1
|
Hedström AK. Risk factors for multiple sclerosis in the context of Epstein-Barr virus infection. Front Immunol 2023; 14:1212676. [PMID: 37554326 PMCID: PMC10406387 DOI: 10.3389/fimmu.2023.1212676] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/26/2023] [Indexed: 08/10/2023] Open
Abstract
Compelling evidence indicates that Epstein Barr virus (EBV) infection is a prerequisite for multiple sclerosis (MS). The disease may arise from a complex interplay between latent EBV infection, genetic predisposition, and various environmental and lifestyle factors that negatively affect immune control of the infection. Evidence of gene-environment interactions and epigenetic modifications triggered by environmental factors in genetically susceptible individuals supports this view. This review gives a short introduction to EBV and host immunity and discusses evidence indicating EBV as a prerequisite for MS. The role of genetic and environmental risk factors, and their interactions, in MS pathogenesis is reviewed and put in the context of EBV infection. Finally, possible preventive measures are discussed based on the findings presented.
Collapse
Affiliation(s)
- Anna Karin Hedström
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
2
|
Chen L, Zhao X, Liu Y, Wu M, Li S, Xu C, Shi Y. Comprehensive analysis of HHV-6 and HHV-7-related gene signature in prognosis and response to temozolomide of glioma. J Med Virol 2023; 95:e28285. [PMID: 36349462 PMCID: PMC9827936 DOI: 10.1002/jmv.28285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
Human herpesvirus (HHV)-6 and HHV-7 have been detected in central nervous system and glioma tissue, while their exact role in glioma remains uncertain. Omics profiles and clinical information were downloaded from public databases, including The Cancer Genome Atlas cohort for training set and the Chinese Glioma Genome Atlas cohorts for validation sets. Differentially expressed genes between HHV-6 and HHV-7 infected or noninfected glioma patients were screened for establishing the HHV-6 and HHV-7 infection (HI) model through Lasso regression analysis. Bioinformatics methods were used to analyze the correlation between HI scores and prognosis, metastasis in glioma patients. Predictable efficacy of HI in temozolomide-resistance and HI-related genetic signatures were also explored. The HI model was constructed as: Risk score = (0.014709*DIRAS3) + (0.029787*TEX26) + (0.223492*FBXO39) + (0.074951*MYBL1) + (0.060202*HILS1). The five gene signature showed good performance in predicting survival time for glioma patients, while higher HI score is correlated with malignant features. Moreover, DNA mismatch repair genes were augmented in glioma patients with higher HI score as well as nonresponse to temozolomide treatment, which was in parallel with the transcriptomic result of temozolomide-resistant glioma cell. Targeting the five gene signature is beneficial for prognosis of glioma patients, especially in glioma patients underwent temozolomide treatment.
Collapse
Affiliation(s)
- Luoyi Chen
- Department of Oncology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuanChina
| | - Xinchen Zhao
- Department of Oncology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuanChina
| | - Yuyang Liu
- Department of Neurosurgery, The First Medical CentreChinese People's Liberation Army (PLA) General HospitalBeijingChina
| | - Mengwan Wu
- Department of Integrative Cancer Center & Cancer Clinical Research Center, Sichuan Cancer Hospital & Institute, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Shurong Li
- Department of Oncology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuanChina
| | - Chuan Xu
- Department of Oncology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuanChina,Department of Integrative Cancer Center & Cancer Clinical Research Center, Sichuan Cancer Hospital & Institute, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Ying Shi
- Department of Oncology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuanChina,Department of Integrative Cancer Center & Cancer Clinical Research Center, Sichuan Cancer Hospital & Institute, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| |
Collapse
|
3
|
Ghorbani S, Letafati A, Khatami A, farzi R, Shabani S, Moradi P, Tambrchi V, Saadati H, Papizadeh S, rad MV, Tabatabaei R, Bahadory S, Tavakoli A, Bokharaei-Salim F, Monavari SH, Fatemipour M, Hoseini M, Kiani SJ. Association between human herpesvirus-6 and primary brain tumors: a systematic review and meta-analysis. Future Virol 2022. [DOI: 10.2217/fvl-2021-0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Aim: The present study aimed to find out the prevalence and any possible association between human herpesvirus (HHV-6) and primary brain tumors. Materials & methods: The systematic literature search was performed by finding related articles from major databases. Analysis was performed by comprehensive meta-analysis software. Results: A total of 13 (25 datasets) articles were included in the study, seven (15 datasets) of which were case/control and the rest (ten datasets) were cross-sectional studies. The pooled prevalence of HHV-6 among primary brain cancer patients was 29% (95% CI: 24–33%; I2 = 97.89%). An association was found between HHV-6 and primary brain cancer (summary odds ratio: 3.77% [95% CI: 2.59–5.49%; I2 = 19.0%]). Conclusion: Our analysis demonstrated that HHV-6 is associated with primary brain cancer. Reactivation of the virus could be triggered by the tumor, therefore, we cannot be certain that the virus appeared before the cancer development.
Collapse
Affiliation(s)
- Saied Ghorbani
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Arash Letafati
- Department of Virology, School of public health, Tehran University of Medical Science, Tehran, Iran
| | - Alireza Khatami
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Rana farzi
- Department of Virology, Faculty of Medicine, Shiraz University of Medical Science, Shiraz, Iran
| | - Soha Shabani
- Faculty of veterinary medicine, Azad University, Research Sciences Branch, Tehran, Iran
| | - Pouya Moradi
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Vahid Tambrchi
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Hassan Saadati
- Department of Epidemiology & Biostatistics, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Saher Papizadeh
- Department of Medical Microbiology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mona Vasei rad
- Paramedicine Department, Islamic Azad University, Babol Medical Sciences Branch, Babol, Mazandaran, Iran
| | - Raheleh Tabatabaei
- Department of Immunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeed Bahadory
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ahmad Tavakoli
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
- Research Center of Pediatric Infectious Diseases, Institute of Immunology & Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Farah Bokharaei-Salim
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
| | | | - Maryam Fatemipour
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Mahdieh Hoseini
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Seyed Jalal Kiani
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
| |
Collapse
|
4
|
Miyake M, Kawamura Y, Ishihara N, Suzuki S, Miura H, Sakaguchi Y, Tanaka M, Takahashi Y, Kojima S, Toyama H, Natsume J, Yoshikawa T. Hippocampal Atrophy in Pediatric Transplant Recipients with Human Herpesvirus 6B. Microorganisms 2021; 9:microorganisms9040776. [PMID: 33917715 PMCID: PMC8068176 DOI: 10.3390/microorganisms9040776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to determine whether human herpesvirus 6B (HHV-6B) infection can impair the hippocampus in pediatric hematopoietic stem cell transplant (HSCT) recipients. Study subjects were pediatric HSCT recipients monitored for HHV-6B infection who underwent brain MRI before and after transplantation. Volumetric analysis of the hippocampus was performed. Of the 107 patients that received HSCT at Nagoya University Hospital Between July 2008 and April 2014, 20 were eligible for volumetric analysis. Eight patients had HHV-6B infection, of whom two had encephalopathy at the time of HHV-6B infection. None of the 12 patients without HHV-6B infection had encephalopathy. The median ratio of the right hippocampal volume from before to after transplantation was 0.93 in patients with HHV-6B infection and 1.02 in without HHV-6B infection (p = 0.007). The median ratio of the left hippocampal volume ratio in patients with and without HHV-6B infection was 0.92 and 1.00, respectively (p = 0.003). Among the eight patients with HHV-6B infection, four had a marked reduction in hippocampal volume (volume ratio < 0.90). Only one of these patients had neurological symptoms at the time of HHV-6B infection. The reduction in the hippocampal volume ratio was higher in pediatric HSCT recipients with HHV-6B infection than those without viral infection. Neurological follow-up may be required for pediatric HSCT recipients with HHV-6B infection.
Collapse
Affiliation(s)
- Misa Miyake
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake 470-1192, Japan; (M.M.); (N.I.); (H.M.); (T.Y.)
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake 470-1192, Japan; (M.M.); (N.I.); (H.M.); (T.Y.)
- Correspondence:
| | - Naoko Ishihara
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake 470-1192, Japan; (M.M.); (N.I.); (H.M.); (T.Y.)
| | - Shigetaka Suzuki
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan; (S.S.); (M.T.)
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake 470-1192, Japan; (M.M.); (N.I.); (H.M.); (T.Y.)
| | - Yoko Sakaguchi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.S.); (Y.T.); (S.K.); (H.T.); (J.N.)
| | - Masaharu Tanaka
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan; (S.S.); (M.T.)
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.S.); (Y.T.); (S.K.); (H.T.); (J.N.)
| | - Seiji Kojima
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.S.); (Y.T.); (S.K.); (H.T.); (J.N.)
| | - Hiroshi Toyama
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.S.); (Y.T.); (S.K.); (H.T.); (J.N.)
| | - Jun Natsume
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.S.); (Y.T.); (S.K.); (H.T.); (J.N.)
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake 470-1192, Japan; (M.M.); (N.I.); (H.M.); (T.Y.)
| |
Collapse
|
5
|
The Association of Human Herpesviruses with Malignant Brain Tumor Pathology and Therapy: Two Sides of a Coin. Int J Mol Sci 2021; 22:ijms22052250. [PMID: 33668202 PMCID: PMC7956256 DOI: 10.3390/ijms22052250] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023] Open
Abstract
The role of certain viruses in malignant brain tumor development remains controversial. Experimental data demonstrate that human herpesviruses (HHVs), particularly cytomegalovirus (CMV), Epstein–Barr virus (EBV) and human herpes virus 6 (HHV-6), are implicated in brain tumor pathology, although their direct role has not yet been proven. CMV is present in most gliomas and medulloblastomas and is known to facilitate oncomodulation and/or immunomodulation, thus promoting cancer cell proliferation, invasion, apoptosis, angiogenesis, and immunosuppression. EBV and HHV-6 have also been detected in brain tumors and high-grade gliomas, showing high rates of expression and an inflammatory potential. On the other hand, due to the neurotropic nature of HHVs, novel studies have highlighted the engagement of such viruses in the development of new immunotherapeutic approaches in the context of oncolytic viral treatment and vaccine-based strategies against brain tumors. This review provides a comprehensive evaluation of recent scientific data concerning the emerging dual role of HHVs in malignant brain pathology, either as potential causative agents or as immunotherapeutic tools in the fight against these devastating diseases.
Collapse
|
6
|
Wouk J, Rechenchoski DZ, Rodrigues BCD, Ribelato EV, Faccin-Galhardi LC. Viral infections and their relationship to neurological disorders. Arch Virol 2021; 166:733-753. [PMID: 33502593 PMCID: PMC7838016 DOI: 10.1007/s00705-021-04959-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/27/2020] [Indexed: 01/26/2023]
Abstract
The chronic dysfunction of neuronal cells, both central and peripheral, a characteristic of neurological disorders, may be caused by irreversible damage and cell death. In 2016, more than 276 million cases of neurological disorders were reported worldwide. Moreover, neurological disorders are the second leading cause of death. Generally, the etiology of neurological diseases is not fully understood. Recent studies have related the onset of neurological disorders to viral infections, which may cause neurological symptoms or lead to immune responses that trigger these pathological signs. Currently, this relationship is mostly based on epidemiological data on infections and seroprevalence of patients who present with neurological disorders. The number of studies aiming to elucidate the mechanism of action by which viral infections may directly or indirectly contribute to the development of neurological disorders has been increasing over the years but these studies are still scarce. Comprehending the pathogenesis of these diseases and exploring novel theories may favor the development of new strategies for diagnosis and therapy in the future. Therefore, the objective of the present study was to review the main pieces of evidence for the relationship between viral infection and neurological disorders such as Alzheimer's disease, Parkinson's disease, Guillain-Barré syndrome, multiple sclerosis, and epilepsy. Viruses belonging to the families Herpesviridae, Orthomyxoviridae, Flaviviridae, and Retroviridae have been reported to be involved in one or more of these conditions. Also, neurological symptoms and the future impact of infection with SARS-CoV-2, a member of the family Coronaviridae that is responsible for the COVID-19 pandemic that started in late 2019, are reported and discussed.
Collapse
Affiliation(s)
- Jéssica Wouk
- Post-Graduation Program of Pharmaceutical Science, Midwest State University, CEDETEG Campus, Guarapuava, Paraná Brazil
| | | | | | - Elisa Vicente Ribelato
- Department of Microbiology, Biological Science Center, Londrina State University, Londrina, Paraná Brazil
| | | |
Collapse
|
7
|
Viral Infection and Autophagy Dysregulation: The Case of HHV-6, EBV and KSHV. Cells 2020; 9:cells9122624. [PMID: 33297368 PMCID: PMC7762304 DOI: 10.3390/cells9122624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 11/30/2020] [Accepted: 12/04/2020] [Indexed: 12/22/2022] Open
Abstract
Human Herpes Virus-6 (HHV-6), Epstein-Barr Virus (EBV) and Kaposi Sarcoma Herpes Virus (KSHV) are viruses that share with other member of the Herpesvirus family the capacity to interfere with the autophagic process. In this paper, mainly based on the findings of our laboratory, we describe how, through different mechanisms, these viruses converge in reducing autophagy to impair DC immune function and how, by infecting and dysregulating autophagy in different cell types, they promote the pathologies associated with their infection, from the neurodegenerative diseases such Alzheimer’s disease to cancer.
Collapse
|
8
|
Dunn N, Kharlamova N, Fogdell-Hahn A. The role of herpesvirus 6A and 6B in multiple sclerosis and epilepsy. Scand J Immunol 2020; 92:e12984. [PMID: 33037649 PMCID: PMC7757173 DOI: 10.1111/sji.12984] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/11/2020] [Accepted: 10/05/2020] [Indexed: 01/07/2023]
Abstract
Human herpesvirus 6A (HHV‐6A) and 6B (HHV‐6B) are two closely related viruses that can infect cells of the central nervous system (CNS). The similarities between these viruses have made it difficult to separate them on serological level. The broad term HHV‐6 remains when referring to studies where the two species were not distinguished, and as such, the seroprevalence is over 90% in the adult population. HHV‐6B has been detected in up to 100% of infants with the primary infection roseola infantum, but less is known about the primary infection of HHV‐6A. Both viruses are neurotropic and have capacity to establish lifelong latency in cells of the central nervous system, with potential to reactivate and cause complications later in life. HHV‐6A infection has been associated with an increased risk of multiple sclerosis (MS), whereas HHV‐6B is indicated to be involved in pathogenesis of epilepsy. These two associations show how neurological diseases might be caused by viral infections, but as suggested here, through completely different molecular mechanisms, in an autoimmune disease, such as MS, by triggering an overreaction of the immune system and in epilepsy by hampering internal cellular functions when the immune system fails to eliminate the virus. Understanding the viral mechanisms of primary infection and reactivation and their spectrum of associated symptoms will aid our ability to diagnose, treat and prevent these severe and chronic diseases. This review explores the role of HHV‐6A and HHV‐6B specifically in MS and epilepsy, the evidence to date and the future directions of this field.
Collapse
Affiliation(s)
- Nicky Dunn
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - Nastya Kharlamova
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - Anna Fogdell-Hahn
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| |
Collapse
|
9
|
Wells MJ, Jacobson S, Levine PH. An evaluation of HHV-6 as an etiologic agent in Hodgkin lymphoma and brain cancer using IARC criteria for oncogenicity. Infect Agent Cancer 2019; 14:31. [PMID: 31709003 PMCID: PMC6833260 DOI: 10.1186/s13027-019-0248-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 09/26/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Human herpesvirus-6 (HHV-6) is a ubiquitous double-stranded DNA virus that can cause roseola infantum, encephalitis, and seizure disorders. Several studies have shown an association between HHV-6 and cancer but confirmation of an etiologic role is lacking. We reviewed the criteria for viral causation of cancer used by The International Agency for Research on Cancer (IARC) for six oncogenic viruses and applied criteria to published reports of HHV-6 and its association with Hodgkin lymphoma and brain tumors. METHODS Our major criteria for oncogenicity were finding evidence of the virus in every tumor cell and prevention of the tumor by an antiviral vaccine. Our six minor criteria included: 1) suggestive serologic correlation, such as higher virus antibody levels in cases compared to controls; 2) evidence of the virus in some but not all tumor cells, and 3) time space clustering. We focused on Epstein-Barr virus (EBV) as the primary virus for comparison as HHV-6 and EBV are both Herpesviridae, ubiquitous infections, and EBV is well-accepted as a human oncovirus. Particular attention was given to Hodgkin lymphoma (HL) and brain cancer as these malignancies have been the most studied. RESULTS No studies reported HHV-6 satisfying either of the major criteria for oncogenicity. Of the minor criteria used by IARC, serologic studies have been paramount in supporting EBV as an oncogenic agent in all EBV-associated tumors, but not for HHV-6 in HL or brain cancer. Clustering of cases was suggestive for both HL and brain cancer and medical intervention suggested by longer survival in patients treated with antiviral agents was reported for brain cancer. CONCLUSION There is insufficient evidence to indicate HHV-6 is an etiologic agent with respect to HL and brain cancers. We suggest that methods demonstrating EBV oncogenicity be applied to HHV-6. It is important that one study has found HHV-6 in all cancer cells in oral cancer in a region with elevated HHV-6 antibodies and therefore HHV-6 can still be considered a possible human oncogenic virus.
Collapse
Affiliation(s)
- Michael J. Wells
- School of Community and Population Health, University of New England, 716 Stevens Ave, Portland, ME 04103 USA
| | - Steven Jacobson
- National Institutes of Health, National Institute of Neurological Disorders and Stroke, Viral Immunology Section, 9000 Rockville Pike, Bethesda, MD 20892 USA
| | - Paul H. Levine
- College of Public Health, University of Nebraska, 984355 Medical Center, Omaha, NE 68198 USA
| |
Collapse
|
10
|
Abstract
In this chapter, we present an overview on betaherpesvirus entry, with a focus on human cytomegalovirus, human herpesvirus 6A and human herpesvirus 6B. Human cytomegalovirus (HCMV) is a complex human pathogen with a genome of 235kb encoding more than 200 genes. It infects a broad range of cell types by switching its viral ligand on the virion, using the trimer gH/gL/gO for infection of fibroblasts and the pentamer gH/gL/UL128/UL130/UL131 for infection of other cells such as epithelial and endothelial cells, leading to membrane fusion mediated by the fusion protein gB. Adding to this scenario, however, accumulating data reveal the actual complexity in the viral entry process of HCMV with an intricate interplay among viral and host factors. Key novel findings include the identification of entry receptors platelet-derived growth factor-α receptor (PDGFRα) and Netropilin-2 (Nrp2) for trimer and pentamer, respectively, the determination of atomic structures of the fusion protein gB and the pentamer, and the in situ visualization of the state and arrangement of functional glycoproteins on virion. This is covered in the first part of this review. The second part focusses on HHV-6 which is a T lymphotropic virus categorized as two distinct virus species, HHV-6A and HHV-6B based on differences in epidemiological, biological, and immunological aspects, although homology of their entire genome sequences is nearly 90%. HHV-6B is a causative agent of exanthema subitum (ES), but the role of HHV-6A is unknown. HHV-6B reactivation occasionally causes encephalitis in patients with hematopoietic stem cell transplant. The HHV-6 specific envelope glycoprotein complex, gH/gL/gQ1/gQ2 is a viral ligand for the entry receptor. Recently, each virus has been found to recognize a different cellular receptor, CD46 for HHV 6A amd CD134 for HHV 6B. These findings show that distinct receptor recognition differing between both viruses could explain their different pathogenesis.
Collapse
Affiliation(s)
- Mitsuhiro Nishimura
- Division of Clinical Virology, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuko Mori
- Division of Clinical Virology, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.
| |
Collapse
|
11
|
Zerr DM. Human Herpesvirus 6B in the Transplant Recipient: When to Worry, When to Act. J Pediatric Infect Dis Soc 2018; 7:S75-S78. [PMID: 30590622 DOI: 10.1093/jpids/piy111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Human herpesvirus 6B (HHV-6B) is a ubiquitous pathogen that infects most individuals before the age of three years. HHV-6B reactivates in approximately 40% of transplant recipients where it has been associated with a number of important outcomes, especially in allogeneic transplant recipients. This article will review the epidemiology, clinical manifestations, diagnosis, and treatment of HHV-6B infection.
Collapse
Affiliation(s)
- Danielle M Zerr
- Seattle Children's Research Institute and Department of Pediatrics, University of Washington, Seattle
| |
Collapse
|
12
|
Eliassen E, Lum E, Pritchett J, Ongradi J, Krueger G, Crawford JR, Phan TL, Ablashi D, Hudnall SD. Human Herpesvirus 6 and Malignancy: A Review. Front Oncol 2018; 8:512. [PMID: 30542640 PMCID: PMC6277865 DOI: 10.3389/fonc.2018.00512] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/19/2018] [Indexed: 12/21/2022] Open
Abstract
In order to determine the role of human herpesvirus 6 (HHV-6) in human disease, several confounding factors, including methods of detection, types of controls, and the ubiquitous nature of the virus, must be considered. This is particularly problematic in the case of cancer, in which rates of detection vary greatly among studies. To determine what part, if any, HHV-6 plays in oncogenesis, a review of the literature was performed. There is evidence that HHV-6 is present in certain types of cancer; however, detection of the virus within tumor cells is insufficient for assigning a direct role of HHV-6 in tumorigenesis. Findings supportive of a causal role for a virus in cancer include presence of the virus in a large proportion of cases, presence of the virus in most tumor cells, and virus-induced in-vitro cell transformation. HHV-6, if not directly oncogenic, may act as a contributory factor that indirectly enhances tumor cell growth, in some cases by cooperation with other viruses. Another possibility is that HHV-6 may merely be an opportunistic virus that thrives in the immunodeficient tumor microenvironment. Although many studies have been carried out, it is still premature to definitively implicate HHV-6 in several human cancers. In some instances, evidence suggests that HHV-6 may cooperate with other viruses, including EBV, HPV, and HHV-8, in the development of cancer, and HHV-6 may have a role in such conditions as nodular sclerosis Hodgkin lymphoma, gastrointestinal cancer, glial tumors, and oral cancers. However, further studies will be required to determine the exact contributions of HHV-6 to tumorigenesis.
Collapse
Affiliation(s)
- Eva Eliassen
- HHV-6 Foundation, Santa Barbara, CA, United States
| | - Emily Lum
- HHV-6 Foundation, Santa Barbara, CA, United States
| | - Joshua Pritchett
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Joseph Ongradi
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Gerhard Krueger
- Department of Pathology and Laboratory Medicine, University of Texas- Houston Medical School, Houston, TX, United States
| | - John R Crawford
- Department of Neurosciences and Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA, United States
| | - Tuan L Phan
- HHV-6 Foundation, Santa Barbara, CA, United States.,Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, United States
| | | | | |
Collapse
|
13
|
Prusty BK, Gulve N, Govind S, Krueger GRF, Feichtinger J, Larcombe L, Aspinall R, Ablashi DV, Toro CT. Active HHV-6 Infection of Cerebellar Purkinje Cells in Mood Disorders. Front Microbiol 2018; 9:1955. [PMID: 30186267 PMCID: PMC6110891 DOI: 10.3389/fmicb.2018.01955] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/02/2018] [Indexed: 12/25/2022] Open
Abstract
Early-life infections and associated neuroinflammation is incriminated in the pathogenesis of various mood disorders. Infection with human roseoloviruses, HHV-6A and HHV-6B, allows viral latency in the central nervous system and other tissues, which can later be activated causing cognitive and behavioral disturbances. Hence, this study was designed to evaluate possible association of HHV-6A and HHV-6B activation with three different groups of psychiatric patients. DNA qPCR, immunofluorescence and FISH studies were carried out in post-mortem posterior cerebellum from 50 cases each of bipolar disorder (BPD), schizophrenia, 15 major depressive disorder (MDD) and 50 appropriate control samples obtained from two well-known brain collections (Stanley Medical Research Institute). HHV-6A and HHV-6B late proteins (indicating active infection) and viral DNA were detected more frequently (p < 0.001 for each virus) in human cerebellum in MDD and BPD relative to controls. These roseolovirus proteins and DNA were found less frequently in schizophrenia cases. Active HHV-6A and HHV-6B infection in cerebellar Purkinje cells were detected frequently in BPD and MDD cases. Furthermore, we found a significant association of HHV-6A infection with reduced Purkinje cell size, suggesting virus-mediated abnormal Purkinje cell function in these disorders. Finally, gene expression analysis of cerebellar tissue revealed changes in pathways reflecting an inflammatory response possibly to HHV-6A infection. Our results provide molecular evidence to support a role for active HHV-6A and HHV-6B infection in BPD and MDD.
Collapse
Affiliation(s)
- Bhupesh K Prusty
- Biocenter, Department of Microbiology, University of Würzburg, Würzburg, Germany.,Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Nitish Gulve
- Biocenter, Department of Microbiology, University of Würzburg, Würzburg, Germany
| | - Sheila Govind
- Division of Virology, National Institute for Biological Standards and Control, Hertfordshire, United Kingdom
| | - Gerhard R F Krueger
- Department of Pathology and Laboratory Medicine, UT-Houston Medical School, Houston, TX, United States
| | - Julia Feichtinger
- Institute of Computational Biotechnology, Graz University of Technology, Graz, Austria.,BioTechMed Omics Center, Graz, Austria
| | - Lee Larcombe
- Applied Exomics Ltd., Stevenage Bioscience Catalyst, Stevenage, United Kingdom
| | - Richard Aspinall
- Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | | | - Carla T Toro
- HHV-6 Foundation, Santa Barbara, CA, United States.,The Institute of Digital Healthcare, The University of Warwick, Warwick, United Kingdom
| |
Collapse
|
14
|
Engdahl E, Niehusmann P, Fogdell-Hahn A. The effect of human herpesvirus 6B infection on the MAPK pathway. Virus Res 2018; 256:134-141. [PMID: 30130603 DOI: 10.1016/j.virusres.2018.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/03/2018] [Accepted: 08/16/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Human herpesvirus 6B (HHV-6B) is a neurotropic virus that has been repeatedly associated with mesial temporal lobe epilepsy (MTLE). However, the mechanism behind this suggested association is not known. Therefore, the aim of this study was to investigate what genes were affected by HHV-6B, possibly revealing HHV-6B induced disease causing mechanisms. MATERIAL AND METHOD First, gene expression in MTLE tissue positive for HHV-6B DNA (n = 10) and negative for HHV-6B DNA (n = 14) was compared using the Affymetrix® Human Gene 2.1 ST Array. Secondly, in vitro experiments were conducted where Molt-3 T cells were infected with HHV-6B and gene expression of MAP2K4 (MKK4) and 89 other genes in the MAPK signaling pathway was investigated using qPCR. In addition, phosphorylated MKK4 was assessed using IFA and the DNA methylation investigated with Illumina Infinium HumanMethylation450 BeadChip array. RESULTS MAP2K4 was one of the most differently expressed genes in the Affymetrix array, suggesting an upregulation by HHV-6B infection in MTLE tissue. No gene reached statistical significance but MAP2K4 was selected for further investigation in vitro, where it was clearly upregulated by HHV-6B infection both on gene expression and protein expression level. Further investigating expression of genes in the MAPK pathways in vitro revealed that several genes were affected by HHV-6B infection, but none of these genes displayed viral induced changes in DNA methylation. CONCLUSIONS As the MAPK pathways are involved in transforming different stimuli (like stress) into a cellular responses (like apoptosis or inflammation), it may not be surprising that genes in these pathways are affected by virus infection. This is the first report of HHV-6B's effect on these signaling cascades and given that both dysregulation of the MAPK pathways and an association with HHV-6B have been previously observed in epilepsy, a possible link of infection induced dysregulation of MAPK in epilepsy warrant further investigation.
Collapse
Affiliation(s)
- Elin Engdahl
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pitt Niehusmann
- Department of Neurology/Pathology, Oslo University Hospital, 0450, Oslo, Norway; Department of Neuropathology, University of Bonn Medical Center, 53113, Bonn, Germany
| | - Anna Fogdell-Hahn
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|
15
|
Point-Counterpoint: Meningitis/Encephalitis Syndromic Testing in the Clinical Laboratory. J Clin Microbiol 2018; 56:JCM.00018-18. [PMID: 29343540 DOI: 10.1128/jcm.00018-18] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTIONSyndromic panels were first FDA cleared for detection of respiratory pathogens in 2008. Since then, other panels have been approved by the FDA, and most recently, the FilmArray meningitis/encephalitis panel (BioFire, Salt Lake City, UT) has become available. This assay detects 14 targets within 1 h and includes pathogens that typically cause different manifestations of infection, although they infect the same organ system. Several studies have reported both false-positive and false-negative results with this test, and all agree that the cost is significant. As with other panels, health care systems have adopted different strategies for offering this assay. Some have implemented strategies to limit the use of the test to certain patient populations, others have elected not to offer the test, and others have elected not to offer the test and instead request that providers order specific PCRs for the pathogens that best fit the patient's symptoms. In this Point-Counterpoint, Jennifer Dien Bard of the Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, and of the Keck School of Medicine at the University of Southern California explains why laboratories should offer these assays without restriction. Kevin Alby of the University of Pennsylvania explains the concerns about the use of these assays as first-line tests and why some limitations on their use might be appropriate.
Collapse
|
16
|
Tang H, Mori Y. Glycoproteins of HHV-6A and HHV-6B. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1045:145-165. [PMID: 29896667 DOI: 10.1007/978-981-10-7230-7_8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Recently, human herpesvirus 6A and 6B (HHV-6A and HHV-6B) were classified into distinct species. Although these two viruses share many similarities, cell tropism is one of their striking differences, which is partially because of the difference in their entry machinery. Many glycoproteins of HHV-6A/B have been identified and analyzed in detail, especially in their functions during entry process into host cells. Some of these glycoproteins were unique to HHV-6A/B. The cellular factors associated with these viral glycoproteins (or glycoprotein complex) were also identified in recent years. Detailed interaction analyses were also conducted, which could partially prove the difference of entry machinery in these two viruses. Although there are still issues that should be addressed, all the knowledges that have been earned in recent years could not only help us to understand these viruses' entry mechanism well but also would contribute to the development of the therapy and/or prophylaxis methods for HHV-6A/B-associated diseases.
Collapse
Affiliation(s)
- Huamin Tang
- Department of Immunology, Nanjing Medical University, Nanjing, China.
| | - Yasuko Mori
- Division of Clinical Virology, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| |
Collapse
|
17
|
Righi E, Carnelutti A, Muser D, Zaja F, Lucchini E, Pea F, Di Gregorio F, Alavi A, Bassetti M. Successful treatment and FDG-PET/CT monitoring of HHV-6 encephalitis in a non-neutropenic patient: case report and literature review. J Neurovirol 2017; 23:908-912. [PMID: 28822107 DOI: 10.1007/s13365-017-0566-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/23/2017] [Accepted: 08/02/2017] [Indexed: 11/27/2022]
Abstract
Human herpesvirus (HHV)-6 reactivation is associated with severe forms of encephalitis among patients undergoing hematopoietic stem cell transplantation. Cases in non-neutropenic patients are uncommon. The efficacy of ganciclovir and other compounds that are used for the treatment of HHV-6 encephalitis remains suboptimal and linked to toxicity. Valganciclovir, the oral prodrug of ganciclovir, could be practical to treat outpatients, but it is not commonly used for severe cases. We report a case of HHV-6 encephalitis in a non-neutropenic patient successfully treated with valganciclovir and undergoing therapeutic drug monitoring in plasma and in the cerebrospinal fluid. Resolution of infectious foci was documented by cerebral MRI and F18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). A review of the literature on HHV-6 encephalitis is also reported.
Collapse
Affiliation(s)
- Elda Righi
- Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 50, Colugna Street, 33100, Udine, Italy.
| | - Alessia Carnelutti
- Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 50, Colugna Street, 33100, Udine, Italy
| | - Daniele Muser
- Department of Cardiology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Zaja
- Department of Hematology, DISM, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Elisa Lucchini
- Department of Hematology, DISM, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Federico Pea
- Institute of Clinical Pharmacology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Fernando Di Gregorio
- Division of Nuclear Medicine, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Abass Alavi
- Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Matteo Bassetti
- Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 50, Colugna Street, 33100, Udine, Italy
| |
Collapse
|
18
|
Multicenter Evaluation of BioFire FilmArray Meningitis/Encephalitis Panel for Detection of Bacteria, Viruses, and Yeast in Cerebrospinal Fluid Specimens. J Clin Microbiol 2016; 54:2251-61. [PMID: 27335149 DOI: 10.1128/jcm.00730-16] [Citation(s) in RCA: 363] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/14/2016] [Indexed: 11/20/2022] Open
Abstract
Rapid diagnosis and treatment of infectious meningitis and encephalitis are critical to minimize morbidity and mortality. Comprehensive testing of cerebrospinal fluid (CSF) often includes Gram stain, culture, antigen detection, and molecular methods, paired with chemical and cellular analyses. These methods may lack sensitivity or specificity, can take several days, and require significant volume for complete analysis. The FilmArray Meningitis/Encephalitis (ME) Panel is a multiplexed in vitro diagnostic test for the simultaneous, rapid (∼1-h) detection of 14 pathogens directly from CSF specimens: Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus agalactiae, cytomegalovirus, enterovirus, herpes simplex virus 1 and 2, human herpesvirus 6, human parechovirus, varicella-zoster virus, and Cryptococcus neoformans/Cryptococcus gattii We describe a multicenter evaluation of 1,560 prospectively collected CSF specimens with performance compared to culture (bacterial analytes) and PCR (all other analytes). The FilmArray ME Panel demonstrated a sensitivity or positive percentage of agreement of 100% for 9 of 14 analytes. Enterovirus and human herpesvirus type 6 had agreements of 95.7% and 85.7%, and L. monocytogenes and N. meningitidis were not observed in the study. For S. agalactiae, there was a single false-positive and false-negative result each, for a sensitivity and specificity of 0 and 99.9%, respectively. The specificity or negative percentage of agreement was 99.2% or greater for all other analytes. The FilmArray ME Panel is a sensitive and specific test to aid in diagnosis of ME. With use of this comprehensive and rapid test, improved patient outcomes and antimicrobial stewardship are anticipated.
Collapse
|
19
|
Chapenko S, Roga S, Skuja S, Rasa S, Cistjakovs M, Svirskis S, Zaserska Z, Groma V, Murovska M. Detection frequency of human herpesviruses-6A, -6B, and -7 genomic sequences in central nervous system DNA samples from post-mortem individuals with unspecified encephalopathy. J Neurovirol 2016; 22:488-97. [PMID: 26727906 DOI: 10.1007/s13365-015-0417-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/25/2015] [Accepted: 12/09/2015] [Indexed: 12/22/2022]
Abstract
In this autopsy-based study, human herpesvirus-6 (HHV-6) and -7 (HHV-7) genomic sequence frequency, HHV-6 variants, HHV-6 load and the expression of HHV-6 antigens in brain samples from the individuals, with and without unspecified encephalopathy (controls), using nested and real-time polymerase chain reactions, restriction endonuclease, and immunohistochemical analysis were examined. GraphPad Prism 6.0 Mann-Whitney nonparametric and chi-square test and Fisher's exact test were used for statistical analysis. The encephalopathy diagnoses were shown by magnetic resonance imaging made during their lifetime and macro- and microscopically studied autopsy tissue materials. Widespread HHV-6 and/or HHV-7 positivity was detected in the brain tissue of various individuals with encephalopathy, as well as in controls (51/57, 89.4 % and 35/51, 68.6 %, respectively; p = 0.009). Significantly higher detection frequency of single HHV-6 and concurrent HHV-6 + HHV-7 DNA was found in pia mater meninges, frontal lobe, temporal lobe, and olfactory tract DNAs in individuals with encephalopathy compared to the control group. HHV-6 load and higher frequency of the viral load >10 copies/10(6) cells significantly differed in samples from individuals with and without encephalopathy. The expression of HHV-6 antigens was revealed in different neural cell types with strong predominance in the encephalopathy group. In all HHV-6-positive autopsy samples of individuals with and without encephalopathy, HHV-6B was revealed. Significantly higher detection frequency of beta-herpesvirus DNA, more often detected HHV-6 load >10 copies/10(6) cells, as well as the expression of HHV-6 antigens in different brain tissue samples from individuals with encephalopathy in comparison with control group indicate on potential involvement of these viruses in encephalopathy development.
Collapse
Affiliation(s)
- Svetlana Chapenko
- August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Ratsupites iela 5, Riga, Latvia.
| | - Silvija Roga
- Study Department, Riga Stradins University, Riga, Latvia.,Pathology Department, Riga 1st Hospital, Riga, Latvia
| | - Sandra Skuja
- Institute of Anatomy and Anthropology, Riga Stradins University, Riga, Latvia
| | - Santa Rasa
- August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Ratsupites iela 5, Riga, Latvia
| | - Maksims Cistjakovs
- August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Ratsupites iela 5, Riga, Latvia
| | - Simons Svirskis
- August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Ratsupites iela 5, Riga, Latvia
| | - Zane Zaserska
- August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Ratsupites iela 5, Riga, Latvia
| | - Valerija Groma
- Institute of Anatomy and Anthropology, Riga Stradins University, Riga, Latvia
| | - Modra Murovska
- August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Ratsupites iela 5, Riga, Latvia
| |
Collapse
|
20
|
Yavarian J, Shatizadeh Malekshahi S, Yavarian R, Yazdani S, Janani L, Shafiei Jandaghi NZ, Kiani SJ, Ahamadkhaniha H. Type specific Real time PCR for detection of human herpes virus 6 in schizophrenia and bipolar patients: a case control study. BMC Psychiatry 2015; 15:296. [PMID: 26584549 PMCID: PMC4653940 DOI: 10.1186/s12888-015-0662-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 10/27/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Schizophrenia (SC) and bipolar disorder (BD) are among the most devastating diseases worldwide. There are several lines of evidence suggesting that viruses may play significant roles in the etiology of these mental disorders. The aim of this study was the detection of HHV-6A/B in the peripheral blood mononuclear cells (PBMC) of SC and BD patients versus the healthy control (HC) subjects using a new method of type-specific Real time PCR analysis. METHODS A type-specific Real time PCR was performed for simultaneous detection and typing of HHV-6A/B in the PBMCs of 120 SC and BD patients and 75 HCs. RESULTS Only one case of HHV-6B out of 120 (0.8 %) SC and BD patients and two cases of HHV-6A (2.7 %) in 75 HCs were detected. CONCLUSIONS The low levels of HHV-6 detection in PBMCs, severely limited the capacity of this study to investigate the association between the presence of HHV-6 and BD or SC in this population, thus no conclusions can be drawn in this regard. Meanwhile this study introduces a Real time PCR based method for type specific detection of HHV-6A/B in clinical samples.
Collapse
Affiliation(s)
- Jila Yavarian
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Roya Yavarian
- Department of Psychiatry, Medical School, Urmia University of Medical Sciences, Urmia, West Azarbayejan, Iran.
| | - Shaghayegh Yazdani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | | | - Seyed Jalal Kiani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - HamidReza Ahamadkhaniha
- Department of Psychiatry, Medical School, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
21
|
Kawamura Y, Nakayama A, Kato T, Miura H, Ishihara N, Ihira M, Takahashi Y, Matsuda K, Yoshikawa T. Pathogenic Role of Human Herpesvirus 6B Infection in Mesial Temporal Lobe Epilepsy. J Infect Dis 2015; 212:1014-21. [DOI: 10.1093/infdis/jiv160] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 01/29/2015] [Indexed: 11/13/2022] Open
|
22
|
Alenda R, Álvarez-Lafuente R, Costa-Frossard L, Arroyo R, Mirete S, Álvarez-Cermeño JC, Villar LM. Identification of the major HHV-6 antigen recognized by cerebrospinal fluid IgG in multiple sclerosis. Eur J Neurol 2014; 21:1096-1101. [PMID: 24724742 DOI: 10.1111/ene.12435] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/06/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Different data show an association between human herpesvirus 6 (HHV-6) and multiple sclerosis (MS). Intrathecal anti-HHV-6 immunoglobulin G (IgG) was detected in MS patients, but the antigen recognized by cerebrospinal fluid (CSF) IgG has not been characterized yet. Our objective was to identify the HHV-6 antigens recognized by IgG present in the CSF of patients with MS. METHODS Cerebrospinal fluid IgG of 15 MS patients and eight patients with other neurological diseases was purified on protein G Sepharose columns. Purified IgG from every patient was linked to a CNBr-activated Sepharose 4B column. Fifty micrograms of viral extract was applied to each column. Bound proteins were eluted and analysed by SDS-PAGE and silver staining. The viral protein was characterized by mass spectrometry. RESULTS A protein of 150 kD was eluted from CSF IgG columns of three of eight patients with primary progressive MS and one of seven with relapsing-remitting MS. After digestion and mass spectrometry analysis 10 peptides were found with 100% homology with the major capsid protein of the HHV-6A. DISCUSSION These findings confirm the presence of anti-HHV-6 IgG in CSF of MS patients, particularly in progressive forms, and identify major capsid protein as the major antigen recognized by CSF IgG from MS patients.
Collapse
Affiliation(s)
- R Alenda
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.,Red Española de Esclerosis Múltiple, Madrid, Spain
| | - R Álvarez-Lafuente
- Red Española de Esclerosis Múltiple, Madrid, Spain.,Department of Neurology, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - L Costa-Frossard
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.,Red Española de Esclerosis Múltiple, Madrid, Spain
| | - R Arroyo
- Red Española de Esclerosis Múltiple, Madrid, Spain.,Department of Neurology, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - S Mirete
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - J C Álvarez-Cermeño
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.,Red Española de Esclerosis Múltiple, Madrid, Spain.,Department of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - L M Villar
- MS Unit, Departments of Immunology and Neurology, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.,Red Española de Esclerosis Múltiple, Madrid, Spain
| |
Collapse
|
23
|
Human herpesvirus 6A infection in CD46 transgenic mice: viral persistence in the brain and increased production of proinflammatory chemokines via Toll-like receptor 9. J Virol 2014; 88:5421-36. [PMID: 24574405 DOI: 10.1128/jvi.03763-13] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
UNLABELLED Human herpesvirus 6 (HHV-6) is widely spread in the human population and has been associated with several neuroinflammatory diseases, including multiple sclerosis. To develop a small-animal model of HHV-6 infection, we analyzed the susceptibility of several lines of transgenic mice expressing human CD46, identified as a receptor for HHV-6. We showed that HHV-6A (GS) infection results in the expression of viral transcripts in primary brain glial cultures from CD46-expressing mice, while HHV-6B (Z29) infection was inefficient. HHV-6A DNA persisted for up to 9 months in the brain of CD46-expressing mice but not in the nontransgenic littermates, whereas HHV-6B DNA levels decreased rapidly after infection in all mice. Persistence in the brain was observed with infectious but not heat-inactivated HHV-6A. Immunohistological studies revealed the presence of infiltrating lymphocytes in periventricular areas of the brain of HHV-6A-infected mice. Furthermore, HHV-6A stimulated the production of a panel of proinflammatory chemokines in primary brain glial cultures, including CCL2, CCL5, and CXCL10, and induced the expression of CCL5 in the brains of HHV-6A-infected mice. HHV-6A-induced production of chemokines in the primary glial cultures was dependent on the stimulation of toll-like receptor 9 (TLR9). Finally, HHV-6A induced signaling through human TLR9 as well, extending observations from the murine model to human infection. Altogether, this study presents a first murine model for HHV-6A-induced brain infection and suggests a role for TLR9 in the HHV-6A-initiated production of proinflammatory chemokines in the brain, opening novel perspectives for the study of virus-associated neuropathology. IMPORTANCE HHV-6 infection has been related to neuroinflammatory diseases; however, the lack of a suitable small-animal infection model has considerably hampered further studies of HHV-6-induced neuropathogenesis. In this study, we have characterized a new model for HHV-6 infection in mice expressing the human CD46 protein. Infection of CD46 transgenic mice with HHV-6A resulted in long-term persistence of viral DNA in the brains of infected animals and was followed by lymphocyte infiltration and upregulation of the CCL5 chemokine in the absence of clinical signs of disease. The secretion of a panel of chemokines was increased after infection in primary murine brain glial cultures, and the HHV-6-induced chemokine expression was inhibited when TLR9 signaling was blocked. These results describe the first murine model for HHV-6A-induced brain infection and suggest the importance of the TLR9 pathway in HHV-6A-initiated neuroinflammation.
Collapse
|
24
|
Affiliation(s)
- Joshua A Hill
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA.
| | - Nagagopal Venna
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
25
|
Abstract
Human herpesvirus (HHV-) 6A and HHV-6B are two distinct β-herpesviruses which have been associated with various neurological diseases, including encephalitis, meningitis, epilepsy, and multiple sclerosis. Although the reactivation of both viruses is recognized as the cause of some neurological complications in conditions of immunosuppression, their involvement in neuroinflammatory diseases in immunocompetent people is still unclear, and the mechanisms involved have not been completely elucidated. Here, we review the available data providing evidence for the capacity of HHV-6A and -6B to infect the central nervous system and to induce proinflammatory responses by infected cells. We discuss the potential role of both viruses in neuroinflammatory pathologies and the mechanisms which could explain virus-induced neuropathogenesis.
Collapse
Affiliation(s)
- Joséphine M. Reynaud
- International Center for Infectiology Research (CIRI), INSERM U1111, CNRS UMR5308, University of Lyon 1, ENS-Lyon, 21 Avenue T. Garnier, 69365 Lyon, France
| | - Branka Horvat
- International Center for Infectiology Research (CIRI), INSERM U1111, CNRS UMR5308, University of Lyon 1, ENS-Lyon, 21 Avenue T. Garnier, 69365 Lyon, France
| |
Collapse
|
26
|
Novel marmoset (Callithrix jacchus) model of human Herpesvirus 6A and 6B infections: immunologic, virologic and radiologic characterization. PLoS Pathog 2013; 9:e1003138. [PMID: 23382677 PMCID: PMC3561285 DOI: 10.1371/journal.ppat.1003138] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 12/03/2012] [Indexed: 11/19/2022] Open
Abstract
Human Herpesvirus 6 (HHV-6) is a ubiquitous virus with an estimated seroprevalence of 95% in the adult population. HHV-6 is associated with several neurologic disorders, including multiple sclerosis, an inflammatory demyelinating disease affecting the CNS. Animal models of HHV-6 infection would help clarify its role in human disease but have been slow to develop because rodents lack CD46, the receptor for cellular entry. Therefore, we investigated the effects of HHV-6 infections in a non-human primate, the common marmoset Callithrix jacchus. We inoculated a total of 12 marmosets with HHV-6A and HHV-6B intravenously and HHV-6A intranasally. Animals were monitored for 25 weeks post-inoculation clinically, immunologically and by MRI. Marmosets inoculated with HHV-6A intravenously exhibited neurologic symptoms and generated virus-specific antibody responses, while those inoculated intravenously with HHV-6B were asymptomatic and generated comparatively lower antibody responses. Viral DNA was detected at a low frequency in paraffin-embedded CNS tissue of a subset of marmosets inoculated with HHV-6A and HHV-6B intravenously. When different routes of HHV-6A inoculation were compared, intravenous inoculation resulted in virus-specific antibody responses and infrequent detection of viral DNA in the periphery, while intranasal inoculation resulted in negligible virus-specific antibody responses and frequent detection of viral DNA in the periphery. Moreover, marmosets inoculated with HHV-6A intravenously exhibited neurologic symptoms, while marmosets inoculated with HHV-6A intranasally were asymptomatic. We demonstrate that a marmoset model of HHV-6 infection can serve to further define the contribution of this ubiquitous virus to human neurologic disorders.
Collapse
|
27
|
Li L, Gu B, Zhou F, Chi J, Wang F, Liu G, Ding C, Xie F, Qing J, Guo Y, Yao K. Human herpesvirus 6A infects human embryonic fibroblasts and induces G2/M arrest and cell death. J Med Virol 2012; 84:657-63. [PMID: 22337306 DOI: 10.1002/jmv.23226] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Human herpesvirus 6 (HHV-6) is a beta-herpesvirus capable of infecting cells from different origin. In this study, infection with HHV-6A of human embryonic fibroblasts (HEFs) was performed. Infected cells showed obvious cytopathic effects (CPE). PCR and immunohistochemical tests also confirmed that HEFs are susceptible to HHV-6A infection. The biological effects of HHV-6A infection on HEFs were studied. Infected cells showed decreased proliferation as measured by [(3)H] thymidine incorporation and cell counting. Further analysis demonstrated that infection with HHV-6A leads to cell cycle arrest at G2/M phase and increasing cell death. This is the first demonstration that infection of HEFs with HHV-6A causes profound alterations of cell properties.
Collapse
Affiliation(s)
- Lingyun Li
- Department of Microbiology and Immunology, Nanjing Medical University, Nanjing, China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Amirian ES, Scheurer ME. Chromosomally-integrated human herpesvirus 6 in familial glioma etiology. Med Hypotheses 2012; 79:193-6. [PMID: 22591997 DOI: 10.1016/j.mehy.2012.04.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 04/20/2012] [Indexed: 01/28/2023]
Abstract
Human herpesvirus 6 (HHV-6) is a highly neurotropic beta-herpesvirus with demonstrated transformative properties. HHV-6 infection has been implicated in the etiologies of cancers, including lymphoma and leukemia; conditions with brain involvement, including epilepsy and encephalitis; and other disorders. HHV-6 is also the only human herpesvirus that has been proven to integrate into the chromosomes of a proportion (1-12%) of infected individuals. Because several traditional genetic association studies have failed to identify a variant that can account for the established relationship between family history and glioma risk, the possibility that chromosomally-integrated HHV-6 (CI-HHV-6), as a heritable factor, may explain a proportion of familial glioma cases warrants evaluation. To test this hypothesis, the prevalence of CI-HHV-6 in familial glioma cases and related and unrelated cancer-free control groups should be compared. Among glioma-affected families, the inheritance pattern of CI-HHV-6 could be evaluated by constructing pedigrees. If CI-HHV-6 is found to be associated with familial glioma risk, this knowledge could potentially lead to the future development of novel therapeutic and preventive approaches, including vaccines and immunotherapies targeted at the HHV-6 sequences.
Collapse
Affiliation(s)
- E Susan Amirian
- Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | | |
Collapse
|
29
|
Kofman A, Marcinkiewicz L, Dupart E, Lyshchev A, Martynov B, Ryndin A, Kotelevskaya E, Brown J, Schiff D, Abounader R. The roles of viruses in brain tumor initiation and oncomodulation. J Neurooncol 2011; 105:451-66. [PMID: 21720806 PMCID: PMC3278219 DOI: 10.1007/s11060-011-0658-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 06/24/2011] [Indexed: 01/30/2023]
Abstract
While some avian retroviruses have been shown to induce gliomas in animal models, human herpesviruses, specifically, the most extensively studied cytomegalovirus, and the much less studied roseolovirus HHV-6, and Herpes simplex viruses 1 and 2, currently attract more and more attention as possible contributing or initiating factors in the development of human brain tumors. The aim of this review is to summarize and highlight the most provoking findings indicating a potential causative link between brain tumors, specifically malignant gliomas, and viruses in the context of the concepts of viral oncomodulation and the tumor stem cell origin.
Collapse
Affiliation(s)
- Alexander Kofman
- Department of Microbiology, University of Virginia, P.O. Box 800168, Charlottesville, VA 22908, USA
| | - Lucasz Marcinkiewicz
- Department of Microbiology, University of Virginia, P.O. Box 800168, Charlottesville, VA 22908, USA
| | - Evan Dupart
- Department of Microbiology, University of Virginia, P.O. Box 800168, Charlottesville, VA 22908, USA
| | - Anton Lyshchev
- St. Petersburg State Department of Health, Laboratory of Molecular Genetics, Hospital #31, Pr. Dinamo 3, St. Petersburg 197110, Russia
| | - Boris Martynov
- S.M.Kirov Medical Academy, Pr. Dinamo 3, St. Petersburg 197110, Russia
| | - Anatolii Ryndin
- Clinical Diagnostic Center, Pr. Dinamo 3, St. Petersburg 197110, Russia
| | - Elena Kotelevskaya
- St. Petersburg State Department of Health, Laboratory of Molecular Genetics, Hospital #31, Pr. Dinamo 3, St. Petersburg 197110, Russia
| | - Jay Brown
- Department of Microbiology, University of Virginia, P.O. Box 800168, Charlottesville, VA 22908, USA
| | - David Schiff
- Department of Cancer Center, University of Virginia, Charlottesville, VA, USA
| | - Roger Abounader
- Department of Microbiology, University of Virginia, P.O. Box 800168, Charlottesville, VA 22908, USA. Department of Cancer Center, University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
30
|
Human herpesvirus-6 viral load and antibody titer in serum samples of patients with multiple sclerosis. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2011; 44:247-51. [DOI: 10.1016/j.jmii.2010.08.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Revised: 05/08/2010] [Accepted: 08/12/2010] [Indexed: 11/19/2022]
|
31
|
Li JM, Lei D, Peng F, Zeng YJ, Li L, Xia ZL, Xia XQ, Zhou D. Detection of human herpes virus 6B in patients with mesial temporal lobe epilepsy in West China and the possible association with elevated NF-κB expression. Epilepsy Res 2011; 94:1-9. [DOI: 10.1016/j.eplepsyres.2010.11.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2009] [Revised: 10/31/2010] [Accepted: 11/14/2010] [Indexed: 11/28/2022]
|
32
|
Cohen JI, Fahle G, Kemp MA, Apakupakul K, Margolis TP. Human herpesvirus 6-A, 6-B, and 7 in vitreous fluid samples. J Med Virol 2010; 82:996-9. [PMID: 20419813 DOI: 10.1002/jmv.21751] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Human herpesvirus 6 and 7 (HHV-6, HHV-7) have been associated with several neurologic syndromes and have been detected in nervous tissue from healthy persons; however, only two cases of HHV-6A have been reported to be associated with intraocular inflammatory disease. Vitreous fluid was tested from 101 patients, including 69 samples from patients with ocular inflammation including CMV retinitis, idiopathic retinitis, iritis, and vitritis, for HHV-6A, HHV-6B, and HHV-7 DNA by PCR. HHV-6A DNA (4,950 copies per ml) was detected in vitreous fluid from one patient with CMV retinitis, HHV-6B DNA (10,140 copies per ml) was detected in vitreous fluid from one patient with idiopathic ocular inflammation in the absence of CMV DNA, and HHV-7 was not detected in any of the vitreous samples. HHV-6A, HHV-6B, and HHV-7 DNA are detectable in less than 2% of vitreous samples in patients with ocular inflammation.
Collapse
Affiliation(s)
- Jeffrey I Cohen
- Medical Virology Section, Laboratory of Clinical Infectious Diseases, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892-1888, USA.
| | | | | | | | | |
Collapse
|
33
|
Chronic viral infection and primary central nervous system malignancy. J Neuroimmune Pharmacol 2010; 5:387-403. [PMID: 20387126 PMCID: PMC2914282 DOI: 10.1007/s11481-010-9204-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 03/05/2010] [Indexed: 01/08/2023]
Abstract
Primary central nervous system (CNS) tumors cause significant morbidity and mortality in both adults and children. While some of the genetic and molecular mechanisms of neuro-oncogenesis are known, much less is known about possible epigenetic contributions to disease pathophysiology. Over the last several decades, chronic viral infections have been associated with a number of human malignancies. In primary CNS malignancies, two families of viruses, namely polyomavirus and herpesvirus, have been detected with varied frequencies in a number of pediatric and adult histological tumor subtypes. However, establishing a link between chronic viral infection and primary CNS malignancy has been an area of considerable controversy, due in part to variations in detection frequencies and methodologies used among researchers. Since a latent viral neurotropism can be seen with a variety of viruses and a widespread seropositivity exists among the population, it has been difficult to establish an association between viral infection and CNS malignancy based on epidemiology alone. While direct evidence of a role of viruses in neuro-oncogenesis in humans is lacking, a more plausible hypothesis of neuro-oncomodulation has been proposed. The overall goals of this review are to summarize the many human investigations that have studied viral infection in primary CNS tumors, discuss potential neuro-oncomodulatory mechanisms of viral-associated CNS disease and propose future research directions to establish a more firm association between chronic viral infections and primary CNS malignancies.
Collapse
|
34
|
Crawford JR, Santi MR, Thorarinsdottir HK, Cornelison R, Rushing EJ, Zhang H, Yao K, Jacobson S, Macdonald TJ. Detection of human herpesvirus-6 variants in pediatric brain tumors: association of viral antigen in low grade gliomas. J Clin Virol 2009; 46:37-42. [PMID: 19505845 DOI: 10.1016/j.jcv.2009.05.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Human herpesvirus-6 (HHV-6) has been associated with a diverse spectrum of central nervous system (CNS) diseases and reported glial tropism. OBJECTIVE To determine if HHV-6 is present in a series of pediatric brain tumors. STUDY DESIGN Pediatric gliomas from 88 untreated patients represented in a tissue microarray (TMA) were screened for HHV-6 by nested polymerase chain reaction (PCR), in situ hybridization (ISH), and immunohistochemistry (IHC) and compared to non-glial tumors (N=22) and control brain (N=32). Results were correlated with tumor grade and overall survival. RESULTS HHV-6 U57 was detected by nested PCR in 68/120 (57%) tumors and 7/32 (22%) age-matched non-tumor brain (P=0.001). HHV-6 U31 was positive in 73/120 (61%) tumors and 11/32 (34%) controls (P=0.019). Seventy-two percent (43/60) of tumors were HHV-6 Variant A. HHV-6 U57 was confirmed by ISH in 83/150 (54%) tumors and 10/32 (31%) controls (P=0.021), revealing a non-lymphocytic origin of HHV-6. HHV-6A/B gp116/64/54 late antigen was detected by IHC in 50/124 (40%) tumors and 6/32 (18%) controls (P=0.013). Interestingly, 58% of low grade gliomas (N=67) were IHC positive compared to 19% of high grade gliomas (N=21, P=0.002) and 25% of non-gliomas (N=36, P=0.001). HHV-6A/B gp116/64/54 antigen co-localized with glial fibrillary acidic protein, confirming the astrocytic origin of antigen. Overall, there was no primary association between HHV-6A/B gp116/64/54 antigen detection and survival (P=0.861). CONCLUSIONS We provide the first reported series of HHV-6 detection in pediatric brain tumors. The predominance of HHV-6 in glial tumors warrants further investigation into potential neurooncologic disease mechanisms.
Collapse
Affiliation(s)
- John R Crawford
- The Department of Neurology, Children's National Medical Center, The George Washington University, Washington, DC, United States.
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Tai AK, Luka J, Ablashi D, Huber BT. HHV-6A infection induces expression of HERV-K18-encoded superantigen. J Clin Virol 2009; 46:47-8. [PMID: 19505843 DOI: 10.1016/j.jcv.2009.05.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The human endogenous retrovirus K-18 (HERV-K18) encodes a superantigen that causes deregulation of the immune system. This provirus is transcriptionally silent, but can be induced by Epstein-Barr virus (EBV) infection and IFN-alpha treatment. OBJECTIVES Since the herpesvirus EBV induces HERV-K18 expression in human B cells, it was of interest to determine if other herpesviruses would have similar HERV-K18 transactivation properties. Human herpesvirus (HHV)-6A, a neurotropic virus associated with multiple sclerosis, was a logical candidate for these studies. STUDY DESIGN HSB2 cells (HHV-6-negative control), HSB2-ML cells (containing latent HHV-6A genome) and HSB2/HHV-6A cells (HSB-2 cells productively infected with HHV-6A) were compared for their level of HERV-K18 transcription, using quantitative RT-PCR. RESULTS Latently infected HSB2-ML cells showed a significant increase in HERV-K18 RNA compared to the control cells. HERV-K18 expression was even greater in HSB2 cells productively infected with HHV-6A for 78h. CONCLUSION These results imply that HHV-6A, either in latent form or during acute infection, directly transactivates HERV-K18. This HERV-K18 induction may be mediated through IFN-alpha that is produced by the HHV-6A-infected cells. The functional implications of superantigen expression are discussed.
Collapse
Affiliation(s)
- Albert K Tai
- Department of Pathology, Tufts University School of Medicine, Boston, MA 02111, United States
| | | | | | | |
Collapse
|
36
|
Crawford JR, Santi MR, Cornelison R, Sallinen SL, Haapasalo H, MacDonald TJ. Detection of human herpesvirus-6 in adult central nervous system tumors: predominance of early and late viral antigens in glial tumors. J Neurooncol 2009; 95:49-60. [PMID: 19424665 DOI: 10.1007/s11060-009-9908-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Accepted: 04/22/2009] [Indexed: 12/21/2022]
Abstract
The purpose is to determine the incidence of active and latent human herpesvirus-6 (HHV-6) infection in a large cohort of adult primary and recurrent CNS tumors. We screened a tissue microarray (TMA) containing more than 200 adult primary and recurrent CNS tumors with known clinical information for the presence of HHV-6 DNA by in situ hybridization (ISH) and protein by immunohistochemistry (IHC). One hundred six of 224 (47%) CNS tumors were positive for HHV-6 U57 Major Capsid Protein (MCP) gene by ISH compared to 0/25 non tumor control brain (P = 0.001). Fourteen of 30 (47%) tumors were HHV-6 MCP positive by nested PCR compared to 0/25 non-tumor brain controls (P = 0.001), revealing HHV-6 Variant A in 6 of 14 samples. HHV-6A/B early (p41) and late (gp116/64/54) antigens were detected by IHC in 66 of 277 (24%) (P = 0.003) and 84 of 282 (35%) (P = 0.002) tumors, respectively, suggesting active infection. HHV-6 p41 (P = 0.645) and gp116/64/54 (P = 0.198) antigen detection was independent of recurrent disease. Glial tumors were 3 times more positive by IHC compared to non glial tumors for both HHV-6 gp116/64/54 (P = 0.0002) and HHV-6 p41 (P = 0.004). Kaplan Meier survival analysis showed no effect of HHV-6 gp116/64/54 (P = 0.852) or HHV-6 p41 (P = 0.817) antigen detection on survival. HHV-6 early and late antigens are detected in adult primary and recurrent CNS tumors more frequently in glial tumors. We hypothesize that the glial-tropic features of HHV-6 may play an important modifying role in tumor biology that warrants further investigation.
Collapse
Affiliation(s)
- John R Crawford
- Department of Neurology, The George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA.
- The Brain Tumor Institute, Children's National Medical Center, The George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA.
- Department of Neurology, University of California, San Diego, 9500 Gilman Drive, La Jolla, San Diego, CA, 92093, USA.
| | - Maria Rita Santi
- Department of Pathology, The George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA
- The Brain Tumor Institute, Children's National Medical Center, The George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - Robbie Cornelison
- Molecular Genetics Section, The National Cancer Institute, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Satu-Leena Sallinen
- Department of Pediatrics, Genetics Outpatient Clinics, Tampere University Hospital, P.O. Box 2000, Tampere, 33521, Finland
| | - Hannu Haapasalo
- Department of Pathology, Tampere University Hospital, P.O. Box 2000, Tampere, 33521, Finland
| | - Tobey J MacDonald
- Department of Hematology-Oncology, The George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA
- The Brain Tumor Institute, Children's National Medical Center, The George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA
| |
Collapse
|
37
|
Theodore WH, Epstein L, Gaillard WD, Shinnar S, Wainwright MS, Jacobson S. Human herpes virus 6B: a possible role in epilepsy? Epilepsia 2008; 49:1828-37. [PMID: 18627418 DOI: 10.1111/j.1528-1167.2008.01699.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Human herpes virus 6 (HHV6) infection is nearly ubiquitous in childhood and may include central nervous system invasion. There are two variants, HHV6A and HHV6B. Usually asymptomatic, it is associated with the common, self-limited childhood illness roseola infantum and rarely with more severe syndromes. In patients with immune compromise, subsequent reactivation of viral activity may lead to severe limbic encephalitis. HHV6 has been identified as a possible etiologic agent in multiple sclerosis, myocarditis, and encephalitis. A preponderance of evidence supports an association between HHV6 and febrile seizures. An ongoing multicenter study is investigating possible links between HHV6 infection, febrile status epilepticus, and development of mesial temporal sclerosis (MTS). Investigation of temporal lobectomy specimens showed evidence of active HHV6B but not HHV6A replication in hippocampal astrocytes in about two-thirds of patients with MTS but not other causes of epilepsy. It has been suggested that HHV6B may cause "excitotoxicity" by interfering with astrocyte excitatory amino acid transport. Although conventional inflammatory changes are not found in most MTS specimens, inflammatory modulators may play a role in neuronal injury leading to MTS as well. If the link between early viral infection, complex or prolonged febrile seizures, and later development of intractable temporal lobe epilepsy is confirmed, new therapeutic approaches to a common intractable epilepsy syndrome may be possible.
Collapse
|
38
|
Alvarez-Lafuente R, García-Montojo M, De Las Heras V, Domínguez-Mozo MI, Bartolome M, Benito-Martin MS, Arroyo R. Herpesviruses and human endogenous retroviral sequences in the cerebrospinal fluid of multiple sclerosis patients. Mult Scler 2008; 14:595-601. [PMID: 18566025 DOI: 10.1177/1352458507086425] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To analyze the possible role of human herpesvirus (HHVs) and human endogenous retroviruses (HERVs) infection in multiple sclerosis (MS) pathogenesis. METHODS A total of 92 cerebrospinal fluid (CSF) samples were collected: 48 from MS patients at the first clinically evident demyelinating event, 23 from patients with other inflammatory neurological diseases (OINDs) and 21 from patients with other non-inflammatory neurological diseases (ONINDs). Total DNA and RNA were isolated, and the prevalences and viral loads of herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6, HERV-H and HERV-W in the CSF of MS patients and controls were evaluated using a quantitative real-time polymerase chain reaction assay. RESULTS (i) For HSV, 1/48 (2.1%, 86 copies/ml of CSF) MS patients and 1/23 (4.3%, 115.2 copies/ml of CSF) OIND patients (a myelitis case) had HSV sequences in the CSF; (ii) for EBV, only 1/48 (2.1%, 72 copies/ml of CSF) MS patients was positive for EBV; (iii) for HHV-6, only 5/48 (10.4%) MS patients had HHV-6 genomes in their CSF (128.1 copies/ml of CSF); (iv) we did not find any positive cases for VZV, CMV, HERV-H and HERV-W among MS patients or controls; (v) no cases of co-infections were found; (vi) the whole prevalence of HHVs was 7/48 (14.6%) for MS patients and 1/44 (2.3%) for controls (p = 0.038). CONCLUSION The findings described here show that HHV infection is more frequent in the CSF of MS patients than in patients with other neurological diseases; however, only HHV-6 seems to be involved in the pathogenesis of MS in a subset of patients.
Collapse
|
39
|
Karatas H, Gurer G, Pinar A, Soylemezoglu F, Tezel GG, Hascelik G, Akalan N, Tuncer S, Ciger A, Saygi S. Investigation of HSV-1, HSV-2, CMV, HHV-6 and HHV-8 DNA by real-time PCR in surgical resection materials of epilepsy patients with mesial temporal lobe sclerosis. J Neurol Sci 2008; 264:151-6. [PMID: 17804017 DOI: 10.1016/j.jns.2007.08.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2006] [Revised: 08/08/2007] [Accepted: 08/13/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study is to investigate the presence of viral DNAs of HSV-1, HSV-2, HHV-6, HHV-8, and CMV in hippocampus of the patients with mesial temporal lobe epilepsy (MTLE) syndrome. METHODS Pathological specimens were obtained from 33 patients with MTLE undergone temporal lobectomy with amygdalo-hippocampectomy due to intractable seizures. Autopsy materials from the hippocampus of 7 patients without neurological disease were used as controls. The data was also correlated with the clinical history of patients including febrile convulsions, age, and history of CNS infections. Real-time polymerase chain reaction method was performed for detection of DNAs of these viruses. RESULTS HHV-6, HSV-1 and HHV-8 were detected in the hippocampus of 3, 2 and 1 patients with MTLE respectively. None of the hippocampus of patients with MTLE was positive for DNA of HSV-2 and/or CMV. Three patients with positive HHV-6 DNAs had febrile convulsions and family history for epilepsy. None of our control specimens showed PCR positivity to any of the 5 tested viruses. CONCLUSIONS Our study is the first to report the presence of HHV-8 viral genome in the brain tissue of patient with MTLE. Viral DNAs were detected in a total of 18% of the patients in this study; we can conclude that activity of the latent virus in patients with hippocampal sclerosis should be more extensively studied to establish its role in active infection.
Collapse
MESH Headings
- Adolescent
- Adult
- Autopsy
- Cytomegalovirus/genetics
- DNA, Viral/analysis
- Encephalitis, Herpes Simplex/complications
- Encephalitis, Herpes Simplex/diagnosis
- Encephalitis, Herpes Simplex/genetics
- Epilepsy, Temporal Lobe/pathology
- Epilepsy, Temporal Lobe/physiopathology
- Epilepsy, Temporal Lobe/virology
- Female
- Herpes Simplex/complications
- Herpesviridae Infections/complications
- Herpesviridae Infections/diagnosis
- Herpesviridae Infections/genetics
- Herpesvirus 1, Human/genetics
- Herpesvirus 2, Human/genetics
- Herpesvirus 6, Human/genetics
- Herpesvirus 8, Human/genetics
- Hippocampus/pathology
- Hippocampus/physiopathology
- Hippocampus/virology
- Humans
- Male
- Reverse Transcriptase Polymerase Chain Reaction
- Virus Latency/genetics
Collapse
Affiliation(s)
- Hulya Karatas
- Hacettepe University, Faculty of Medicine, Department of Neurology, Sihhiye, Ankara, 06100, Turkey.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Purification of infectious human herpesvirus 6A virions and association of host cell proteins. Virol J 2007; 4:101. [PMID: 17949490 PMCID: PMC2164960 DOI: 10.1186/1743-422x-4-101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 10/19/2007] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Viruses that are incorporating host cell proteins might trigger autoimmune diseases. It is therefore of interest to identify possible host proteins associated with viruses, especially for enveloped viruses that have been suggested to play a role in autoimmune diseases, like human herpesvirus 6A (HHV-6A) in multiple sclerosis (MS). RESULTS We have established a method for rapid and morphology preserving purification of HHV-6A virions, which in combination with parallel analyses with background control material released from mock-infected cells facilitates qualitative and quantitative investigations of the protein content of HHV-6A virions. In our iodixanol gradient purified preparation, we detected high levels of viral DNA by real-time PCR and viral proteins by metabolic labelling, silver staining and western blots. In contrast, the background level of cellular contamination was low in the purified samples as demonstrated by the silver staining and metabolic labelling analyses. Western blot analyses showed that the cellular complement protein CD46, the receptor for HHV-6A, is associated with the purified and infectious virions. Also, the cellular proteins clathrin, ezrin and Tsg101 are associated with intact HHV-6A virions. CONCLUSION Cellular proteins are associated with HHV-6A virions. The relevance of the association in disease and especially in autoimmunity will be further investigated.
Collapse
|
41
|
Detection and typing of human herpesvirus 6 by molecular methods in specimens from patients diagnosed with encephalitis or meningitis. J Clin Microbiol 2007; 45:3972-8. [PMID: 17942643 DOI: 10.1128/jcm.01692-07] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human herpesvirus 6 (HHV-6) was detected in specimens from patients hospitalized with symptoms of encephalitis or meningitis. A real-time PCR assay was developed which has a linear dynamic range of 5 to 5 x 10(6) copies of HHV-6 and a sensitivity of five gene copies per reaction. While the assay detects both subtypes, HHV-6A and HHV-6B, it is specific and does not cross-react with a selected specificity panel. A total of 1,482 patient specimens, which were collected between 2003 and 2007, were tested; 26 specimens from 24 patients were found to be positive for HHV-6 by real-time PCR. The HHV-6 detection rate in this population was therefore 1.75%. The majority of the specimens tested (>95%) were cerebrospinal fluid (CSF) specimens. We were able to type 20 of the 26 positive specimens by conventional PCR and sequence analysis; all were HHV-6B. Forty-two percent of the patients were 3 years of age or younger, which may indicate a primary infection in these patients. Given the ages of the remaining patients (from 4 to 81 years), their infections were most probably due to virus reactivations. Where information was available, symptoms of patients included fever (71%), altered mental status (67%), and abnormal CSF profile (75%). Fifty percent of patients of 3 years of age or younger suffered from seizures. The detection of HHV-6 in specimens from patients diagnosed with encephalitis or meningitis, in the absence of a positive PCR result for other agents, strongly suggests a role for HHV-6 in the pathogenesis of these central nervous system diseases.
Collapse
|
42
|
Fotheringham J, Williams EL, Akhyani N, Jacobson S. Human Herpesvirus 6 (HHV-6) Induces Dysregulation of Glutamate Uptake and Transporter Expression in Astrocytes. J Neuroimmune Pharmacol 2007; 3:105-16. [DOI: 10.1007/s11481-007-9084-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Accepted: 07/30/2007] [Indexed: 10/22/2022]
|
43
|
De Filippis L, Foglieni C, Silva S, Vescovi AL, Lusso P, Malnati MS. Differentiated human neural stem cells: a new ex vivo model to study HHV-6 infection of the central nervous system. J Clin Virol 2007; 37 Suppl 1:S27-32. [PMID: 17276364 DOI: 10.1016/s1386-6532(06)70008-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND HHV-6 is the etiologic agent of exanthem subitum, a pediatric illness that may be associated with clinical and laboratory signs of central nervous system involvement. The absence of suitable experimental models has so far hampered the elucidation of the mechanisms of HHV-6-mediated neural cell damage. Recently, the growing knowledge in neurobiology has permitted the establishment of long-term cultures of human neural stem cells (hNSC) that, by virtue of their self-renewal capacity and multipotentiality, provide a valuable tool for the study of neurodegenerative disorders. OBJECTIVES AND STUDY DESIGN We studied the effects of HHV-6 infection in differentiated cultures of hNSC derived from the telencephalic and diencephalic regions of a 13.5 week post conception (pcw) fetal brain. The prototypic HHV-6 strain GS (subgroup A) was used. RESULTS hNSC were differentiated ex vivo to obtain mixed cultures encompassing astrocytes, neurons and oligodendrocytes. These differentiated hNSC cultures were found to be susceptible to productive HHV-6A infection, resulting in the formation of syncytia associated with phenotypic alterations. CONCLUSION These results demonstrate that hNSC may provide a physiologically relevant model to investigate the pathogenic role of HHV-6 in central nervous system disorders.
Collapse
Affiliation(s)
- Lidia De Filippis
- Stem Cell Research Institute, DIBIT, San Raffaele Scientific Institute 20132 Milan, Milan, Italy
| | | | | | | | | | | |
Collapse
|
44
|
Mock DJ, Strathmann F, Blumberg BM, Mayer-Proschel M. Infection of murine oligodendroglial precursor cells with Human Herpesvirus 6 (HHV-6)--establishment of a murine in vitro model. J Clin Virol 2007; 37 Suppl 1:S17-23. [PMID: 17276361 DOI: 10.1016/s1386-6532(06)70006-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Human Herpesvirus 6 was previously demonstrated to infect human oligodendroglial precursor cells (OPCs) in vitro causing cell cycle arrest and premature differentiation with consequent loss of the precursor pool. OBJECTIVES To develop an in vitro murine OPC model to study the cell cycle and differentiation effects of HHV-6 in more readily available, genetically well-defined cells free of the risk of contamination with human herpesviruses. STUDY DESIGN Murine OPCs were exposed to infectious HHV-6A or HHV-6B and analyzed for production of viral transcripts, particles, and replicating virus. FACS analysis and specific markers were used to evaluate effects on cell cycling and differentiation. RESULTS HHV-6 infection of murine OPCs resulted in production of both immediate-early and some late transcripts but no replicating virus by TaqMan quantitative PCR or electron microscopy. Both a specific G1/S cell cycle arrest and premature loss of OPCs through differentiation into oligodendrocytes as previously seen with human precursors were recapitulated. CONCLUSIONS Infection of murine OPCs by HHV-6 reproduces the critical phenotypes of cell cycle arrest and altered differentiation seen in human cells. The murine system provides a highly defined, accessible, and reproducible source of cells permitting the elucidation of specific viral and cell cycle genes involved in CNS viral infections of OPCs.
Collapse
Affiliation(s)
- David J Mock
- Department of Neurology, University of Rochester, Rochester, NY 14642, USA.
| | | | | | | |
Collapse
|
45
|
Méchaï F, Boutolleau D, Manceron V, Gasnault J, Quertainmont Y, Brosseau JP, Delfraissy JF, Labetoulle M, Goujard C. Human herpesvirus 6-associated retrobulbar optic neuritis in an HIV-infected patient: response to anti-herpesvirus therapy and long-term outcome. J Med Virol 2007; 79:931-4. [PMID: 17516535 DOI: 10.1002/jmv.20833] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Like other herpesviruses, human herpesvirus 6 (HHV-6) can reactivate in immunocompromised patients. A case is described of an HIV-1-infected patient who developed bilateral retrobulbar optic neuritis associated with HHV-6 infection. A 59-year-old woman, infected with HIV for 18 years, interrupted antiretroviral treatment because of therapeutic failure and severe metabolic complications. She presented subsequently with blurred vision and ophthalmological examination showed visual loss due to optic neuritis. Her CD4+ count was 285 cells/mm(3) and her plasma HIV-1 RNA level was 5.5 log(10) copies (cp)/ml. Magnetic resonance imaging of the brain was normal. HHV-6 loads were 3.2 log cp/ml in cerebrospinal fluid (CSF) and 6.3 log cp/10(6) peripheral blood mononuclear cells. Combined intravenous treatment was started with foscarnet and ganciclovir then changed to cidofovir and long-term valganciclovir. Her ocular condition improved gradually despite little decrease of the HHV-6 load in the CSF. Salvage antiretroviral treatment was then administered, with marked immunological and virological responses, contributing to further progressive ocular improvement. HHV-6-related optic neuritis has not been described previously in HIV-infected patients. Anti-HHV-6 treatment improved the patient's vision, but immune restoration seems to remain essential for long-term recovery.
Collapse
Affiliation(s)
- Frédéric Méchaï
- Department of Internal Medicine and Infectious Diseases, Bicêtre University Hospital, Le Kremlin Bicêtre Cedex, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Glotzbecker MP, Dormans JP, Pawel BR, Wills BP, Joshi Y, Elkan M, Hodinka RL. Langerhans cell histiocytosis and human herpes virus 6 (HHV-6), an analysis by real-time polymerase chain reaction. J Orthop Res 2006; 24:313-20. [PMID: 16479562 DOI: 10.1002/jor.20039] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients with Langerhans cell histiocytosis (LCH) usually present to orthopedic surgeons because this disease most commonly affects bone. The pathogenesis of LCH is unknown, although roles for environmental, infectious, immunologic, and genetic causes have been postulated. More specifically, there is limited data suggesting that human herpes virus 6 (HHV-6) may be a potential etiologic agent. Frozen biopsy material was obtained from 13 patients with LCH and 20 patients without the disease. After ensuring histologic adequacy of the material, the tissue was tested for HHV-6 by qualitative and quantitative real-time TaqMan PCR. Four of 13 patients with LCH had evidence of HHV-6 DNA in their tissue while 7 of 20 control patients tested positive for HHV-6 genome. Viral loads are reported for the positive patients; no statistical difference was observed in the presence or quantity of HHV-6 DNA found in either population, suggesting that the prevalence of HHV-6 in the tissue of LCH patients is the same as that found in tissue from individuals without disease.
Collapse
Affiliation(s)
- Michael P Glotzbecker
- Harvard Combined Orthopedic Residency Program, 55 Fruit Street, VBK210 Boston, Massachusets 02114, USA
| | | | | | | | | | | | | |
Collapse
|
47
|
Delbue S, Pagani E, Guerini FR, Agliardi C, Mancuso R, Borghi E, Rossi F, Boldorini R, Veggiani C, Car PG, Ferrante P. Distribution, characterization and significance of polyomavirus genomic sequences in tumors of the brain and its covering. J Med Virol 2005; 77:447-54. [PMID: 16173013 DOI: 10.1002/jmv.20474] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The etiology of brain tumors and meningiomas is still unknown. Several factors have been considered, such as genetic predisposition and environmental risk factors, but the hypothesis that one or more infectious agents may play a role in tumor pathogenesis has also been investigated. Therefore, emphasis was placed on the neurooncogenic family Polyomaviridae and the presence of human polyomavirus DNA sequences and JCV mRNA were examined in malignant human brain biopsies. Italian patients affected with different types of neoplasias of the brain and its covering were enrolled. The patients underwent surgical tumor excision and the presence of the polyomavirus genome in biopsy and other body fluids was evaluated by PCR. In addition, the genomic organization of JCV was examined in depth, with the aim of providing information on genotype distribution and TCR rearrangements in the population affected with intracranial neoplasms. On the whole, polyomavirus DNA was found in 50% of the biopsy specimens studied, JC virus DNA and BK virus DNA were amplified in 40.6% mainly glioblastomas and 9.4% of the tissue specimens, respectively, while none of the biopsy specimens tested contained Simian virus 40 DNA. Genotype 1 and Mad 4 TCR organization were the most frequent in the population enrolled. Although a cause and effect was not demonstrated and the specific role of the viruses remains unknown, the findings appear to confirm the hypothesis that JCV and BKV could be important co-factors in tumor pathogenesis.
Collapse
Affiliation(s)
- Serena Delbue
- Laboratory of Molecular Biology and Biotechnology, Don Carlo Gnocchi Foundation, IRCCS, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Ahlqvist J, Fotheringham J, Akhyani N, Yao K, Fogdell-Hahn A, Jacobson S. Differential tropism of human herpesvirus 6 (HHV-6) variants and induction of latency by HHV-6A in oligodendrocytes. J Neurovirol 2005; 11:384-94. [PMID: 16162481 PMCID: PMC7095087 DOI: 10.1080/13550280591002379] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Human herpesvirus 6 (HHV-6) is a ubiquitous β-herpesvirus associated with a number of clinical disorders. Two closely but biologically distinct variants have been described. HHV-6 variant B causes the common childhood disease exhanthem subitum, and although the pathologic characteristics for HHV-6 variant A are less well defined, HHV-6A has been suggested to be more neurotropic. We studied the effect of both HHV-6 variants in an oligodendrocyte cell line (MO3.13). Infection of M03.13 was monitored by cytopathic effect (CPE), quantitative TaqMan PCR for viral DNA in cells and supernatant, reverse transcriptase-polymerase chain reaction (RT-PCR) to detect viral RNA, and indirect immunofluorescence (IFA) to detect viral protein expression. HHV-6A infection induced significantly more CPE than infection with HHV-6B. HHV-6B induced an abortive infection associated with a decrease of the initial viral DNA load over time, early RNA expression, and no expression of viral antigen. In contrast, infection with HHV-6A DNA persisted in cells for at least 62 days. During the acute phase of infection with HHV-6A, intracellular and extracellular viral load increased and cells expressed the viral protein IE-2 and gp116/54/64. No HHV-6A RNA or protein was expressed after 30 days post infection, suggesting that HHV-6A formed a latent infection. These studies provide in vitro support to the hypothesis that HHV-6 can actively infect oligodendrocytes. Our results suggest that HHV-6A and HHV-6B have different tropism in MO3.13 cells and that an initially active HHV-6A infection can develop latency. Differences between HHV-6A and -6B infection in different neural cell types may be associated with different neurological diseases.
Collapse
Affiliation(s)
- Jenny Ahlqvist
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland USA
- Division of Neurology, Neurotec Department, Karolinska Institutet at Huddinge University Hospital, Huddinge, Sweden
| | - Julie Fotheringham
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland USA
| | - Nahid Akhyani
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland USA
| | - Karen Yao
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland USA
| | - Anna Fogdell-Hahn
- Division of Neurology, Neurotec Department, Karolinska Institutet at Huddinge University Hospital, Huddinge, Sweden
| | - Steven Jacobson
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland USA
- Viral Immunology Section, NINDS/NIH, 10 Center Drive, Building 10 Room 5B16, 20892 Bethesda, MD USA
| |
Collapse
|
49
|
Meeuwsen S, Persoon-Deen C, Bsibsi M, Bajramovic JJ, Ravid R, De Bolle L, van Noort JM. Modulation of the cytokine network in human adult astrocytes by human herpesvirus-6A. J Neuroimmunol 2005; 164:37-47. [PMID: 15904975 DOI: 10.1016/j.jneuroim.2005.03.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2004] [Revised: 03/16/2005] [Accepted: 03/16/2005] [Indexed: 11/27/2022]
Abstract
Human herpesvirus-6A (HHV-6A) is a common pathogen whose role in CNS disorders including multiple sclerosis remains controversial. To understand how HHV-6A could influence inflammatory pathways in the CNS, we infected cultured human adult astrocytes and examined the expression of 268 cytokines, chemokines, growth factors and their receptors by gene profiling. HHV-6 infection alone had little effect on the astrocyte gene profile but strongly altered the astrocyte response to proinflammatory cytokines. Under those conditions astrocytes express higher levels of anti-inflammatory mediators including IL-10 and IL-11, chemotactic factors, growth factors and factors controlling type I interferon production. Our data suggest that HHV-6 itself does not evoke a pro-inflammatory response in astrocytes but rather triggers immune modulatory factors in the face of inflammation.
Collapse
Affiliation(s)
- Sonja Meeuwsen
- Division Biomedical Research, TNO Prevention and Health, P.O. Box 2215, 2301 CE Leiden, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
50
|
Donati D, Martinelli E, Cassiani-Ingoni R, Ahlqvist J, Hou J, Major EO, Jacobson S. Variant-specific tropism of human herpesvirus 6 in human astrocytes. J Virol 2005; 79:9439-48. [PMID: 16014907 PMCID: PMC1181567 DOI: 10.1128/jvi.79.15.9439-9448.2005] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Though first described as a lymphotropic virus, human herpesvirus 6 (HHV-6) is highly neuropathogenic. Two viral variants are known: HHV-6A and HHV-6B. Both variants can infect glial cells and have been differentially associated with central nervous system diseases, suggesting an HHV-6 variant-specific tropism for glial cell subtypes. We have performed infections with both viral variants in human progenitor-derived astrocytes (HPDA) and monitored infected cell cultures for cytopathic effect (CPE), intra- and extracellular viral DNA load, the presence of viral particles by electronic microscopy, mRNA transcription, and viral protein expression. HHV-6A established a productive infection with CPE, visible intracellular virions, and high virus DNA loads. HHV-6B-infected HPDA showed no morphological changes, intracellular viral particles, and decreasing intra- and extracellular viral DNA over time. After long-term passage, HHV-6B-infected HPDA had stable but low levels of intracellular viral DNA load with no detectable viral mRNA. Our results demonstrate that HHV-6A and HHV-6B have differential tropisms and patterns of infection for HPDA in vitro, where HHV-6A results in a productive lytic infection. In contrast, HHV-6B was associated with a nonproductive infection. These findings suggest that HHV-6 variants might be responsible for specific infection patterns in glial cells in vivo. Astrocytes may be an important reservoir for this virus in which differential tropism of HHV-6A and HHV-6B may be associated with different disease outcomes.
Collapse
Affiliation(s)
- Donatella Donati
- Viral Immunology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | | | | | | | | | | | | |
Collapse
|