Recent studies utilizing an ex vivo mouse model of herpes simplex virus (HSV) reactivation have led to the hypothesis that, under physiologic conditions inducing viral reactivation, the immune cells within the infected ganglion block the viral replication cycle and maintain the viral genome in a latent state. One prediction from the ex vivo study is that reactivation in ganglia in vivo would be inhibited at early times postinoculation, when the numbers of inflammatory cells in the ganglia are greatest. To distinguish between an effect of the immune infiltrates on (i) infectious virus produced and/or recovered in the ganglion and (ii) the number of neurons undergoing lytic transcriptional activity (reactivating), an assay to quantify the number of neurons expressing lytic viral protein in ganglia in vivo was developed. Infectious virus and HSV protein-positive neurons were quantified from days 9 through 240 postinoculation in latently infected trigeminal ganglia before and at 22 h after hyperthermic-stress-induced reactivation. Significant increases in the amount of virus and the number of positive neurons were detected poststress in ganglia at all times examined. Unexpectedly, the greatest levels of reactivation occurred at the times examined most proximal to inoculation. Acyclovir was utilized to stop residual acute-phase virus production, and this treatment did not reduce the level of reactivation on day 14.
Thus, the virus measured after induction was a product of reactivation. These data indicate that, in contrast to observations in the ex vivo model, immune cells in the ganglia during the resolution of acute infection do not inhibit reactivation of the virus in ganglia in vivo.Herpes simplex virus (HSV) invades the host nervous system during infection at the body surface (7,38,40,44; for a review, see reference 8). In the nervous system, the virus proceeds through the lytic replicative cycle in some neurons, whereas in others lytic-phase transcription is either not initiated or aborted and the viral genome enters a transcriptionally repressed or latent state (see reference 31 for a recent review). These latently infected neurons serve as a lifelong reservoir of viral genetic information within the host. Periodically, in response to stressful stimuli, there is reentry into lytic-phase transcription and infectious virus is produced. This virus is amplified and shed at the surface, either asymptomatically or in association with lesions.In animal models and in humans, HSV reactivation occurs despite an activated competent immune response. Although several potential strategies for immunoevasion by HSV have been identified (discussed in references 1, 19, and 24), which, if any, of these strategies are important for recurrent disease and transmission remains unclear. There is evidence in animal models that augmenting the immune response by specific immunotherapeutic strategies can reduce peripheral disease associated with reactivation (13,14,28,30,47,48). Theoretically, immunotherapeutic strategies could function ...