Analysis of Herpes Virus Group (DNA) from Cerebrospinal Fluid in Vogt-Koyanagi-Harada Disease

Hotta, Yoshihiro; Hayakawa, Mutsuko; Kawano, Hiroyuki; Sakuma, Hitoshi; Momose, T; Ohkoshi, Kishiko; Usuba, Sumio; Ogasa, Utako; Kawaguchi, Ryuji; Hikiji, Kazumasa; Kanai, Atsushi

doi:10.3109/09273949609079639

Cited by 7 publications

(9 citation statements)

References 10 publications

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“…Patients 1 and 2 were co-workers; patients 3 and 4 were friends; patients 5 and 6 were neighbors. findings demonstrated by Hotta et al [3] and us. We cannot comment on the findings of viral antibodies in VKH syndrome from other groups [1,8], because we have analyzed only one patient, and the serological findings in each pair of patients were not complete.…”

Section: Discussionsupporting

confidence: 63%

“…It is likely that the factor is only weakly infectious. Hotta et al [3] reported that no DNA fragment corresponding to the DNA sequence of the herpes virus group, including herpes simplex virus, varicella-zoster virus, cytomegalovirus, and Epstein-Barr virus, was detected in the cerebrospinal fluid from patients with VKH syndrome. Patient 2 in our present study had negative antibody titers in the serum against herpes virus group and influenza virus.…”

Section: Discussionmentioning

confidence: 98%

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Almost simultaneous onset of Vogt–Koyanagi–Harada syndrome in co-workers, friends, and neighbors

Hayasaka

2004

Graefe's Arch Clin Exp Ophthalmol

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 98%

Almost simultaneous onset of Vogt–Koyanagi–Harada syndrome in co-workers, friends, and neighbors

Hayasaka

2004

Graefe's Arch Clin Exp Ophthalmol

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“…Virus infections, including Hepatitis B (39), Hepatitis C virus under interferon therapy (40), cytomegalovirus (CMV) and other herpesviruses (38,41) have all been associated with VKH disease. Efforts to corroborate the latter findings failed so far and the ensemble of such studies cautions that an association does not necessarily represent a cause (42). In this respect, the type of body fluid analyzed (vitreous vs. cerebrospinal fluid) may be critical to detect the presence of viruses, as it is known that even in single patients different strains of viruses may be compartmentalized at specific locations (37,43).…”

Section: Vkh Disease Is a Prototypic Example Of Autoimmune Diseasementioning

confidence: 97%

New Perspectives on the Immunopathogenesis and Treatment of Uveitis Associated With Vogt-Koyanagi-Harada Disease

et al. 2021

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Uveitis associated with Vogt-Koyanagi-Harada (VKH) disease is a bilateral, chronic, granulomatous autoimmune disease associated with vitiligo, poliosis, alopecia, and meningeal and auditory manifestations. The disease affects pigmented races with a predisposing genetic background. Evidence has been provided that the clinical manifestations are caused by a T-lymphocyte-mediated autoimmune response directed against antigens associated with melanocytes in the target organs. Alongside of T lymphocytes, autoreactive B cells play a central role in the development and propagation of several autoimmune diseases. The potential role of B lymphocytes in the pathogenesis of granulomatous uveitis associated with VKH disease is exemplified within several studies. The early initial-onset acute uveitic phase typically exhibits granulomatous choroiditis with secondary exudative retinal detachment and optic disc hyperemia and swelling, subsequently involving the anterior segment if not adequately treated. The disease eventually progresses to chronic recurrent granulomatous anterior uveitis with progressive posterior segment depigmentation resulting in “sunset glow fundus” appearance and chorioretinal atrophy if not properly controlled. Chronically evolving disease is more refractory to treatment and, consequently, vision-threatening complications have been recognized to occur in the chronic recurrent phase of the disease. Conventional treatment with early high-dose systemic corticosteroids is not sufficient to prevent chronic evolution. Addition of immunomodulatory therapy with mycophenolate mofetil as first-line therapy combined with systemic corticosteroids in patients with acute initial-onset disease prevents progression to chronic evolution, late complications, vitiligo, and poliosis. Furthermore, patients under such combined therapy were able to discontinue treatment without relapse of inflammation. These findings suggest that there is a therapeutic window of opportunity for highly successful treatment during the early initial-onset acute uveitic phases, likely because the underlying disease process is not fully matured. It is hypothesized that early and aggressive immunosuppressive therapy will prevent remnant epitope generation in the initiation of the autoimmune process, the so-called primary response. B cell depleting therapy with the anti-CD20 monoclonal antibody rituximab is effective in patients with refractory chronic recurrent granulomatous uveitis. The good response after rituximab therapy reinforces the idea of an important role of B cells in the pathogenesis or progression of chronic recurrent uveitis associated with VKH disease.

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“…Although the definitive mechanisms involved need further detailed research, the widely accepted hypothesis suggests that viruses may play a triggering role in the development of this disease. The presence of meningeal manifestations such as fever, headache, and the detection of EBV DNA in the cerebrospinal fluid 7 or vitreous 8 from patients with VKH disease, provided supporting evidence for the triggering role of viral infection in the pathogenesis. However, conflicting findings from other studies and the ubiquity of EBV in humans cast doubt on the exclusive role of this virus in the disease.…”

Section: Discussionmentioning

confidence: 87%

Vogt–Koyanagi–Harada disease after SARS‐CoV‐2 infection: Case report and literature review

Zou,

Zhang,

Chen

et al. 2024

Immunity Inflam & Disease

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BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is responsible for coronavirus disease 2019 (COVID‐19), a complex and multifaceted illness. COVID‐19 is associated with various ocular manifestations including conjunctivitis, retinal vein occlusion and optic neuritis. However, the case of Vogt‐Koyanagi‐Harada (VKH) disease associated with SARS‐CoV‐2 is infrequent, and the specific association is still unclear.Case PresentationIn the present study, a 35‐year‐old female patient without any significant medical history presented with 1 week of bilateral blurred vision, occurring 2 weeks after a clinical course of COVID‐19. Upon examination, both eyes exhibited bullous serous retinal detachments. She was diagnosed with incomplete VKH disease. Early diagnosis and treatment of VKH disease are essential for the visual prognosis of this aggressive disease. In this particular patient, ocular inflammatory signs and visual acuity improved via corticosteroid therapy. It is worth noting that the occurrence of VKH disease associated with SARS‐CoV‐2 is uncommon, and the specific connection between the two remains unknown. We review and summarize the clinical characteristics of VKH disease following SARS‐CoV‐2 infection, and discuss the potential mechanisms that may explain this phenomenon, based on similar studies previously reported.ConclusionDespite the unclear causality, it is important for ophthalmologists and physicians to be recognizant of the possible association between VKH disease and COVID‐19. SARS‐CoV‐2 may play a potential immunological triggering role in VKH disease. However, further in‐depth research is necessary to investigate the clinical and epidemiological features, as well as the underlying mechanisms of this association.

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Analysis of Herpes Virus Group (DNA) from Cerebrospinal Fluid in Vogt-Koyanagi-Harada Disease

Cited by 7 publications

References 10 publications

Almost simultaneous onset of Vogt–Koyanagi–Harada syndrome in co-workers, friends, and neighbors

Almost simultaneous onset of Vogt–Koyanagi–Harada syndrome in co-workers, friends, and neighbors

New Perspectives on the Immunopathogenesis and Treatment of Uveitis Associated With Vogt-Koyanagi-Harada Disease

Vogt–Koyanagi–Harada disease after SARS‐CoV‐2 infection: Case report and literature review

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