Varicella-zoster virus (VZV) expresses immediate-early protein 62 (IE62), and zoster is associated with neuropathic pain. Brain-derived neurotrophic factor (BDNF) is involved in the neuronal mechanism underlying pain hypersensitivity. Zoster is associated with prodrome and the robust production of booster antibody to VZV. We hypothesized that the intrathecal production of antibody to IE62 cross-reacting with BDNF and the nerve injury by skin lesions may augment allodynia in zoster by enhancing BDNF activity. Zoster produces a vesicular rash in a dermatomal distribution with sensory abnormalities, and it causes neurological complications such as zoster-associated pain (ZAP) or postherpetic neuralgia (PHN) (5,11,14,16,33). Zoster is associated with robust booster antibody production to varicella-zoster virus (VZV), which makes it possible to prevent or modify varicella as varicella-zoster immune globulin. PHN is the most frequent complication of zoster, occurring in 7 to 35% of patients, and it is characterized by the combination of constant pain, lancinating pain, and allodynia. However, the pathophysiology of ZAP and PHN has not been elucidated (10,17). VZV expresses the immediate-early protein 62 (IE62), a major transactivator of viral genes during lytic infection, and at least genes 4, 21, 29, 62, and 63 in latently infected ganglia (6,8,19,20,29,30). Although VZV or its products such as IE62 may be involved in the pathogenesis of PHN (12, 13), VZV is ubiquitously and latently distributed in sensory ganglia after varicella and zoster, but PHN is limited only to some patients with zoster.Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family that plays an important role in the development and plasticity of the peripheral and central nervous systems (3, 37). BDNF is involved in the neuronal mechanism underlying clinical pain hypersensitivity, particularly neuropathic pain (7, 21-23, 27, 37, 38). BDNF from microglia has been reported to participate in the pain hypersensitivity that underlies tactile allodynia (7). We hypothesized that BDNF participates in the pathogenesis of PHN and examined the immune response to VZV and BDNF in sera from patients with zoster and PHN. We found immunological cross-reactivity between IE62 and BDNF, and this cross-reaction of IE62 and BDNF was characterized using anti-IE62 monoclonal antibody (anti-IE62 MAb) and anti-BDNF MAb. Surprisingly, the anti-IE62 MAb recognized both the linear epitope (amino acids 414 to 429, designated p414-429) of IE62 and the conformational epitope of BDNF, and it augmented the functional activity of BDNF in cultured neurons. Sera from patients with zoster and PHN recognized BDNF and augmented BDNF activity in cultured neurons. The augmentation of BDNF by anti-IE62 MAb reduced the threshold to mechanical allodynia in mice with