What is new on HHV 6,7,8 infections?, Henry J.C. de Vries
Embed Size (px)
Transcript of What is new on HHV 6,7,8 infections?, Henry J.C. de Vries
- 1. Henry J.C. de Vries Dermatology Academic Medical Centre University of AmsterdamThe Netherlands
- Until 1986, 5 herpes viruses
- new human herpes viruses (HHV)
- HHV-6 and -7
- both members of theRoseolovirusgenus of the -herpesviruses.
- T-lymphotropic but can infect other cell types
- primary infections are associated withroseola infantum(a.k.a.exanthem subitumor 6th disease)
- HHV lifetime infection
- HHV-7 and HHV-6 reactivation associated with pityriasis rosea (Drago, 1997 and Yasukawa, 1999)
- Innocent bystander?
- Multiple agents?
- Drug Reaction Eosinophilia and Systemic side effect Syndrome (DRESS)
- HHV 6 reactivation (Deschamps 2001)
- exanthema,hepatitis, colitis lymphadenopathy, eosinophilia, fever
- EBV and amoxicillin associated drug rash in mononucleosis infectiosa
C Goldberg, UCSD and Ascend Media Healthcare 5. Ascend Media Healthcare 6.
- Highest prevalence in over 50 year olds
- Self limiting
- Normally one episode
- Association with HCV (Mokni 1991)
- The epidemiological association is not strong (Imhof, 1997)
7. Electron microscopy oflichen planus lesional skin lichen planus lichen planus lichen planus reference herpes virus 8.
- Objective :
- To find candidate herpes viruses associated with lichen planus.
- Methods :
- Lichen planus patients (pathologically confirmed, n=18)
- Intra patient comparison of skin biopsies:
- lesional vs. non-lesional
- before vs. after remission
- Inter patient comparison of skin biopsies:
- psoriasis patients (lesional, n=11, and non-lesional, n=3)
- normal skin (redundant after breast reduction, n=4)
- DNA of HSV1 and 2, VZV, CMV, EBV (commercial PCR )
- DNA of HHV 6, -7 and -8 (in house nested PCR)
9. * p=0,06, # p=0,05 p values calculated with McNemar test
- All samples were free of HSV-1, HSV-2, VZV, CMV and HHV-8 DNA.
- EBV DNA was detected in 2/15 lichen planus lesional samples.
HHV7 HHV6 Lichen planus lesional non-lesional PBMC 11/18 (61%)* ,# 1/11(9%)* 5/13(38%) 0/18 (0%) 0/11 (0%) 2/13 (15%) Psoriasis lesional non-lesional 2/11(18%) # 0/3(0%) 1/11 (9%) 0/3(0%) Normal skin 0/4(0%) 0/4(0%) 10.
- Immunohistochemical detection viral protein (HHV-7)
- tegument protein pp85 (Advanced Biotechnologies)
- positive cells/mm 2
- (non) lesional lichen planus, psoriasis, normal skin
lesional skin non-lesional skin de Vries et al. Br J Dermatol 154: 361, 2006 11. psoriasislesional lichen planus normal skinnon lesional lichen planusde Vries et al. Br J Dermatol 154: 361, 2006- 12. lesional skin non-lesional skin CD123 positive cells(red), endothelial cells (blue) de Vries et al. Br J Dermatol 154: 361, 2006 13. HHV-7/BDCA-2 double staining HHV-7/CD-3 double staining lesional lichen planus lesional lichen planus de Vries et al. Arch Dermatol Res 299: 213, 2007 14. before treatment after remission de Vries et al. Arch Dermatol Res 299: 213, 2007 15.
- herpes virus like particles reside in lesional lichen planus skin
- not HSV1, HSV2, CMV, VZV, HHV6 or HHV8 DNA
- HHV-7 replicates in lesional lichen planus,
- not in non-lesional lichen planus, psoriatic or normal skin
- HHV-7 replicatesin plasmacytoid dendritic cells
- HHV-7 replication in lichen planus stops after remission
- HHV-7 (subclinical) primo infection during childhood
- HHV-7 reactivation in adult life
- replication in basal keratinocytes/dermal lymphocytes
- presentation (plasmacytoid) dendritic cells
- inflammatory T lymphocytic response
- destruction of the basal layer
Skin Immune System, Bos JD ed. 3rd edition, 2005 17.
- viral innocent bystander
- Kochs postulates
- g eographic variation in viral distribution
- differences in laboratory protocols
- virus-virus interactions
- association with skin diseases?
- or candidates in search of a disease?
- Jan van Marle
- Jan Weel
- Fokla Zorgdrager and Marion Cornelissen
- molecular biology
- Daisy Picavet and Marcel Teunissen