Usefulness of Inflammatory Markers for the Prediction of Postherpetic Neuralgia in Patients with Acute Herpes Zoster

Abstract

Background: Increasing evidence suggests a pivotal role for neuronal inflammation in response to replicating varicella zoster virus in the development of postherpetic neuralgia (PHN). Objective: In this study, we investigated the value of serum levels of various inflammatory markers in acute herpes zoster (HZ) as predictors for the development of PHN. Methods: A total of 116 patients with acute HZ were enrolled in this study. We measured scores on the pain visual analogue scale (VAS) at baseline and at 1, 3, and 6 months after diagnosis of HZ. We defined PHN as pain greater than 1 on the VAS lasting for more than 6 months. Serum samples for laboratory assay, including complete blood count were obtained at the initial visit. Correlations between the levels of each inflammatory marker and the development of PHN were evaluated. Results: Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte count, and albumin showed significant correlations with development of PHN in univariate analysis. Levels of ESR, CRP, and lymphocyte count also showed significant correlations in multivariate analysis. ESR level showed stronger correlations with development of PHN than levels of CRP and lymphocyte count. Conclusion: In this study, we confirmed that elevated ESR was an independent and significant predictor of PHN in patients with acute HZ. To validate these results, further well-designed, randomized clinical trials are needed. (Ann Dermatol 30(2) 158∼163, 2018)

Aging and the Immune System: the Impact of Immunosenescence on Viral Infection, Immunity and Vaccine Immunogenicity

“…The underlying mechanisms involved in VZV reactivation and susceptibility among the elderly or immunocompromised populations are currently unclear, although recent studies suggest aging cells as the cause of the inefficient clearance of virus-infected cells (91,92). Few markers that correlate with age-related severity in shingles or poor response to vaccination have also been identified (93)(94)(95). In particular, elderly residents in long-term care experience elevated incidence of shingles and post-herpetic neuralgia due to the high degree of immunosenescence, malnutrition, and existing chronic conditions.…”

Easy‐to‐use prediction model for postherpetic neuralgia

“…PHN negatively impacts patients’ quality of life and causes substantial health‐care burden on individuals and society 1 . Therefore, the development of a model predicting PHN in patients with acute phase HZ is important to establish preventive strategies 2,3 . However, thus far, there have been few reliable PHN‐prediction models that can be easily applied to clinical practice 3 .…”

“…Therefore, the development of a model predicting PHN in patients with acute phase HZ is important to establish preventive strategies 2,3 . However, thus far, there have been few reliable PHN‐prediction models that can be easily applied to clinical practice 3 . Herein, we present a novel predictive model for PHN using easy‐to‐obtain predictors.…”

“…The estimation of the risk is straightforward as follows: the probability of PHN in groups with miRS/any age, msRS/<70 years, and msRS/≥70 years corresponds to low risk (<3%), middle risk (15.0%), and high risk (~30%), respectively. As not depending on laboratory tests such as blood samplings, this model is more easily applicable in various clinical settings 3 …”

Pilot Analyses of Interferon Subtype Expression Profiles in Patients with Herpes Zoster or Postherpetic Neuralgia

“…HZ manifestations range from a mild itch to agonizing rash and lesions or shingles, all results of the reactivation of dormant or latent varicella zoster virus (VZV) infections (23). Furthermore, PHN can manifest regardless of clinical presentation of zoster (12). PHN generally arises in elderly individuals or in patients with compromised immune systems (8).…”