Role of Neutralizing Antibody in the Pathogenesis of Zoster and the Correlation of Severity with Anti‐gE: gI Antibody Response

Antibody response to varicella-zoster virus glycoproteins and neutralizing antibodies were examined to correlate them with the severity of the zoster. Antibody rise to whole viral antigen was observed in 17 of 19 patients, that to gE: gI was not increased in 7 patients, and antibody to gE: gI in severe cases was significantly lower compared with mild cases in the convalescent phase than in the acute phase (p<0.05 Fisher's exact test). Antibody rise to gE: gI was well correlated with limited development of zoster lesions and, in contrast, antibody titer without rise was associated with increased severity and wider development of zoster lesions. As gE is the most abundant glycoprotein in the infected cells, the antibodies may be consumed in severe and widespread lesions, resulting in an antibody response to gE: gI without a rise. When the ratio of neutralizing antibody to anti-gE: gI antibody titers in the acute phase was compared with that in the recovery phase, the former was significantly lower in the severe cases than the latter (p=0.0082 Student t-test). This suggested that neutralizing antibody was specifically consumed in the acute phase of zoster among the anti-VZV antibodies. The role of humoral immunity in the pathogenesis of zoster might have been reflected in the antibody response to the neutralizing antibody in the acute phase and antibody to gE: gI in the severe cases.