Cytokines are important immune response mediators that integrate cellular behavior into immune cells; they also play a significant role in the understanding of cellular immunity. The concentrations of cytokines (IL-22, IL-17, and TNF-α) in VZV patients were determined in this study. The most crucial function of the immune mechanism against VZV infection is cellular immunity.
According to our findings, the cytokine levels were considerably greater in the VZV group than in the normal group. These findings support widespread immune system activation throughout VZV infection, which involves both humoral and cellular immunity. Furthermore, the serum IL-17 concentration was the highest. In response to IL-17, prioninflammatory cytokines are created. Increased production of IL-17 has been linked to several inflammatory disorders, including asthma (Molet et al., 2001), atopic dermatitis (Toda et al., 2003), and psoriasis (Molet et al., 2001). (Arican et al., 2005). In particular, in infectious diseases, however, IL-17 acts as a barrier against pathogens such as bacteria and fungi (Trinchieri, 2003). As a result, while the activities of the above mentioned cytokines have been studied, the increase in IL-17 production noted in our study is a novel finding in the HZ. The serum IL-17 concentration was significantly greater in VZV patients than in controls.
Ihara et al. (1991) showed that the VZV has "tropism" to immunity. The development of immune mechanisms against the virus involves the activation of CD4 + and CD8 + T lymphocytes, which typically manifest three days after the initial entry of the microorganism into the host. Natural killer (NK) cells lyse fibroblasts and other virus-infected cells as the first host response. Several proinflammatory cytokines, such as TNF-α and IL17, stimulate and maintain this cellular response (Karadag et al., 2013).
The broad spectrum of effector functions of Th17-secreted cytokines is described by their ability to regulate a diverse variety of cells. Th17 cells are also major producers of IL-22. The following is an example illustrating the broad range of cells strongly affected by these mediators. IL-22 also helps to stimulate the release of cytokines and chemokines, which are implicated in the recruitment of new neutrophils to sites of inflammation (Korn, et al., 2009). In addition to their role in various cell populations, Th17 cells are an important source of cytokines (Shohan et al., 2020). Th17 cell processing of IL-22 is completely reliant on the action of IL-23. One of the processes by which this process is impeded is TGF, which prevents the expression of IL-23R (Zhou et al., 2008).
The HZ virus antibody serological test detects IgG and IgM antibodies and is used to distinguish between primary and secondary infections and to assess immunity (Yeo et al., 2005). In addition, when IgG antibody titers are high, the IgM antibody test is used to detect acute infection, has low sensitivity, and has false-positivity and cross-reactivity with other herpes viruses (Sauerbrei et al., 1999).
Sundqvist et al. (1982) used ELISA to investigate the regularity and selectivity of the VZV IgM response and reported that 21 of 25% of patients were positive, likely resulting in an 84% positive rate. Dobec et al. (2008), who investigated the prognosis of53 patients with fairly standard HZ morphology and propagation ofskin lesions,reported a positive rate of 47% IgM for the identification of VZV in the HZ.
Even though IgM antibody testing is usually used to detect viral infection, modification of the IgM test will not provide substantial clinical utility in many cases, although a few reports suggest that the titer appears within 2 to 5 days of lesion appearance and after 2 to 3 weeks of peak infection before rapidly declining to undetectable after a year (Heininger et al., 2005).