Prevalence of Herpesvirus DNA in Corneal Transplant Recipients

Bu, Julia Bing; Grabitz, Stephanie D.; Pfeiffer, Norbert; Wasielica‐Poslednik, Joanna

doi:10.3390/jcm12010289

Cited by 6 publications

(9 citation statements)

References 32 publications

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“…Graft failure after Penetrating Keratoplasty is common in eyes with HSK, hence it is important that HSV-1 or VZV PCR testing is done on all explanted cornea[ 456 ]. High-dose antivirals with prolonged tapering steroid doses prior to performing mushroom keratoplasty on eyes with herpetic vascularized corneal scars resulted in lower rates of graft failure and immunologic rejection in a longitudinal study conducted by Yu et al [ 457 ].…”

Section: Surgical Interventions For Herpes Simplex Keratitis: Corneal...mentioning

confidence: 99%

Herpes simplex keratitis: A brief clinical overview

Musa,

Enaholo,

Aluyi-Osa

et al. 2024

World J Virol

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The aim of our minireview is to provide a brief overview of the diagnosis, clinical aspects, treatment options, management, and current literature available regarding herpes simplex keratitis (HSK). This type of corneal viral infection is caused by the herpes simplex virus (HSV), which can affect several tissues, including the cornea. One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea. After the initial infection, the HSV can establish a latent infection in the trigeminal ganglion, a nerve cluster near the eye. The virus may remain dormant for extended periods. Periodic reactivation of the virus can occur, leading to recurrent episodes of HSK. Factors triggering reactivation include stress, illness, immunosuppression, or trauma. Recurrent episodes can manifest in different clinical patterns, ranging from mild epithelial involvement to more severe stromal or endothelial disease. The severity and frequency of recurrences vary among individuals. Severe cases of HSK, especially those involving the stroma and leading to scarring, can result in vision impairment or even blindness in extreme cases. The cornea's clarity is crucial for good vision, and scarring can compromise this, potentially leading to visual impairment. The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization. Antiviral medications, such as oral Acyclovir or topical Ganciclovir, may be prescribed for prophylaxis. The immune response to the virus can contribute to corneal damage. Inflammation, caused by the body's attempt to control the infection, may inadvertently harm the corneal tissues. Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation. In summary, the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.

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Section: Surgical Interventions For Herpes Simplex Keratitis: Corneal...mentioning

confidence: 99%

Herpes simplex keratitis: A brief clinical overview

Musa,

Enaholo,

Aluyi-Osa

et al. 2024

World J Virol

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“…All CIS biomaterials gelled in situ within 5 min, forming firm gels after 20 min. Two days after surgery, all operated eyes were infected with 10 4 plaque-forming units (PFU) of HSV-1 McKrae virus to mimic peri-surgical viral reactivation 22 . All animals showed photophobia, conjunctivitis, periorbital edema, and tearing, the clinical signs of inflammation resulting from perforation and HSV-1 infection (Fig.…”

Section: In Vivo Rabbit Hsv-1-perforation Model and Wound Healingmentioning

confidence: 99%

“…While corneal transplantation is the current treatment for damaged corneas, even with immunosuppression, surgery or any trauma to the eye can reactivate HSV-1. Peri-surgical reactivation resulting in graft failure for over 18% of corneal transplantations is therefore challenging 22 . Anti-viral drugs (e.g., Acyclovir or Ganciclovir) efficaciously clear viruses from the body by preventing their replication but are inefficient prophylactics with known adverse side effects 23 .…”

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confidence: 99%

“…LL37 is cytotoxic, but its smaller fragments with anti-viral activity are more biocompatible. GF17, a 17 amino acid LL37 fragment containing the crucial antimicrobial region (residues [17][18][19][20][21][22][23][24][25][26][27][28][29] and extra amino acids, N-L-V, has demonstrated anti-viral activity against the human immunodeficiency virus (HIV) 26 . GF17 also showed direct anti-viral activity against Zika, another enveloped neurotropic virus, by disruption of the viral envelope; GF17 can also act through the interferon pathway by upregulating type I interferon 27 .…”

mentioning

confidence: 99%

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Inflammation-suppressing cornea-in-a-syringe with anti-viral GF19 peptide promotes regeneration in HSV-1 infected rabbit corneas

Simoliunas,

Ruedas-Torres,

Jiménez-Gómez

et al. 2024

npj Regen Med

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Pathophysiologic inflammation, e.g., from HSV-1 viral infection, can cause tissue destruction resulting in ulceration, perforation, and ultimately blindness. We developed an injectable Cornea-in-a-Syringe (CIS) sealant-filler to treat damaged corneas. CIS comprises linear carboxylated polymers of inflammation-suppressing 2-methacryloyloxyethyl phosphorylcholine, regeneration-promoting collagen-like peptide, and adhesive collagen-citrate glue. We also incorporated GF19, a modified anti-viral host defense peptide that blocked HSV-1 activity in vitro when released from silica nanoparticles (SiNP-GF19). CIS alone suppressed inflammation when tested in a surgically perforated and HSV-1-infected rabbit corneal model, allowing tissue and nerve regeneration. However, at six months post-operation, only regenerated neocorneas previously treated with CIS with SiNP-GF19 had structural and functional features approaching those of normal healthy corneas and were HSV-1 virus-free. We showed that composite injectable biomaterials can be designed to allow regeneration by modulating inflammation and blocking viral activity in an infected tissue. Future iterations could be optimized for clinical application.

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“…4 However, these manifestations are similar to those of viral endothelial keratitis, an infection of the corneal endothelium caused by a viral pathogen. [5][6][7][8][9][10][11] The involved viral agents include herpes simplex virus (HSV) 1, HSV 2, varicella-zoster virus (VZV), cytomegalovirus (CMV) and, possibly, Epstein-Barr virus (EBV). [5][6][7][8][9][10][11][12] Viral endothelial keratitis can also occur in patients who have undergone keratoplasty, [6][7][8][11][12][13][14][15][16] also leading to persistent corneal inflammation, corneal edema, possibly inflammation in the anterior chamber and graft failure.…”

mentioning

confidence: 99%

PCR testing for herpesviruses in aqueous humor samples from patients with and without clinical corneal endothelial graft rejection

Abu Dail,

Daas,

Flockerzi

et al. 2024

Journal of Medical Virology

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To compare prevalence of positive PCR tests for herpesviruses between patients with and without a history of clinical corneal endothelial allograft rejection (AGR). Retrospective cross‐sectional study with two‐group comparison. A total of 307 aqueous humor (AH) samples from 235 Patients and 244 eyes who underwent penetrating keratoplasty or Descemet membrane endothelial keratoplasty or had a diagnostic AH aspiration due to clinical AGR between 2019 and 2023 were tested for DNA of herpes simplex virus (HSV), varicella‐zoster virus (VZV), cytomegalovirus (CMV), and Epstein‐Barr virus (EBV). PCR test results were compared between the two groups (with/without AGR). Another sub‐analysis examined the results of patients without a history of herpetic keratitis. A total of 8% of eyes with clinical AGR (9/108) had a positive PCR result for one of the herpesviruses (HSV:3, CMV:3, EBV:2, VZV:1). All patients in the group without AGR had negative PCR results for all previous viruses (0/136). The difference was statistically significant (p < 0.001). The sub‐analysis of eyes without a history of herpetic keratitis also revealed significantly more positive herpes PCR results (7/87) in eyes with AGR than in eyes without AGR (0/42, p = 0.005). Clinical AGR after keratoplasty shows a significant correlation to viral replication. Herpetic infection and AGR could occur simultaneously and act synergistically. Timely differentiation between active herpetic infection and/or AGR is pivotal for proper treatment and graft preservation.

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Prevalence of Herpesvirus DNA in Corneal Transplant Recipients

Cited by 6 publications

References 32 publications

Herpes simplex keratitis: A brief clinical overview

Herpes simplex keratitis: A brief clinical overview

Inflammation-suppressing cornea-in-a-syringe with anti-viral GF19 peptide promotes regeneration in HSV-1 infected rabbit corneas

PCR testing for herpesviruses in aqueous humor samples from patients with and without clinical corneal endothelial graft rejection

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