Ganglia of monkeys with reactivated simian varicella virus (SVV) contained more CD8 than CD4 T cells around neurons. The abundance of CD8 T cells was greater less than 2 months after reactivation than that at later times and correlated with that of CXCL10 RNA but not with those of SVV protein or open reading frame 61 (ORF61) antisense RNA. CXCL10 RNA colocalized with T-cell clusters. After SVV reactivation, transient T-cell infiltration, possibly mediated by CXCL10, parallels varicella zoster virus (VZV) reactivation in humans.
Varicella zoster virus (VZV) causes varicella (chickenpox) and becomes latent in ganglia, producing zoster (shingles) upon reactivation. Because VZV infects only humans, studies of virus latency and reactivation have been restricted to autopsy tissues. Analyses of ganglia obtained after death from individuals with recent zoster revealed lymphocytic infiltration (1, 2), possibly mediated by antigenic stimuli or chemokines, including CXCL10 (3). VZV-specific T cells have not been identified in human ganglia latently infected with VZV (4, 5). Simian varicella virus (SVV) infection in monkeys closely resembles VZV infection in humans (6). Earlier, we demonstrated reactivation of latent SVV in immunosuppressed monkeys (7). Herein, we extended those studies by examining ganglia containing reactivated SVV for infiltrating T cells. Four cynomolgus macaques (GP02, -04, -06, and -07) were naturally infected with SVV (7). Ten to 14 days later, all monkeys developed varicella ( Fig. 1). At 4 months postinfection, monkeys were immunosuppressed with tacrolimus, resulting in a 34% reduction in mean white blood cell counts at 6 weeks posttreatment (7). Monkeys GP02, -06, and -07 developed zoster at 23, 3, and 10 days, respectively, after starting tacrolimus. Monkeys were euthanized at monthly intervals post-tacrolimus treatment (Fig. 1). Detection of SVV glycoproteins in lungs and multiple ganglia in monkey GP04, which did not develop skin rash, confirmed subclinical reactivation (7).Immunohistochemical analysis of consecutive ganglion tissue sections from these monkeys and from an uninfected control monkey (CTRL) for CD3, CD4 and CD8 expression showed that SVV reactivation was associated with T-cell infiltration, mostly CD8 T cells, in ganglia along the entire neuraxis (Fig. 2). T cells were dispersed throughout ganglia. T-cell clusters, of both CD4 and CD8 T cells, were occasionally detected adjacent to neurons ( Fig. 2A). Rare granzyme B ϩ (grB) cells, not restricted to T-cell clusters, were observed in ganglia from all monkeys ( Fig. 2A), suggesting that ganglion-infiltrating T cells did not encounter their cognate antigen (8). Ganglion-infiltrating CD8 T cells in zoster patients are also predominantly grB negative (9).We analyzed 11 to 19 ganglia from each monkey to determine the number of T cells per neuron. The number of ganglionic neurons counted in sections from each anatomical level of the neuraxis ranged from 657 to 3,991 (Table 1). Ganglia obtained from monkey GP02, euthanized at 4 days post-...