Study of patients with persistent HHV-6 infection after DIHS

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K17811
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53050:Dermatology-related
• Research Institution: Nara 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
• 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

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.

Free Research Field

皮膚科学

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。