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Niemeyer CS, Traina-Dorge V, Doyle-Meyers L, Das A, Looper J, Mescher T, Feia B, Medina E, Nagel MA, Mahalingam R, Bubak AN. Simian varicella virus infection and reactivation in rhesus macaques trigger cytokine and Aβ40/42 alterations in serum and cerebrospinal fluid. J Neurovirol 2024; 30:86-99. [PMID: 38453879 DOI: 10.1007/s13365-024-01196-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 03/09/2024]
Abstract
Simian varicella virus (SVV) produces peripheral inflammatory responses during varicella (primary infection) and zoster (reactivation) in rhesus macaques (RM). However, it is unclear if peripheral measures are accurate proxies for central nervous system (CNS) responses. Thus, we analyzed cytokine and Aβ42/Aβ40 changes in paired serum and cerebrospinal fluid (CSF) during the course of infection. During varicella and zoster, every RM had variable changes in serum and CSF cytokine and Aβ42/Aβ40 levels compared to pre-inoculation levels. Overall, peripheral infection appears to affect CNS cytokine and Aβ42/Aβ40 levels independent of serum responses, suggesting that peripheral disease may contribute to CNS disease.
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Affiliation(s)
- Christy S Niemeyer
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
| | - Vicki Traina-Dorge
- Division of Microbiology, Tulane National Primate Research Center, Tulane University, 18703 Three Rivers Road, Covington, LA, 70433, USA
| | - Lara Doyle-Meyers
- Division of Veterinary Medicine, Tulane National Primate Research Center, Tulane University, 18703 Three Rivers Road, Covington, LA, 70433, USA
| | - Arpita Das
- Division of Microbiology, Tulane National Primate Research Center, Tulane University, 18703 Three Rivers Road, Covington, LA, 70433, USA
| | - Jayme Looper
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, 70803, USA
| | - Teresa Mescher
- Department of Psychiatry Behavioral Health and Wellness Program, University of Colorado School of Medicine, Aurora, Co, 80045, USA
| | - Brittany Feia
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
| | - Eva Medina
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
| | - Maria A Nagel
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Co, 80045, USA
| | - Ravi Mahalingam
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
| | - Andrew N Bubak
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA.
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Niemeyer CS, Traina-Dorge V, Doyle-Meyers L, Das A, Looper J, Mescher T, Feia B, Medina E, Nagel MA, Mahalingam R, Bubak AN. Simian Varicella Virus Infection and Reactivation in Rhesus Macaques Trigger Cytokine and Aβ40/42 Alterations in Serum and Cerebrospinal Fluid. RESEARCH SQUARE 2023:rs.3.rs-3367215. [PMID: 37886544 PMCID: PMC10602180 DOI: 10.21203/rs.3.rs-3367215/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Simian varicella virus (SVV) produces peripheral inflammatory responses during varicella (primary infection) and zoster (reactivation) in rhesus macaques (RM). However, it is unclear if peripheral measures are accurate proxies for central nervous system (CNS) responses. Thus, we analyzed cytokine and Aβ42/Aβ40 changes in paired serum and cerebrospinal fluid (CSF) during the course of infection. During varicella and zoster, every RM had variable changes in serum and CSF cytokine and Aβ42/Aβ40 levels compared to pre-inoculation levels. Overall, peripheral infection appears to affect CNS cytokine and Aβ42/Aβ40 levels independent of serum responses, suggesting that peripheral disease may contribute to CNS disease.
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Affiliation(s)
| | | | | | | | - Jayme Looper
- Louisiana State University School of Veterinary Medicine
| | - Teresa Mescher
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
| | - Brittany Feia
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
| | - Eva Medina
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
| | - Maria A Nagel
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
| | - Ravi Mahalingam
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
| | - Andrew N Bubak
- University of Colorado School of Medicine: University of Colorado Anschutz Medical Campus School of Medicine
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Yuan J, Wang A, Hou Y, Xu X. Case report: Varicella-zoster virus infection triggering progressive encephalomyelitis with rigidity and myoclonus. Front Neurol 2022; 13:1042988. [DOI: 10.3389/fneur.2022.1042988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 11/30/2022] Open
Abstract
Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare neurological disease of unknown etiology, and most patients with PERM are positive for anti-glycine receptor (GlyR) antibody. In this case study, we report a clinical case of a varicella-zoster virus-infected patient who developed anti-GlyR antibody-positive PERM. He initially suffered from herpes zoster and gradually developed symptoms of impaired brainstem functions including hoarse voice and dysphagia, accompanied by paroxysmal sympathetic hyperactivity. The patient also suffered from severe spasms, which were easily triggered by external stimuli. Glycine receptor antibodies were then found to be positive in serum and cerebrospinal fluid, and the diagnosis of PERM was confirmed. Methylprednisolone and gamma globulin treatments were given, and spasms were improved after treatment. Unfortunately, the patient's family insisted on automatic discharge and the patient passed away several days later.
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Current In Vivo Models of Varicella-Zoster Virus Neurotropism. Viruses 2019; 11:v11060502. [PMID: 31159224 PMCID: PMC6631480 DOI: 10.3390/v11060502] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/24/2019] [Accepted: 05/28/2019] [Indexed: 12/13/2022] Open
Abstract
Varicella-zoster virus (VZV), an exclusively human herpesvirus, causes chickenpox and establishes a latent infection in ganglia, reactivating decades later to produce zoster and associated neurological complications. An understanding of VZV neurotropism in humans has long been hampered by the lack of an adequate animal model. For example, experimental inoculation of VZV in small animals including guinea pigs and cotton rats results in the infection of ganglia but not a rash. The severe combined immune deficient human (SCID-hu) model allows the study of VZV neurotropism for human neural sub-populations. Simian varicella virus (SVV) infection of rhesus macaques (RM) closely resembles both human primary VZV infection and reactivation, with analyses at early times after infection providing valuable information about the extent of viral replication and the host immune responses. Indeed, a critical role for CD4 T-cell immunity during acute SVV infection as well as reactivation has emerged based on studies using RM. Herein we discuss the results of efforts from different groups to establish an animal model of VZV neurotropism.
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Traina-Dorge V, Mehta S, Rooney B, Crucian B, Doyle-Meyers L, Das A, Coleman C, Nagel M, Mahalingam R. Simian Varicella Virus DNA in Saliva and Buccal Cells After Experimental Acute Infection in Rhesus Macaques. Front Microbiol 2019; 10:1009. [PMID: 31143167 PMCID: PMC6520666 DOI: 10.3389/fmicb.2019.01009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/23/2019] [Indexed: 01/16/2023] Open
Abstract
Simian varicella virus (SVV) infection of non-human primates is the counterpart of varicella zoster virus (VZV) infection in humans. To develop non-invasive methods of assessing SVV infection, we tested for the presence of SVV DNA in saliva, as has been documented in human VZV infection, and in buccal cells to determine whether epithelial cells might provide a more reliable source of material for analysis. Five rhesus macaques intratracheally inoculated with SVV all developed varicella with viremia and macular-papular skin rash in 1-2 weeks, which resolved followed by establishment of latency. DNA extracted from longitudinal blood peripheral blood mononuclear cells (PBMCs), saliva and buccal samples collected during acute infection and establishment of latency were analyzed by real-time qPCR. After intratracheal inoculation, viremia was observed, with peak levels of 101-102 copies of SVV DNA in 100 ng of PBMC DNA at 4 and 7 days post inoculation (dpi), which then decreased at 9-56 dpi. In saliva and buccal cells at 7 dpi, 101-104 copies and 101-105 copies of SVV DNA in 100 ng of cellular DNA, respectively, were detected in all the five monkeys. At 9 dpi, saliva samples from only two of the five monkeys contained SVV DNA at 102-103 copies/100 ng of saliva DNA, while buccal cells from all five monkeys showed 100-103 copies of SVV DNA/100 ng of buccal cell DNA. Similar to viremia, SVV DNA in saliva and buccal cells at 11-56 dpi was lower, suggesting clearance of viral shedding. SVV DNA levels were generally higher in buccal cells than in saliva. Our findings indicate that SVV shedding into the oral cavity parallels acute SVV infection and underscore the relevance of both saliva and buccal cell samples to monitor acute varicella virus infection.
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Affiliation(s)
- Vicki Traina-Dorge
- Division of Microbiology, Tulane National Primate Research Center, Tulane University, Covington, LA, United States
| | - Satish Mehta
- Jes Tech, Houston, TX, United States.,KBR wyle Laboratories, Houston, TX, United States
| | | | - Brian Crucian
- Johnson Space Center, NASA, Houston, TX, United States
| | - Lara Doyle-Meyers
- Division of Veterinary Medicine, Tulane National Primate Research Center, Tulane University, Covington, LA, United States
| | - Arpita Das
- Division of Microbiology, Tulane National Primate Research Center, Tulane University, Covington, LA, United States
| | - Colin Coleman
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Maria Nagel
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ravi Mahalingam
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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Reactivation of Simian Varicella Virus in Rhesus Macaques after CD4 T Cell Depletion. J Virol 2019; 93:JVI.01375-18. [PMID: 30404798 DOI: 10.1128/jvi.01375-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 10/25/2018] [Indexed: 02/06/2023] Open
Abstract
Rhesus macaques intrabronchially inoculated with simian varicella virus (SVV), the counterpart of human varicella-zoster virus (VZV), developed primary infection with viremia and rash, which resolved upon clearance of viremia, followed by the establishment of latency. To assess the role of CD4 T cell immunity in reactivation, monkeys were treated with a single 50-mg/kg dose of a humanized monoclonal anti-CD4 antibody; within 1 week, circulating CD4 T cells were reduced from 40 to 60% to 5 to 30% of the total T cell population and remained low for 2 months. Very low viremia was seen only in some of the treated monkeys. Zoster rash developed after 7 days in the monkey with the most extensive CD4 T cell depletion (5%) and in all other monkeys at 10 to 49 days posttreatment, with recurrent zoster in one treated monkey. SVV DNA was detected in the lung from two of five monkeys, in bronchial lymph nodes from one of the five monkeys, and in ganglia from at least two dermatomes in three of five monkeys. Immunofluorescence analysis of skin rash, lungs, lymph nodes, and ganglia revealed SVV ORF63 protein at the following sites: sweat glands in skin; type II cells in lung alveoli, macrophages, and dendritic cells in lymph nodes; and the neuronal cytoplasm of ganglia. Detection of SVV antigen in multiple tissues upon CD4 T cell depletion and virus reactivation suggests a critical role for CD4 T cell immunity in controlling varicella virus latency.IMPORTANCE Reactivation of latent VZV in humans can result in serious neurological complications. VZV-specific cell-mediated immunity is critical for the maintenance of latency. Similar to VZV in humans, SVV causes varicella in monkeys, establishes latency in ganglia, and reactivates to produce shingles. Here, we show that depletion of CD4 T cells in rhesus macaques results in SVV reactivation, with virus antigens found in zoster rash and SVV DNA and antigens found in lungs, lymph nodes, and ganglia. These results suggest the critical role of CD4 T cell immunity in controlling varicella virus latency.
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Sorel O, Messaoudi I. Varicella Virus-Host Interactions During Latency and Reactivation: Lessons From Simian Varicella Virus. Front Microbiol 2018; 9:3170. [PMID: 30619226 PMCID: PMC6308120 DOI: 10.3389/fmicb.2018.03170] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/07/2018] [Indexed: 01/11/2023] Open
Abstract
Varicella zoster virus (VZV) is a neurotropic alphaherpesvirus and the causative agent of varicella (chickenpox) in humans. Following primary infection, VZV establishes latency in the sensory ganglia and can reactivate to cause herpes zoster, more commonly known as shingles, which causes significant morbidity, and on rare occasions mortality, in the elderly. Because VZV infection is highly restricted to humans, the development of a reliable animal model has been challenging, and our understanding of VZV pathogenesis remains incomplete. As an alternative, infection of rhesus macaques with the homologous simian varicella virus (SVV) recapitulates the hallmarks of VZV infection and thus constitutes a robust animal model to provide critical insights into VZV pathogenesis and the host antiviral response. In this model, SVV infection results in the development of varicella during primary infection, generation of an adaptive immune response, establishment of latency in the sensory ganglia, and viral reactivation upon immune suppression. In this review, we discuss our current knowledge about host and viral factors involved in the establishment of SVV latency and reactivation as well as the important role played by T cells in SVV pathogenesis and antiviral immunity.
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Affiliation(s)
- Océane Sorel
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
| | - Ilhem Messaoudi
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
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Ouwendijk WJD, van Veen S, Mahalingam R, Verjans GMGM. Simian varicella virus inhibits the interferon gamma signalling pathway. J Gen Virol 2017; 98:2582-2588. [PMID: 28901902 PMCID: PMC5845570 DOI: 10.1099/jgv.0.000925] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/22/2017] [Indexed: 01/08/2023] Open
Abstract
The alphaherpesvirus simian varicella virus (SVV) causes varicella and zoster in nonhuman primates. Herpesviruses evolved elaborate mechanisms to escape host immunity, but the immune evasion strategies employed by SVV remain ill-defined. We analysed whether SVV impairs the cellular response to key antiviral cytokine interferon-γ (IFNγ). SVV infection inhibited the expression of IFNγ-induced genes like C-X-C motif chemokine 10 and interferon regulatory factor 1. Phosphorylation and nuclear translocation of the signal transducer and activator of transcription 1 (STAT1) was blocked in SVV-infected cells, which did not involve cellular and viral phosphatases. SVV infection did not downregulate IFNγ receptor α and β chain expression on the cell surface. Instead, STAT1, Janus tyrosine kinases 1 (JAK1) and JAK2 protein levels were significantly decreased in SVV-infected cells. Collectively, these results demonstrate that SVV targets three proteins in the IFNγ signal transduction pathway to escape the antiviral effects of IFNγ.
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Affiliation(s)
| | - Suzanne van Veen
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Ravi Mahalingam
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Georges M. G. M. Verjans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
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Abstract
Varicella zoster virus (VZV) is a ubiquitous, exclusively human alphaherpesvirus. Primary infection usually results in varicella (chickenpox), after which VZV becomes latent in ganglionic neurons along the entire neuraxis. As VZV-specific cell-mediated immunity declines in elderly and immunocompromised individuals, VZV reactivates and causes herpes zoster (shingles), frequently complicated by postherpetic neuralgia. VZV reactivation also produces multiple serious neurological and ocular diseases, such as cranial nerve palsies, meningoencephalitis, myelopathy, and VZV vasculopathy, including giant cell arteritis, with or without associated rash. Herein, we review the clinical, laboratory, imaging, and pathological features of neurological complications of VZV reactivation as well as diagnostic tests to verify VZV infection of the nervous system. Updates on the physical state of VZV DNA and viral gene expression in latently infected ganglia, neuronal, and primate models to study varicella pathogenesis and immunity are presented along with innovations in the immunization of elderly individuals to prevent VZV reactivation.
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Affiliation(s)
- Don Gilden
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, 12700, USA; Department of Immunology & Microbiology, University of Colorado School of Medicine, Aurora, Colorado, 12800, USA
| | - Maria Nagel
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, 12700, USA
| | - Randall Cohrs
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, 12700, USA; Department of Immunology & Microbiology, University of Colorado School of Medicine, Aurora, Colorado, 12800, USA
| | - Ravi Mahalingam
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, 12700, USA
| | - Nicholas Baird
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, 12700, USA
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Interferon Gamma Prolongs Survival of Varicella-Zoster Virus-Infected Human Neurons In Vitro. J Virol 2015; 89:7425-7. [PMID: 25948748 DOI: 10.1128/jvi.00594-15] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/28/2015] [Indexed: 11/20/2022] Open
Abstract
Infection of human neurons in vitro with varicella-zoster virus (VZV) at a low multiplicity of infection does not result in a cytopathic effect (CPE) within 14 days postinfection (dpi), despite production of infectious virus. We showed that by 28 dpi a CPE ultimately developed in infected neurons and that interferon gamma inhibited not only the CPE but also VZV DNA accumulation, transcription, and virus production, thereby prolonging the life of VZV-infected neurons.
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