Measurement of melatonin, indole‐dioxygenase, IL‐6, IL‐18, ferritin, CRP, and total homocysteine levels during herpes zoster

Abstract

The risk of herpes zoster (HZ) increases with age and declining immune function. Increased oxidative stress and inflammatory conditions may cause a negative impact on the immune responses. The present study aimed to assess the levels of oxidative/inflammatory stress biomarkers in HZ patients compared with the controls. This case‐control study included 43 HZ patients and 47 age‐matched controls. Melatonin (MLT), Indole‐dioxygenase (IDO), Interleukin‐18 (IL‐18), Interleukin‐6 (IL‐6), ferritin, C‐reactive protein (hsCRP), and total homocysteine (tHcy) levels were measured and compared in both groups. The significant high levels of IDO, IL‐18, IL‐6, ferritin, hsCRP, and tHcy, as well as low levels of MLT were found in HZ patients compared with the controls (P < 0.001); these significant differences were also associated with rash and pain severity (P < 0.001). The final logistic regression model with the area under the curve (0.99; 95% confidence interval [CI], 0.98‐1.00) showed the association of HZ with decreased level of MLT (odds ratio [OR], 0.95; 95% CI, 0.92‐0.98; P = 0.007) and increased levels of tHcy (OR, 1.53; 95% CI, 1.06‐2.19; P = 0.02). The findings showed increased inflammation‐associated oxidative stress in HZ patients. Elevated tHcy levels and reduced MLT levels may be associated with the manifestation of HZ. More investigations are required to confirm the results.

Antioxidant and inflammatory biomarkers in herpes zoster

“…Recent studies have proposed that herpetic pain is related to the participation of oxygen free radicals attributed to damage to the sensory nerves. Long‐term accumulation of ROS/RNS in the dorsal root ganglion may be responsible for the neuronal damage, thus leading to inflammatory hyperalgesia and central and peripheral nerve injury‐induced neuropathic pain 28,29 . The prevention and treatment of PHN is a challenging process since one‐third of vaccinated (against VZV) adults over the age of 60 still develop PHN, which can negatively affect patients' daily activities and sleep quality, as well as cause an unsatisfactory response to treatment 30,31 .…”

“…Long-term accumulation of ROS/RNS in the dorsal root ganglion may be responsible for the neuronal damage, thus leading to inflammatory hyperalgesia and central and peripheral nerve injury-induced neuropathic pain. 28,29 The prevention and treatment of PHN is a challenging process since one-third of vaccinated (against VZV) adults over the age of 60 still develop PHN, which can negatively affect patients' daily activities and sleep quality, as well as cause an unsatisfactory response to treatment. 30,31 Despite the fact that antiviral treatment was initiated within the first 3 days of our study, 26.4% of the patients developed PHN, and all of those who developed PHN had a history of acute herpetic pain.…”

“…Increased Hcy in HZ may reflect a deficiency of vitamins B6, B12, and folate as well as increased inflammatory markers and oxidative stress. In a study of 43 HZ cases and 47 HCs, Khazan et al 29 observed oxidative stress components of elevated Hcy and high‐sensitivityCRP levels associated with increased inflammation in HZ patients. Many acquired disorders, including cardiovascular disease, cerebrovascular disease, dementia‐type disorders, osteoporosis‐associated fractures, chronic renal disease, autoimmune diseases, and inflammatory diseases, have elevated Hcy levels.…”

Preventive Vaccination with Mesenchymal Stem Cells Protects Mice from Lethal Infection Caused by Herpes Simplex Virus 1

“…Introduction of the selected mMSCs led to a change in the concentration of cytokines in the blood of immunized mice as well: the concentration of IFN-γ decreased approximately 2-fold and the concentration of IL-6 increased 2-fold. An increase in the level of IL-6 is recorded during various inflammatory diseases and is considered a marker of the development of severe forms of diseases, including herpesvirus etiology [ 38 ] and COVID-19 [ 39 ]. Apparently, such changes in the cytokine pattern contribute to a decrease in the protective activity of the mMSC-immunogen compared to MSCs in the experimental model of HSV-1 infection, since when vaccinated with primary MSCs, which induce 100% survival of mice, the concentration of IL-6 did not change, but IFN-γ increased.…”

Melatonin as a Reducer of Neuro- and Vasculotoxic Oxidative Stress Induced by Homocysteine

“…We can hypothesize that the simultaneous increase in the concentrations of an antioxidant and an oxidant [ 86 ] might be a protective mechanism against the action of the latter one. However, in some conditions, such as ulcerative colitis [ 87 ] or a herpes zoster infection [ 88 ], the state of hyperhomocysteinemia is accompanied by a decreased melatonin concentration. Thus, in these cases, there would be no compensatory antioxidant response (melatonin) to the oxidant (homocysteine), as we might have speculated to occur in depression.…”