No abstract

Background Varicella-zoster-virus (VZV) establishes a life-long latent infection with risk of reactivation in patients with autoimmune disorders receiving immunosuppressive/immunomodulatory therapy. Objectives The study was aimed to evaluate the VZV-specific cellular immune response in the presence of cytokine-blocking antibodies in rheumatoid arthritis (RA) patients and healthy controls (HC). Methods IFNgamma- and IL-6-producing-CD4+ and -CD8+ T-cells were determined following stimulation with VZV-antigen in the presence of anti-IL-6 or anti-TNFalpha antibodies in vitro. Intracellular cytokine production was determined by flow cytometry in RA patients and HC. Results No differences in the IFNgamma- and IL-6-producing CD4+ or CD8+ T-cells were found between RA and HC following VZV stimulation. In the presence of anti-IL-6 in vitro, VZV-specific CD4+ T-cells producing IFNgamma reduced in RA compared to HC (11.0% versus 7.9%). In the presence of anti-IL-6, VZV-stimulated cells showed a reduction of IL-6-producing-CD4+ T-cells compared to cells stimulated with VZV alone in RA (7.2% versus 4.8%). No differences were observed in CD8+ T-cells in RA or in CD4+/CD8+ T-cells in HC. In the presence of anti-TNFalpha in vitro, IL-6-producing-CD4+ T-cells of RA patients were lower following stimulation with VZV compared to HC (6.2% versus 9.2%). Conclusions The reduction of the CD4+ cellular immune response to VZV by blocking of TNFalpha and IL-6 in vitro suggests an important role of inflammatory cytokines in the modulation of the T-cell response to VZV in RA. The influence of different cytokines on the long-term anti-VZV cellular immunity in patients with autoimmune conditions may need further investigated to prevent VZV reactivation. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5781

ZusammenfassungEnergydrinks erfreuen sich großer Beliebtheit unter Kindern und Jugendlichen. Mehrere Behandlungsberichte suggerieren eine Assoziation zwischen dem Konsum von Energydrinks und dem Auftreten unerwünschter kardiovaskulärer Ereignisse bei Minderjährigen. In diesem Artikel werden Ergebnisse der EDUCATE-Studie, welche die akuten Auswirkungen des Energydrinkkonsums auf die Herz-Kreislauf-Funktion bei Kindern und Jugendlichen erstmalig untersucht hat, prägnant dargestellt. Passend zu dieser Studie beschreiben wir das Auftreten eines therapierefraktären Kammerflimmerns nach Energydrinkkonsum bei einer Jugendlichen mit abgeheilter Myokarditis.