HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

A relationship between varicella-zoster virus-specific delayed hypersensitivity and varicella-zoster virus-induced anterior uveitis.

AbstractBACKGROUND:
We recently reported that acute retinal necrosis in humans develops in a setting where delayed hypersensitivity (DH) to the varicella-zoster virus (VZV) antigen was absent, implying that virus-specific DH mitigates against acute retinal necrosis.
OBJECTIVE:
To determine whether a similar correlation exists for patients with anterior uveitis caused by VZV.
DESIGN:
Using VZV and purified protein derivative (PPD) antigens to evaluate DH, we skin tested patients with acute, VZV-induced anterior uveitis (herpes zoster ophthalmicus [ZO-AU]) (n = 12), those with uveitis caused by VZV in the absence of dermatitis (zoster sine herpete [ZSH-AU]) (n = 3), and age-matched patients whose ophthalmic herpes zoster was unassociated with uveitis as controls (n = 7). Varicella-zoster virus-induced anterior uveitis was diagnosed by polymerase chain reaction methods and serum antibody titration. Serum samples were collected and analyzed for anti-VZV antibody titers. Anterior uveitis activity was assessed clinically. Delayed hypersensitivity skin tests were repeated in patients with zoster sine herpete 3 months after onset, when ocular recovery had taken place.
RESULTS:
All patients with VZV-induced skin disease alone (control group) displayed intense DH when tested with VZV and PPD antigens. By contrast, only 4 (33%) of 12 patients with ZO-AU had a positive DH to VZV, whereas 11 (91.6%) of these patients displayed positive PPD skin reactions. The clinical intensity of anterior uveitis correlated negatively with VZV DH responses (P<.05). Serum anti-VZV and anti-herpes simplex virus antibody titers were comparable in DH-positive VZV cases and in DH-negative patients with uveitis. Patients with uveitis and ZSH-AU also displayed absent VZV-specific DH, although their PPD responses were normal.
MAIN OUTCOME MEASURES:
Varicella-zoster virus-specific DH, PPD-specific DH, VZV-specific antibody titration, and intraocular pressure in patients with ZO-AU.
CONCLUSIONS:
Absence (or loss) of DH reactivity to VZV antigens seems to be a concomitant feature of VZV uveitis of high intensity, implying that virus-specific DH may interfere with the emergence of VZV-induced anterior uveitis, as it does for acute retinal necrosis.
CLINICAL RELEVANCE:
In a clinical setting, absence of virus-specific DH to anterior uveitis caused by VZV may not only reveal a possible pathogenic mechanism, but a negative DH response may prove useful in diagnosing ZSH-AU in the acute stage.
AuthorsTakeshi Kezuka, Jun-Ichi Sakai, Hiroshi Minoda, Masaru Takeuchi, Hiroshi Keino, J Wayne Streilein, Masahiko Usui
JournalArchives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 120 Issue 9 Pg. 1183-8 (Sep 2002) ISSN: 0003-9950 [Print] United States
PMID12215092 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Antibodies, Viral
  • Antigens, Viral
Topics
  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Viral (blood)
  • Antigens, Viral (immunology)
  • Aqueous Humor (immunology)
  • Female
  • Herpes Zoster Ophthalmicus (immunology)
  • Herpesvirus 3, Human (immunology)
  • Humans
  • Hypersensitivity, Delayed (immunology)
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Skin Tests
  • Uveitis, Anterior (immunology, virology)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: