Herpesvirus hominis type 2 meningoencephalitis following renal transplantation

Linnemann, Calvin C.; First, M. Roy; Alvira, Mariano M.; Alexander, Jason; Schiff, Gilbert M.

doi:10.1016/0002-9343(76)90149-2

Cited by 40 publications

(9 citation statements)

References 18 publications

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“…Such a clinical course, although uncommon, is most often seen in immunosuppressed patients e.g. transplant patients, neonates or pregnant women [114][115][116]. In pregnancy, primary infection with HSV without previous seroconversion at the time of delivery seems to be the main risk factor for infection of the newborn [109,117].…”

Section: Epidemiologymentioning

confidence: 99%

Macrophages and cytokines in the early defence against herpes simplex virus

Ellermann-Eriksen

2005

Virol J

113

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Herpes simplex virus (HSV) type 1 and 2 are old viruses, with a history of evolution shared with humans. Thus, it is generally well-adapted viruses, infecting many of us without doing much harm, and with the capacity to hide in our neurons for life. In rare situations, however, the primary infection becomes generalized or involves the brain.Normally, the primary HSV infection is asymptomatic, and a crucial element in the early restriction of virus replication and thus avoidance of symptoms from the infection is the concerted action of different arms of the innate immune response. An early and light struggle inhibiting some HSV replication will spare the host from the real war against huge amounts of virus later in infection. As far as such a war will jeopardize the life of the host, it will be in both interests, including the virus, to settle the conflict amicably. Some important weapons of the unspecific defence and the early strikes and beginning battle during the first days of a HSV infection are discussed in this review.Generally, macrophages are orchestrating a multitude of anti-herpetic actions during the first hours of the attack. In a first wave of responses, cytokines, primarily type I interferons (IFN) and tumour necrosis factor are produced and exert a direct antiviral effect and activate the macrophages themselves. In the next wave, interleukin (IL)-12 together with the above and other cytokines induce production of IFN-γ in mainly NK cells. Many positive feed-back mechanisms and synergistic interactions intensify these systems and give rise to heavy antiviral weapons such as reactive oxygen species and nitric oxide. This results in the generation of an alliance against the viral enemy.However, these heavy weapons have to be controlled to avoid too much harm to the host. By IL-4 and others, these reactions are hampered, but they are still allowed in foci of HSV replication, thus focusing the activity to only relevant sites. So, no hero does it alone. Rather, an alliance of cytokines, macrophages and other cells seems to play a central role. Implications of this for future treatment modalities are shortly considered.

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Section: Epidemiologymentioning

confidence: 99%

Macrophages and cytokines in the early defence against herpes simplex virus

Ellermann-Eriksen

2005

Virol J

113

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“…However, whether the pathogenesis in HSV-1 encephalitis in man is influenced by the neurovirulence of HSV-1 strains is still not known. Herpes simplex virus type 2 (HSV-2) is a rare cause of encephalitis in man (2), and in most cases reported the patients have been immunocompromised (14,15). Instead, HSV-2 may sometimes induce a serous meningitis when HSV-2 infection spreads from the genital tract to the CNS (16,17).…”

Section: Neurovirulence Of Herpes Simplex Virus Types 1 and 2 Isolatementioning

confidence: 99%

Neurovirulence of herpes simplex virus types 1 and 2 isolates in diseases of the central nervous system

Bergström

Alestig²,

Svennerholm

et al. 1990

Eur. J. Clin. Microbiol. Infect. Dis.

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Herpes simplex virus (HSV) isolates derived from the central nervous system of ten patients with HSV-1-induced encephalitis, one patient with multiple sclerosis, and 14 patients with HSV-2-induced meningitis were investigated for neurovirulence by assaying the LD50 after nose and intracerebral (i.c.) inoculation of mice. HSV-1 encephalitis strains were significantly more virulent after nose inoculation (i.e. neuroinvasive) when compared with HSV-1 isolates from patients with oral lesions only, whereas HSV-2 meningitis strains were significantly more virulent after i.c. inoculation when compared with HSV-2 isolates from patients with genital lesions only. No correlation between high neurovirulence (defined as low LD50 for both routes of infection) and replication in cell cultures of neuronal and non-neuronal cell lines was found, but the weakly neurovirulent HSV-1 strain isolated from a patient with multiple sclerosis gave low replication yields. After nose inoculation, a highly neuroinvasive HSV-1 laboratory reference strain replicated to high titers in nose tissue, the trigeminal ganglia and brainstem, while a strain with low neuroinvasiveness but high i.c. virulence replicated less well in the brainstem. Neuroinvasiveness of the virus strain might be one factor of relevance in the pathogenesis of HSV-1 encephalitis in man.

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“…In adults, in contrast with HSV -1, neurological disease is usually not severe (Craig and Nahmias, 1973). Occasional cases with a relatively mild encephalitic illness in immunocompetent (Morrison et at., 1974; and immunoincompetent (Sutton et at., 1974;Linneman et at., 1976;Young et at., 1976) adults have been described. In those who survived nonneurological pathology, there were no (Morrison et at., 1974; or relatively mild (Young et at., 1976) sequelae, the latter consisting of "transient episodes of dizziness and moderately severe memory loss."…”

Section: Herpes Simplex Virusmentioning

confidence: 99%

“…In those who survived nonneurological pathology, there were no (Morrison et at., 1974; or relatively mild (Young et at., 1976) sequelae, the latter consisting of "transient episodes of dizziness and moderately severe memory loss." This residual amnesia and the pathological material that is available (Sutton et at., 1974;Linneman et at., 1976; suggests that, like HSV-l, HSV-2 may primarily involve temporal lobe structures.…”

Section: Herpes Simplex Virusmentioning

confidence: 99%