research Achievements

Varicella zoster virus(VZV) reactivates in 30~50% of stem cell transplantation(SCT) recipients, causing herpes zoster. To minimize these complications, acyclovir (ACV) prophylaxis has been used. However, prolonged use of ACV may lead to antiviral resistance or may impair the reconstitution of VZV specific immunity. In this study we evaluated VZV specific cell mediated immune responses after SCT, aiming to develop a strategy for prevention of VZV reactivation.
The Enzyme-Linked Immunospot (ELISPOT) assay was optimal for analyze the reconstruction of cell-mediated immunity.
The results of this study show that the assessment of cell-mediated immunity reconstruction will be an important factor in determining the "optimal time of vaccination" in individual cases.

Free Research Field

ウイルス特異的T細胞、がん免疫療法

Academic Significance and Societal Importance of the Research Achievements

本研究の成果は、臨床的に有効なVZVサブユニットワクチンの開発における、抗原選択の重要性を示した。また、移植後細胞性免疫の再構築の評価は、ウイルス抗体価、リンパ球数、リンパ球機能などの検査値や免疫抑制剤内服の有無、帯状疱疹発症の有無などの臨床経過と併せ、将来的にサブユニットワクチンが導入された際に問題になるであろう、個々の症例における「接種する最適な時期」を決定する重要な要素であることを示した。