Anti-herpes IgG and IgG Subclass Antibodies in Bell's Palsy

Abstract

To ascertain if there is an association between Bell's palsy and infection by viruses of the herpes group, 78 patients and 59 controls were investigated. The specific antiviral IgG subclass pattern in serum against cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1) and varicella zoster virus (VZV) was analysed using an enzyme-linked immunosorbent assay (ELISA) combined with monoclonal antibodies directed against the four subclasses of human IgG. Additional ELISA assays of IgG and IgM antibodies were also used. The mean titres of IgG antibodies against HSV-1 were higher in the acute and convalescent stages compared with controls. The frequency of values greater than 0.2 for all subclasses was raised in the patients, but not significantly so. The mean values for the subclasses were alike in patients and controls. The mean titres of IgG antibodies against CMV and VZV were similar throughout the palsy and also in controls. In the patients, the pattern of IgG subclasses was different from the controls, but not statistically so. The patients and controls were not seropositive for IgM against CMV and VZV. Four patients in the acute phase, 4 in the convalescent phase and 3 controls were positive for IgM against HSV-1. While the subclass pattern of IgG antibodies against HSV-1 is not diagnostic of reactivation of the virus, the raised IgG antibodies may suggest reactivation of a disease process and/or a superadded infection.

Revisión sistemática sobre la prevalencia de la serología infecciosa en la parálisis facial periférica

“…Del total de pacientes estudiados en nuestro trabajo, (628), 76 pacientes presentaron serología positiva (12,10%), lo que supondría que uno de cada diez pacientes con parálisis facial periférica tendría serología vírica positiva en el momento del diagnóstico para los gérmenes estudiados. En cuanto a la distribución por sexos, no hay una diferencia significativa, siendo el 48,95% mujeres y el 51,05% hombres de los 521 pacientes que se pudo determinar el sexo ya que hubo dos estudios que no aportaron dicha variable [42][43][44]. Ante estos resultados, nos preguntamos los siguientes interrogantes: ¿Está relacionada la serología vírica positiva con la aparición de la parálisis facial periférica?, ¿Hay algún germen que sea el principal causante?…”

“…Diagrama con la selección de artículosLos estudios analizados[7,[37][38][39][40][41][42][43][44] se muestran en la Tabla 1. Un total de 628 pacientes con parálisis facial periférica fueron sometidos a estudio; de esos pacientes, se pudo determinar el sexo de 521, ya que hubo dos estudios de los que no se pudo obtener la distribución por sexos[42][43][44]. De esos pacientes, 266 son hombres (51,05%), mientras que 255 son mujeres (48,95%).…”

IgG index in acute idiopathic peripheral facial palsy

“…Herpes group viruses have long been accused for AIPFP (6,12). Though no direct evidence could be obtained, raised HSV-1 antibodies in patients' sera might imply a viral infection and those cases presenting with only facial palsy should be forms frustes (1,13,(17)(18)(19)(20). Determining antibodies in CSF against various viruses may help specific diagnosis (8,14).…”

“…Though many different etiologies may lead variations in immunologic responses, such results are generally thought to reflect a virus-induced demyelination. However, direct or indirect abnormal findings in blood serology does not necessarily point to viral cause for AIPFP (9,17). Intrathecal immunoglobulin synthesis is regarded a strong evidence for an immunologic abnormality within CNS.…”

Association between cytomegalovirus infection and neurological disorders: A systematic review

“…The pathway of neurotropic viruses such as herpes is thought to be through the oral mucosa and their extension might be through a retrograde route in the sensory components of the facial nerve. 142 Diabetes, a recent upper respiratory tract infection, and pregnancy are considered risk factors for BP. [143][144][145] Steroids have demonstrated efficacy in enhancing recovery in cases of BP, whereas antivirals (such as acyclovir) have not exhibited similar effectiveness.…”