Exhausted T-Cells and Memory T-Cell Subsets in Adult Varicella-Zoster Patients
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Lawrence M. DuBuske, MD, FAAAAI, Andrei Y. Hancharou, G. M. Davidovich
Rationale: Chicken Pox or Varicella (VZ), which uncommonly occurs in adults, may be related to memory T-cell subsets and exhausted T-cells.

Methods: Blood taken from 12 adult patients with VZ infection was assayed for exhausted T-cell counts using 3 markers of exhausted T-cells: Tim-3, CD223 (Lag-3) and CD279 (PD-1). T-cells were divided into subsets: Naïve (CCR7+CD45RA+), TCM (CCR7+CD45RA), TEM (CCR7CD45RA), TEM1 (CCR7CD45RACD28+), TEM2 (CCR7CD45RACD28), and TEMRA (CCR7CD45RA+).

Results: Tim-3+, Lag-3+ and PD-1hi T-cell counts were 5-8 fold greater in VZ patients versus controls, indicating immune impairment (Tim-3+ VZ: 1.93(0.5–5.08)%; C: 0.35(0.25-0.67)%, p=0.02; Lag-3+ VZ: 1.24(1.12–1.51)%; C: 0.21(0.15-0.45)%, p=0.0001; PD-1hi VZ: 7.6 (4.6-10.7)%; C: 0.96(0.36-1.45)%, p=0.0001). Naïve and TCM subsets were decreased (p=0.00005, both subpopulations), while TEM was increased (p=0.0001). VZ had a tendency (p=0.09) towards increased TEMRA subset (VZ: 22.2(10.5—26.9)%; C: 10.8(4.9-19.1)%). CD28+T-cells were lower in VZ versus C (VZ: 39.6(28.5-44.5)%; C: 59.5(54.0-61.4)%, p=0.0005).

Conclusions: VZ infection induces changes in memory/effector T-cells, naïve and TCM cells differentiating into TEM and TEMRA subsets that migrate to peripheral tissues and function as effector cells, with marked increase in exhausted T-cells.