Genital infection with type 2 herpesvirus hominis

Fc Receptor-Like Structures on in Vitro-Cultured Human Ovarian Tumor Cells

Four ovarian cystadenocarcinomas cultured in vitro were tested by a radioisotopic method with sera from cancer patients or healthy donors to search for a possible specific antitumor immune response of patients bearing ovarian tumors. However, the ovarian tumor cells were found to bear on their membrane surface structures able to bind immunoglobulins from any tested serum, thus making impossible the detection of a hypothetical specific antitumor antibody. These structures were demonstrated to bind the Fc portion of the Ig and were therefore similar to the Fc receptors described on various normal cells, particularly of the immunocompetent compartment.

Perinatal infections: prevention of long-term sequelae

All the congenital infections and most of the natal and postnatally acquired infections of man are associated with disease of the central nervous system and long-term sequelae in the survivors. The most important perinatal pathogens in this regard are group B streptococcus, Escherichia coli and other coliform bacteria, cytomegalovirus, Toxoplasma gondii and herpes simplex virus. All these agents are the subject of active and, in some instances, promising investigation. The strategies for prevention are discussed here. Recent clinical trails of two cytomegalovirus vaccines (Towne 125 and AD 169) are considered in detail.

Immunopathogenesis of herpetic ocular disease

Herpes viruses are among the most prevalent of human virus infections. Productive replication of herpes simplex virus (HSV) is usually confined to mucocutaneous sites by the rapid deployment of innate and adaptive immune responses. Infection invariably results in establishment of latency and in some cases results in periodic reactivation of the virus. This article focuses primarily on ocular herpes with emphasis on the pathogenesis of stromal keratitis. Herpetic stromal keratitis (HSK) is an immunopathologic disease, which indeed is one of the leading causes of blindness in the Western world. The mechanisms by which HSV infection in human beings results in HSK is not well understood but studies using the mouse model has clearly indicated the role of T-cell-mediated immune response as the cause for ocular damage. We, in this article, attempt to provide an interpretive synthesis on different aspects of HSK pathogenesis, reviewing what is currently known and speculating on mysterious issues, such as, whether HSK represents a virus-induced autoimmune disease. We also discuss aspects of remission of the disease.

Oral cancer

In the U.S. oral cancer accounts for 2.1% of all cancers and 1% of cancer deaths. Two to three times as many males as females are affected. Blacks have more intra-oral cancer than whites, and their incidence and mortality rates have increased in recent years. The etiologic process very likely involves several factors. The major etiologic agents are tobacco (all types) and alcoholic beverages. Herpes simplex virus, human papilloma virus, and Candida have been implicated. Host factors include poor state of dentition, nutritional aberrations, cirrhosis of liver, lichen planus, and immunologic impairmant. Cellular changes include amplification of some oncogenes, alterations in antigen expression, production of gamma-glutamyl transpeptidase, and disturbance of keratin and involucrin production. Experimentally, cancer is readily produced on the hamster cheek pouch and rat oral mucosa. Unlike oral cancer in humans, most experimental lesions are exophytic, and they rarely metastasize.

Monoclonal antibodies to HSV-infection-related antigens cross-react with tumor cell lines and tumor tissue sections

The purpose of our study was to evaluate a possible association between herpes simplex virus (HSV) and various tumors, including oral squamous cell carcinoma (SCC). To this end, we tested the binding of appropriate monoclonal antibodies to a panel of cell lines and tumor sections. The 25 monoclonal antibodies were reactive with HSV-infected cells but not with uninfected cells. Of these antibodies, three bound to several SCC cell lines and to one non-SCC cell line (K562). One of these three antibodies also reacted with sections of oral SCC tumors, the adjacent mucosa, and normal esophageal epithelium. In contrast, it did not bind to sections of kidney, spleen, esophageal smooth muscle, and skin. To evaluate whether the observed antibody binding could reflect an actual infection by HSV, hybridization experiments between K562 DNA and HSV DNA were performed. HSV DNA sequences were found in K562 DNA at a ratio of 0.1 genome-equivalents/cell. Although these data do not characterize the nature of the relationship, they clearly confirm the postulated association of HSV with some tumors (in particular oral SCC).

Oncogenic potential of sexually transmitted viruses with special reference to oral cancer

Recent changes in social mores have been accompanied by a noted increase in the frequency of sexually transmitted diseases. Viruses that have been identified as causative agents for a large proportion of these diseases have also been associated with various malignant states. Concomitantly, the number of cases of oral cancer (considered to occur usually around or after the fifth decade of life) reportedly has been increasing among young adults. The oncogenic potential of several sexually transmitted viruses (HSV, HPV, CMV, and LAV/HTLV III) and their possible role in the development of malignant conditions, in particular oral cancer, are discussed in this review.

Varicella-zoster virus-induced transformation of mammalian cells in vitro

A mixture of varicella-zoster virus-infected human embryonic lung fibroblasts and hamster embryo cells produced foci of morphologically transformed cells after several weeks of incubation. These transformed cells exhibited virus-specific antigens by immunofluorescence and developed surface Fc receptors. They induced aggressive fibrosarcomas when injected back into inbred hamsters. Cells derived from hamster tumor tissue exhibited similar properties. The tumor-bearing hamsters develop antibodies specific for varicella-zoster virus (VZV) antigens. Cell lines derived from both the original transformants and explanted hamster tumor tissue have varying growth properties. All maintain indefinite growth. All eventually lose varicella-zoster virus-specific immunofluorescence. None retain VZV-specific DNA sequences as determined by dot blot and Southern blot hybridization using radiolabeled whole VZV DNA and cloned VZV DNA fragments as a probe. A few transformed and tumor cell lines frozen relatively soon after isolation and stored in liquid nitrogen were also thawed, replicated to mass culture, and analyzed for VZV-specific DNA sequences. Hybridization with radiolabeled whole VZV DNA initially suggested that some of these cell lines did contain virus-specific DNA sequences. However, hybridization with cloned VZV DNA fragments radiolabeled in vitro and representing greater than 95% of the virus genome was negative. Karyotyping of these "positive" transformed cells indicated that they are of human and not hamster origin. The positive hybridization with whole VZV DNA therefore most likely represented contamination of the probe by host DNA sequences. The cells that survived freezing then were predominantly transformants of human origin. Attempts to repeat the transformation of hamster embryo and baby hamster kidney cells with laboratory-passaged VZV strains have been unsuccessful. Similarly, we have been unable to transform cells with whole VZV DNA or cloned VZV DNA fragments, although whole VZV DNA is demonstrably infectious. Apparently, transformation of cells by the varicella-zoster virus is a very rare event and one that may require a recent clinical isolate. Fresh clinical isolates of varicella-zoster virus are seemingly able to transform mammalian cells in vitro. The transformed cells have malignant properties and are capable of indefinite growth. Although VZV gene function can be detected early after transformation, there is no evidence that a VZV-specific protein product is required. Transformation of mammalian cells by varicella-zoster virus apparently occurs through a "hit-and-run" mechanism.

Serial urinary and cervical cytological studies in women undergoing renal transplantation

Cervical dysplasia has been reported to occur more frequently in female renal transplant patients. The incidence of pre-existing dysplasia is unknown. A prospective study of several urinary and cervical cytological screenings of 50 transplant patients was undertaken. Two of 38 patients studied before transplantation had pre-existing dysplasia. No new cases of dysplasia were found during the study (mean surveillance 3 years). A high incidence of urinary viral infection was found, but a relation to cervical dysplasia was not noted. The frequency of cervical abnormalities previously reported might have been due to different immunosuppressive regimes or to failure to exclude pre-existing disease. Despite the low incidence of abnormalities the use of cytological screening provided valuable reassurance to our patients, and its use is recommended.

Tubular structures in the cervix of mice experimentally infected with herpes simplex virus type 2

Experimental infection of the C3H/N mouse genital tract was demonstrated after intravaginal inoculation with herpes simplex virus type 2 (HSV-2). About 75% of the infected animals died by Day 7, and 75% of the surviving animals had severe vaginitis or neurological signs on Day 7. Titers of the virus recovered from vaginal secretions of infected animals reached a maximum on Day 2 and gradually decreased until Day 7. On the other hand, under the electron microscope, virus particles and tubular structures could be found in the nuclei of infected cells of the cervix in the 1st, 2nd and 4th days after infection. All cases in which virus particles could be found in the nuclei of infected cells were also positive for tubular structures and vice versa. These observations indicate that in situ diagnosis of HSV-2 infection can be made in the mouse model. The same method would be applicable for the diagnosis of human HSV-2 infection.

Genital herpesvirus infection in women attending a venereal diseases clinic

Routine cervical viral cultures (and cultures from lesions if present) were performed on 2630 female patients attending a venereal diseases clinic over a period of four years. Of these patients 96 (3.7%) had genital herpetic infection; of these 23 (24%) were asymptomatic. The association of herpesvirus with other genital infections is considered, but no increase in the incidence of Neisseria gonorrhoeae, Trichomonas vaginalis, and genital warts was found; there was an increased incidence of Candida albicans. A significantly higher percentage of the patients with herpesvirus took oral contraceptives. The findings are discussed and compared with previous reports.

Persistence in herpes simplex virus infections

Diseases of man caused by the virus of herpes simplex fall into two broad categories. The primary disease occurs only once in any individual's life and is caused by transmission of virus from an already infected human. Thereafter, the individual may be subject to recurrent herpetic disease, the manifestations of which are different from the primary disease. Recurrent disease varies in severity from trivial, to incapacitating and frankly lethal (as in diseases resulting from the virus's neurotropic and oncogenic properties). The source of the virus in recurrent herpetic disease has never been conclusively resolved, but is almost certainly endogenous to the patient. Theories, case reports and experiments exist to show that endogenous virus may, in periods of clinical quiescence, be latent (or persistent) at the site of the recurrent lesions itself, or more remotely in nerve tissues related to the site of recurrence.

Complement-dependent cytotoxic antibodies in the course of cervical carcinoma

Complement-dependent cytotoxic antibodies to three cervical carcinoma cell lines (Me-180, SW-732 and HeLa) and to Herpes simplex virus type 2 (HSV-2)-infected cells were determined in a long-term study of women with cervical carcinoma. Cytolysis of surface antigens differed significantly between the cervical carcinoma cell lines and HSV-2. Regression of the tumor during treatment was accompanied by decreasing cytolysis in the cervical carcinoma lines, while tumor bearers and patients who became severely ill had high or increasing cytotoxic antibodies, The opposite was noted for the antibody response to HSV-2 infected cells: patients with less advanced cancer had significantly higher cytolytic activity than those who were severely ill or had advanced cancer; long-term survivors demonstrated high, stable lysis of HSV-2 infected cells. As a control of the cervical carcinoma cell lines, cytolytic activity was tested also on a lung carcinoma cell line, A-549. No significant differences were found between the patients with cervical cancer and the control women. Tumor bearers and patients treated for advanced cervical cancer showed a slight but non-significant increase in cytolytic activity on the A-549 line.

Leukocyte transforming agent (Epstein-Barr virus) in newborn infants and older individuals

The lymphocyte transforming agent, associated with Epstein-Barr virus, was sought in the oropharynx and other clinical sites of 443 individuals in the following groups: premature and term neonates; infants with congenital malformations or with suspected TORCH syndrome; children with various illnesses; pregnant and postpartum women; healthy adults; and patients with infectious mononucleosis. Evidence of intrauterine infection was found in one newborn infant and LTA was demonstrated in a 16-day-old infant who developed transient hepatosplenomegaly. LTA was not detected in 96 other newborn infants and 57 infants with various anomalies or illnesses; nor was it found in the cervix of 125 pregnant or postpartum women. LTA was demonstrated in varying frequency in ill children, healthy adults, and those with infectious mononucleosis. It is suggested that the clinicoepidemiologic patterns of EBV infection in newborn infants and children will best be established by prospective studies.

Type 2 herpes simplex virus infections

The problems related to herpes simplex virus (HSV) type 2 infections include: (1) the clinical diseases produced primarily at urogenital sites, but also in extragenital areas, and the frequent recurrences of such infections; (2) the severity of the diseases produced in immunocompromised hosts and in newborns, including a varity of ocular manifestations; and (3) the possible role of the virus in human cancers. The usually sexually transmitted mode of spread of this virus has increased current medical concern with this virus. Although laboratory diagnosis of HSV-2 infection is currently available, we still lack effective preventive or therapeutic means for most clinical forms of the infection. However, the great progress made over the past decade in the molecular, virological, immunological and clinicoepidemiological aspects of HSV are providing the necessary tools to attain this goal.

Overview of tumor immunology in gynecologic oncology

Highlights of recent advances in the field of gynecologic tumor immunology are presented in an effort to demonstrate that at least some cancers of the female genitalia evoke an immune response that can be quantitated in the laboratory. The overview will discuss investigations into the various in vitro assays of both humoral and cell-mediated immunity. The concept of clinical testing of delayed hypersensitivity reactions as it relates to the clinical outcome of the patients with malignancy is presented. Along this line, preliminary studies at our own institution are reviewed in an attempt to establish a rough correlation between patients with a healthy outcome and patients with a strong immunologic index as manifested by skin testing. A progress report on the isolation of tumor-associated antigens in cancer of the cervix and ovary is presented. The prevalence of carcinoembryonic antigen in the plasma of patients with gynecological malignancy is then discussed. Finally, approaches to immunotherapy are discussed, with a suggestion as to future directions.

Viruses and cancer of the lower genital tract

The importance of viruses as oncogenic agents in animals is well established. Recent work suggests that viruses may also be etiologically related to some human cancers. Herpes simplex virus type 2 (HSV-2) and the genital wart virus are prime suspects in carcinomas involving the female lower genital tract. In particular, a close association has been found between HSV-2 infection and cervical neoplasia in cytohistopathologic and seroepidemiologic studies. Preliminary results of prospective studies show further that women with genital herpetic infection are at increased risk of developing cervical neoplasia. Additional studies are also in progress on animal models, including subhuman primates, and efforts continue in the attempt to confirm the presence of viral genetic material or its expression in human cervical cancer cells. The possibility that human wart viruses have an oncogenic potential is suggested by clinicopathologic and electron microscopic observations. Further research is needed to ascertain the precise role of viruses in genital cancer.

Sexually transmissible diseases

There is a widespread recrudescence of venereal disease. The possible reasons for this are discussed. Each disease is then considered from the viewpoints of clinical course, diagnosis, and treatment. Treatment failures are discussed in detail, immunity is covered, and recommendations for the future conclude the presentation.

Antibodies to herpesvirus type 2 in carcinoma of the cervix uteri in Ibadan, Nigeria

Carcinoma of the cervix is by far the commonest gynecologic malignancy seen in Ibadan, Nigeria. In a study aimed at investigating the role of herpesvirus type 2 (HT-2) in its pathogenesis, antibodies to HT-2 were detected by immunofluorescence above a titer of 640 in 31 (70.5 percent) of 44 women with invasive carcinoma of the cervix as compared with five (11.1 percent) of 45 healthy women of the same age group. Analysis according to histologic types of growths showed that 31 (83.8 percent) of 37 cases of squamous-cell carcinoma had antibodies above a titer of 640, whereas none of the other types (one adenocarcinoma and six undifferentiated carcinoma of the cervix) had antibodies above this titer. It was concluded that the results of the present study support the hypothesis of an association between HT-2 and carcinoma of the cervix, most especially the squamous-cell type.

Herpes genitalis and circumcision

214 patients with genital herpes infection proven by culture and a control group of 410 other patients were included in a retrospective study devised to investigate the relationship of circumcision to genital HSV infection in the male. The percentage of patients circumicised in the control group was significantly larger than in the herpes group (P less than 0-01). The was not found to be the case for other sexually-transmitted diseases apart from monilial balanitis. There was also a significant difference in contraceptive methods in the two groups, barrier methods being used less ofter than other methods in the herpes group and the reverse in the control group. It is concluded that there is a positive relationship between absence of circumicision and genital HSV infection, but that a prospective study should be undertaken to confirm these results.

Herpes genitalis in guinea-pigs. I. Kinetic study in infection with Herpesvirus hominis type 2

The kinetics of virus replication after vaginal infection of guinea-pigs with HVH 2/Angelotti were studied in relation to the appearance of local and general symptoms. Most virus was isolated from the genital tract 24-48 hours post infection. Virus was first isolated from the spinal cord 48-72 hours post infection. Penetration into the brain only occurred occasionally, and later. Under the experimental conditions employed, no virus was found in the blood, spleen, kidneys, adrenals or inguinal lymph nodes. The local symptoms (typical genital herpes) and the general symptoms (paralysis and death) started after maximum virus replication had been reached and seemed to be a consequence of neural, rather than of haematogenic or lymphogenic spread.

Genital herpesvirus hominis type 2 infection: an experimental model in cebus monkeys

Genital infection with herpesvirus hominis type 2 was established in ten female cebus monkeys. Clinical and laboratory findings in the cebus mimic closely those observed in humans, thus providing an experimental model which may be used in the study of the possible role of genital herpetic infection in cervical cancer and in perinatal and chronic neurological diseases.