Schub D, et al. – Experts distinguished ZV–specific T–cells from cerebrospinal fluid (CSF) and blood of patients with active CNS–disease. In patients with VZV–related CNS–infection, they observed increased frequency and CTLA–4 expression of VZV–specific T–cells from CSF or blood.

Methods

• They recruited and classified 27 patients with pleocytosis in the CSF into three groups (10 VZV-related, 10 non-VZV-related, 7 unclear).
• They quantified VZV-specific CD4+ T-cells in CSF and blood after simultaneous stimulation with a VZV-antigen-lysate and detection of cytokines (IFNγ, IL-2, TNFα) and CTLA-4.
• Moreover, polyclonal stimulation served as positive control.

Results

• Results revealed higher VZV-specific CD4+ T-cell-frequencies in both CSF (p = 0.0001) and blood (p = 0.011) of patients with VZV-infection.
• At the site of infection, VZV-specific CD4+ T-cell-frequencies were enriched (p = 0.002).
• Minor differences between the groups were exhibited by cytokine expression-profiles.
• In addition, CTLA-4 expression-levels on VZV-specific T-cells from CSF and blood were significantly increased in VZV-related CNS-infections (p = 0.0002 and p<0.0001) and clearly identified VZV-related CNS-diseases (100% sensitivity and 100% specificity).
• Between the groups, polyclonally stimulated T-cells did not show any quantitative and phenotypical differences.