水痘-带状疱疹病毒潜伏感染的研究现状

水痘-带状疱疹病毒潜伏感染后的再活化可引起带状疱疹,其潜伏感染与再活化的机制还不完全清楚。本文综述了该病毒潜伏感染和再活化的实验模型新进展,并概述了从这些实验模型中所获得的最新知识。     

水痘一带状疱疹病毒研究进展

水痘－带状疱疹病毒（ＶＺＶ）是致人类疾病的重要疱疹病毒之一。为预防水痘与带状疱疹,日本研制成功水痘减毒活疫苗,并出口到世界一些国家。本文就ＶＺＶ的分子生物学特性、病毒的致病机制与临床特征、病毒感染的体液免疫与细胞免疫,水痘疫苗株病毒与疫苗等的研究情况作一简要综述。     

带状疱疹疫苗的研究进展及应用

带状疱疹是由潜伏在体内的水痘-带状疱疹病毒再激活引起的一种急性皮肤病,主要发生于老年人和免疫力低下人群。带状疱疹是一种自限性疾病,临床主要表现为带状、成片的皮疹,而其后遗神经痛为该病中最复杂且最常见的一种不良并发症。带状疱疹的发病机制较为复杂,推测与机体的特异性T细胞免疫水平降低有关。本文就带状疱疹与T细胞之间的关系,最新疫苗研究进展进行综述,为疫苗的研发及带状疱疹的预防提供参考。     

人巨细胞病毒潜伏感染机制的研究进展

人巨细胞病毒可通过原发感染或者潜伏感染再激活而广泛传播.基于对人巨细胞病毒AD169株和Towne株基因测序的完成,以及人巨细胞病毒的基因功能研究及其相关动物模型如小鼠模型、猪模型、恒河猴模型等的研究,人巨细胞病毒感染的潜伏机制研究取得了一定进展.本文从人巨细胞病毒的感染机制、免疫应答和免疫逃避三方面对人巨细胞病毒潜伏感染机制的研究现状进行简要综述.     

以BAC为基础的水痘-带状疱疹病毒的感染性克隆技术及其应用

水痘-带状疱疹病毒（VZV）属于疱疹病毒科α亚科,其原发感染为水痘,潜伏再度激活则引起带状疱疹。目前对其基因功能和疫苗的减毒机制尚不十分清楚。细菌人工染色(BAC)是一种新的用于大分子DNA克隆的载体系统,它具有容量大、遗传稳定、操作简单等优点。将VZV全基因组克隆至BAC系统构建成VZV的感染性克隆,并利用现代基因修饰技术可极大促进对该病毒的研究。就近年来以BAC为基础VZV感染性克隆技术的建立和应用做一综述。     

水痘-带状疱疹病毒疫苗的评价与研究进展

水痘-带状疱疹病毒(VZV)属疱疹病毒α亚科,即人类疱疹病毒3型,为双链DNA病毒。原发感染可引起具有高度传染性的全球流行性疾病——水痘;潜伏病毒的再激活感染可引发典型的疼痛性皮肤病——带状疱疹及不典型的内脏器官感染。日本和美国分别自1987年和1995年开始实行给全体儿童预防接种水痘减毒活疫苗(vOka)后,两国儿童的水痘发病率和病死率显著降低。但VZV疫苗的不良反应,包括二次传播和突破感染等时有发生,因此有必要研发更为有效、安全的新型疫苗。本文就VZV相关疫苗的有效性、安全性及其新型疫苗的研究进展进行综述。     

水痘-带状疱疹病毒感染中性粒细胞引发自噬的作用研究

前期研究发现,细胞自噬能为人体快速提供能量,消灭掉入侵的细菌和病毒,同时对人体抗衰老有非常重要的意义;另外中性粒细胞具有免疫防御功能,并且水痘-带状疱疹病毒能引起细胞自噬,那么探讨水痘-带状疱疹病毒感染导致中性粒细胞自噬的作用机制显得尤为重要。本研究发现水痘-带状疱疹病毒感染诱导中性粒细胞发生自噬性死亡,有助于进一步研究自噬抑制剂在抗病毒感染中的应用。其中,在人神经视网膜上皮细胞(ARPE-19)中可观察到水痘-带状疱疹病毒粒子,同时可检测到带状疱疹病毒的糖蛋白E;另外,HL-60细胞经维A酸(ATRA)刺激后诱导分化成成熟的中性粒细胞,细胞核呈分叶状,RT-PCR检测细胞的CD14/CD11b表达量升高7倍,髓过氧化物酶MPO升高1.6倍;病毒感染后细胞活力随感染剂量增加逐渐降低,Beclin-1和LC3b Ⅱ的表达与病毒的量及感染时间呈现正相关,自噬抑制剂3-ma能有效抑制由病毒感染导致的中性粒细胞自噬的发生。     

带状疱疹后神经痛的射频治疗

带状疱疹后神经痛(postherpetic neuralgia,PHN)是带状疱疹的严重并发症,发病机制复杂,是一种难治性、顽固性的神经病理性疼痛,常见于老年患者或免疫功能低下的患者,严重影响日常生活。带状疱疹后神经痛的治疗方法包括药物治疗、神经刺激法、射频疗法以及神经阻滞法等。其中,射频疗法作为一项临床较为常用的治疗手段,已在各种慢性疼痛的治疗上取得了有效应用。本文将综合国内外近期的相关研究,对射频的机制、射频的分类、射频治疗PHN的疗效和治疗靶点的选择进行总结。     

带状疱疹并发神经痛患者危险因素的相关研究

目的:探讨带状疱疹患者并发神经痛患者的相关危险因素.方法:采用回顾性分析的方法,对我院100例合并带状疱疹后神经痛(PHN)患者年龄、性别、患病后初诊日、急性期发作频度、急性期疼痛程度、疱疹部位、疼痛的性质等进行统计,并进行多因素Logistic相关分析.结果:不同年龄、性别、及疼痛评分间PHN患病率间差异有统计学意义(P＜0.05或P＜0.01).而患病后初诊日及急性期发作频度、不同疱疹部位的PHN患病率、不同疼痛性质的PHN患病率差异无统计学意义(P＞0.05).Logistic相关分析显示,年龄、性别、不同疼痛程度与PHN患病率存在一定的相关性,相关P值分别为0.003、0.002、0.005,均P＜0.01.结论:年龄、性别、不同疼痛程度可影响PHN的发生.针对急性期PHN患者,应早发现,早治疗,提高患者生活质量.     

水痘-带状疱疹病毒的基因分型与分子进化

水痘-带状疱疹病毒(Varicella-zoster virus,VZV)又称人类疱疹病毒3型,属疱疹病毒科,与单纯疱疹病毒HSV-1、HSV-2一起归入α亚科。人类是其唯一的自然宿主,对其普遍易感。VZV引起的原发感染表现为水痘,并在宿主的感觉神经节内潜伏,再激活时可引起带状疱疹。近年来VZV分子流行病学的研究涉及流行病学、病毒学、生物信息学等相关领域,通过监测、研究VZV的基因变异,区分疫苗株或野生株引起的感染,探讨世界范围内各VZV病毒株的系统发育关系和各遗传支之间的分子进化史。现将近年来有关VZV不同的地理分布和遗传支进化的研究状况综述如下。     

Varicella zoster virus vaccines: potential complications and possible improvements

Varicella zoster virus(VZV) is the causative agent of varicella(chicken pox) and herpes zoster(shingles). After primary infection, the virus remains latent in sensory ganglia, and reactivates upon weakening of the cellular immune system due to various conditions, erupting from sensory neurons and infecting the corresponding skin tissue. The current varicella vaccine(v-Oka) is highly attenuated in the skin, yet retains its neurovirulence and may reactivate and damage sensory neurons. The reactivation is sometimes associated with postherpetic neuralgia(PHN), a severe pain along the affected sensory nerves that can linger for years, even after the herpetic rash resolves. In addition to the older population that develops a secondary infection resulting in herpes zoster, childhood breakthrough herpes zoster affects a small population of vaccinated children. There is a great need for a neuro-attenuated vaccine that would prevent not only the varicella manifestation, but, more importantly, any establishment of latency, and therefore herpes zoster. The development of a genetically-defined live-attenuated VZV vaccine that prevents neuronal and latent infection, in addition to primary varicella, is imperative for eventual eradication of VZV, and, if fully understood, has vast implications for many related herpesviruses and other viruses with similar pathogenic mechanisms.     

Neuronal Subtype and Satellite Cell Tropism Are Determinants of Varicella-Zoster Virus Virulence in Human Dorsal Root Ganglia Xenografts In Vivo

Varicella zoster virus (VZV), a human alphaherpesvirus, causes varicella during primary infection. VZV reactivation from neuronal latency may cause herpes zoster, post herpetic neuralgia (PHN) and other neurologic syndromes. To investigate VZV neuropathogenesis, we developed a model using human dorsal root ganglia (DRG) xenografts in immunodeficient (SCID) mice. The SCID DRG model provides an opportunity to examine characteristics of VZV infection that occur in the context of the specialized architecture of DRG, in which nerve cell bodies are ensheathed by satellite glial cells (SGC) which support neuronal homeostasis. We hypothesized that VZV exhibits neuron-subtype specific tropism and that VZV tropism for SGC contributes to VZV-related ganglionopathy. Based on quantitative analyses of viral and cell protein expression in DRG tissue sections, we demonstrated that, whereas DRG neurons had an immature neuronal phenotype prior to implantation, subtype heterogeneity was observed within 20 weeks and SGC retained the capacity to maintain neuronal homeostasis longterm. Profiling VZV protein expression in DRG neurons showed that VZV enters peripherin+ nociceptive and RT97+ mechanoreceptive neurons by both axonal transport and contiguous spread from SGC, but replication in RT97+ neurons is blocked. Restriction occurs even when the SGC surrounding the neuronal cell body were infected and after entry and ORF61 expression, but before IE62 or IE63 protein expression. Notably, although contiguous VZV spread with loss of SGC support would be predicted to affect survival of both nociceptive and mechanoreceptive neurons, RT97+ neurons showed selective loss relative to peripherin+ neurons at later times in DRG infection. Profiling cell factors that were upregulated in VZV-infected DRG indicated that VZV infection induced marked pro-inflammatory responses, as well as proteins of the interferon pathway and neuroprotective responses. These neuropathologic changes observed in sensory ganglia infected with VZV may help to explain the neurologic sequelae often associated with zoster and PHN.     

Varicella-zoster virus early infection but not complete replication is required for the induction of chronic hypersensitivity in rat models of postherpetic neuralgia

Herpes zoster, the result of varicella-zoster virus (VZV) reactivation, is frequently complicated by difficult-to-treat chronic pain states termed postherpetic neuralgia (PHN). While there are no animal models of VZV-induced pain following viral reactivation, subcutaneous VZV inoculation of the rat causes long-term nocifensive behaviors indicative of mechanical and thermal hypersensitivity. Previous studies using UV-inactivated VZV in the rat model suggest viral gene expression is required for the development of pain behaviors. However, it remains unclear if complete infection processes are needed for VZV to induce hypersensitivity in this host. To further assess how gene expression and replication contribute, we developed and characterized three replication-conditional VZV using a protein degron system to achieve drug-dependent stability of essential viral proteins. Each virus was then assessed for induction of hypersensitivity in rats under replication permissive and nonpermissive conditions. VZV with a degron fused to ORF9p, a late structural protein that is required for virion assembly, induced nocifensive behaviors under both replication permissive and nonpermissive conditions, indicating that complete VZV replication is dispensable for the induction of hypersensitivity. This conclusion was confirmed by showing that a genetic deletion recombinant VZV lacking DNA packaging protein ORF54p still induced prolonged hypersensitivities in the rat. In contrast, VZV with a degron fused to the essential IE4 or IE63 proteins, which are involved in early gene regulation of expression, induced nocifensive behaviors only under replication permissive conditions, indicating importance of early gene expression events for induction of hypersensitivity. These data establish that while early viral gene expression is required for the development of nocifensive behaviors in the rat, complete replication is dispensable. We postulate this model reflects events leading to clinical PHN, in which a population of ganglionic neurons become abortively infected with VZV during reactivation and survive, but host signaling becomes altered in order to transmit ongoing pain.     

Genome-Wide Analysis of T Cell Responses during Acute and Latent Simian Varicella Virus Infections in Rhesus Macaques

Varicella zoster virus (VZV) is the etiological agent of varicella (chickenpox) and herpes zoster (HZ [shingles]). Clinical observations suggest that VZV-specific T cell immunity plays a more critical role than humoral immunity in the prevention of VZV reactivation and development of herpes zoster. Although numerous studies have characterized T cell responses directed against select VZV open reading frames (ORFs), a comprehensive analysis of the T cell response to the entire VZV genome has not yet been conducted. We have recently shown that intrabronchial inoculation of young rhesus macaques with simian varicella virus (SVV), a homolog of VZV, recapitulates the hallmarks of acute and latent VZV infection in humans. In this study, we characterized the specificity of T cell responses during acute and latent SVV infection. Animals generated a robust and broad T cell response directed against both structural and nonstructural viral proteins during acute infection in bronchoalveolar lavage (BAL) fluid and peripheral blood. During latency, T cell responses were detected only in the BAL fluid and were lower and more restricted than those observed during acute infection. Interestingly, we identified a small set of ORFs that were immunogenic during both acute and latent infection in the BAL fluid. Given the close genome relatedness of SVV and VZV, our studies highlight immunogenic ORFs that may be further investigated as potential components of novel VZV vaccines that specifically boost T cell immunity.     

Varicella zoster virus encephalitis during treatment with anti-tumor necrosis factor-alpha agent in a psoriatic arthritis patient

The introduction of targeted immunotherapies has greatly improved the therapeutic options of several inflammatory diseases such as psoriatic arthritis. However treatment-related opportunistic infections and viral reactivations may still occur. We describe a case of varicella zoster virus (VZV) encephalitis due to the reactivation of latent VZV infection during a long therapy with the anti-tumor necrosis factor-alpha (TNF-alpha) drug Adalimumab. The low incidence of VZV encephalitis in patients treated with biological agents does not justify VZV serological screening in these subjects, but careful monitoring of the patients is recommended to recognize early signs and symptoms of herpes zoster to start prompt antiviral therapy to prevent associated complications.     

Culture media optimization for Chinese hamster ovary cell growth and expression of recombinant varicella-zoster virus glycoprotein E

Herpes zoster (HZ) is caused by reactivation of varicella-zoster virus (VZV) latent in the sensory ganglia and causes severe pain, often leading to postherpetic neuralgia (PHN). Two prophylactic vaccines against HZ are currently licensed for human use, a live attenuated vaccine and a subunit vaccine containing recombinant VZV glycoprotein E (gE) as antigen. The latter has superior protective efficacy against HZ and PHN. During HZ subunit vaccine development, we obtained Chinese hamster ovary (CHO) cell clones expressing VZV gE. This study was performed to optimize culture media conditions for CHO cell growth and gE production. Using a high-throughput culture system, three CHO cell clones were cultured in microtiter plates containing 24 different basal media, and three basal media were selected. The clone with the highest gE expression was fed-batch cultured in each of the three basal media in combination with 13 different feed media. A pair of media, BalanCD CHO Growth A and EX-CELL Advanced CHO Feed 1, with the highest productivity was selected for gE production. Scale-up fed-batch cultures of the selected clone cultured in a wave bag bioreactor containing the optimized media yielded 2440 mg gE protein/L culture, a 11.5-fold increase compared to original culture conditions (batch culture in CD OptiCHO medium). The optimized media condition is used to produce VZV gE antigen for an HZ subunit vaccine, which is under phase I clinical trial. This study would provide valuable insights on culture media optimization for CHO cells expressing a recombinant vaccine antigen.