BACKGROUND This study aimed to investigate the serum levels of inflammatory cytokines in patients with herpes zoster (HZ) and to assess their correlation with the development of postherpetic neuralgia (PHN). Understanding this relationship may offer insight into the mechanisms of PHN and provide avenues for targeted treatment. MATERIAL AND METHODS We selected 169 patients diagnosed with HZ and 43 healthy controls (HCs) for the study. Serum levels of inflammatory cytokines were measured in all participants. Pain severity was evaluated using the visual analog scale (VAS). Based on follow-up data, the 169 HZ patients were categorized into 2 groups: those who developed PHN (HZ-PHN) and those who did not (HZ-Con). We then analyzed the differences in cytokine levels and their correlation with PHN development. RESULTS Compared to the HCs group, HZ patients exhibited a significant decrease in TNF-a levels and an increase in IL-10 levels (P<0.05, P<0.01). The VAS score was negatively correlated with TNF-alpha levels and positively correlated with IL-10 levels in HZ patients (r=-0.3081, P<0.01; r=0.5619, P<0.01). Distinctive levels of TNF-alpha, IL-6, IL-8, and IL-10 were observed among different pain groups (P<0.05, P<0.01). The HZ-PHN group showed lower TNF-alpha and higher IL-10 levels compared to the HZ-Con group (P<0.05, P<0.01). IL-10 level was identified as an independent risk factor for PHN, with a sensitivity and specificity of 76.4% and 54.3%, respectively. CONCLUSIONS Abnormal levels of inflammatory cytokines are present in HZ patients, and the IL-10 level may serve as a valuable indicator for predicting the risk of developing PHN.

Neurosyphilis is a chronic infectious disease with involvement of central nervous system infection by Treponema pallidum. This study was to investigate the contents of B lymphocyte chemokine 1 (BLC-1/chemokine [C-X-C motif] ligand 13), Th1 cytokines (Interleukin [IL]-2, IL-12, and Interferon [IFN]-γ), and Th2 cytokines (IL-6 and IL-10) in serum and cerebrospinal fluid (CSF) of HIV-negative patients with neurosyphilis before and after treatment, aiming to elucidate roles of CXCL13 and Th1/Th2 cytokines in immune response to and pathogenesis of neurosyphilis. Enzyme-linked immunosorbent assay was employed to detect the contents of CXCL13, IL-2, IL-12, IFN-γ, IL-6, and IL-10 in serum and CSF of 47 HIV-negative patients with neurosyphilis, 36 syphilis patients without neurological involvement and 23 controls (noninfectious intracranial disease) before, 3 and 12 months after treatment with high dose penicillin. Results showed that there was no significant difference in blood CXCL13 content among 3 groups (P > .05); CSF CXCL13 content in neurosyphilis patients was significantly higher than in other 2 groups (P < .001), and positively related to leucocyte count, protein concentration, and IgG index. IL-6 and IL-10 contents of the serum and CSF in neurosyphilis patients were markedly higher than in other 2 groups (P < .05 or .01), but IL-2, IL-12, and IFN-γ of the serum and CSF were significantly lower than in other 2 groups (P < .05 or .01). The IL-6, IL-10, IL-2, IL-12, and IFN-γ contents of the serum and CSF were comparable between control group and syphilis group (P > .05). CSF CXCL13 content was positively related with IL-6 and IL-10 content, while negatively related to IL-12 content in neurosyphilis patients. CSF IL-6 content was negatively related with IL-12 content. In neurosyphilis patients, the CSF CXCL13 content reduced significantly at 3 and 12 months (P < .001), the CSF IL-2 and IL-12 contents increased significantly at 12 months, and CSF IL-6 contents reduced significantly at 12 months after treatment (P < .05 or .01). It is concluded that neurosyphilis patients did not have normal immune function. CXCL13 and Th1/Th2 cytokines are involved in the immune response of neurosyphilis patients. CSF CXCL13 and Th1/Th2 cytokines contents may be used for the diagnosis and evaluation of therapeutic efficacy of neurosyphilis.

Background: Postherpetic neuralgia (PHN) typically occurs in immunocompromised patients. However, there is a lack of prospective studies involving large samples of immunocompetent individuals. A prospective study was conducted to ascertain the association between serum levels of various markers and the occurrence of PHN in acute herpes zoster (HZ) patients with immunocompetent.Methods: A total of 887 acute HZ patients with immunocompetent who were admitted to Hangzhou Third People’s Hospital between April 2021 and December 2023 were selected. Peripheral venous blood at their initial visit was collected and the levels of various serum markers were detected. According to whether PHN occurred or not during follow-up, the participants were divided into PHN group and non-PHN group. Multivariate logistic regression analysis was used to screen the influencing factors of PHN.Results: Two hundred and seventeen cases (24.5%) developed PHN. Compared with the non-PHN group, age, numerical rating scale (NRS) scores, levels of C reactive protein (CRP) and homocysteine (HCY) in PHN group were significantly increased (p < 0.01), while CD3⁺ (p < 0.05), CD4⁺ (p < 0.01), CD4⁺/CD8⁺ ratios (p < 0.05), albumin levels (p < 0.01), and albumin/globulin (A/G) ratios (p < 0.05) were significantly decreased. Multivariate logistic regression analysis showed that age, NRS scores, levels of CRP, and HCY were independent risk factors for PHN among acute HZ patients with immunocompetent. ROC curve analysis showed that the sensitivity and specificity of combined with age, NRS scores, CRP and HCY levels in predicting PHN were 68.4 and 74.1%, respectively.Conclusion: Age and the severity of pain at the time of onset were also the risk factors for PHN in acute HZ patients with immunocompetent. The levels of serum CRP and HCY as potential biomarkers may have certain reference value for predicting the occurrence of PHN in acute HZ patients with immunocompetent.

Background:The aim of this study was to investigate the influence of carotid artery stenting (CAS) on the cognition and quality of life of elderly patients with severe stenosis of the internal carotid artery. Material andMethods:65 elderly patients w...

Objective: This study investigated the proteomic characteristics of cerebrospinal fluid (CSF) in patients with varicella zoster virus (VZV) meningitis to understanding the pathogenesis of central nervous system (CNS) infection by reactivated VZV.Method: We used data‐independent acquisition model to analyze the CSF proteomic differences of 28 patients with VZV meningitis and 11 herpes zoster (HZ) patients. According to the clinical manifestations at discharge, 28 VZV meningitis patients were divided into favorable outcome group and unfavorable outcome (UO) group and their differences in CSF proteome were also analyzed.Results: Compared with the HZ group, the proteins (CXCL10, ELANE, IL‐1RN, MPO, PRTN3, etc.) related to inflammation and immune cell activation were significantly upregulated in the VZV meningitis group (p < .01). The protein related to the nerve function and energy metabolism (CKMT1B, SLITRK3, Synaptotagmin‐3, KIF5B, etc.) were significantly downregulated (p < .05). The levels of a pro‐inflammatory factor, IL‐18, in CSF were significantly higher in patients in the UO group as compared to patients with favorable prognosis (p < .05).Conclusion: Inflammatory immune response is an important pathophysiological mechanism of CNS infection by VZV, and the CSF IL‐18 levels might be a potential prognostic indicator of the outcomes of VZV meningitis.