1 / 18

What is new on HHV 6, 7, 8 infections?

What is new on HHV 6, 7, 8 infections?. Henry J.C. de Vries Dermatology Academic Medical Centre University of Amsterdam The Netherlands. HHV 6 and 7 Acute/primary infection. Until 1986, 5 herpes viruses new human herpes viruses (HHV) HHV-6 and -7

alton
Download Presentation

What is new on HHV 6, 7, 8 infections?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. What is new on HHV 6, 7, 8 infections? Henry J.C. de Vries Dermatology Academic Medical Centre University of Amsterdam The Netherlands

  2. HHV 6 and 7Acute/primary infection • Until 1986, 5 herpes viruses • new human herpes viruses (HHV) • HHV-6 and -7 • both members of the Roseolovirus genus of the β-herpesviruses. • T-lymphotropic but can infect other cell types • primary infections are associated with roseola infantum (a.k.a. exanthem subitum or 6th disease)

  3. HHV 6 and 7Reactivation/endogenous infection • HHV lifetime infection • ubiquitous • reactivation • HHV-7 and HHV-6 reactivation associated with pityriasis rosea (Drago, 1997 and Yasukawa, 1999) • Debated • Innocent bystander? • Multiple agents?

  4. DRESS syndrome C Goldberg, UCSD and Ascend Media Healthcare • 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

  5. Drugs that can cause DRESS Ascend Media Healthcare

  6. Is lichen planus caused by a viral infection? • 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 of lichen planus lesional skin lichen planus lichen planus reference herpes virus lichen planus

  8. Study outline • 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. Herpes DNA analysis • 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. * p=0,06, # p=0,05 p values calculated with McNemar test

  10. HHV-7 protein in lesional lichen planus lesional skin non-lesional skin de Vries et al. Br J Dermatol 154: 361, 2006 Immunohistochemical detection viral protein (HHV-7) • tegument protein pp85 (Advanced Biotechnologies) • positive cells/mm2 • (non) lesional lichen planus, psoriasis, normal skin

  11. HHV-7 protein positive cells psoriasis lesional lichen planus normal skin non lesional lichen planus - de Vries et al. Br J Dermatol 154: 361, 2006

  12. plasmacytoiddendritic cells (CD123+) associated with viral infection in lesional lichen planus 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 replicates in plasmacytoid dendritic (BDCA-2+) cells lesional lichen planus lesional lichen planus HHV-7/BDCA-2 double staining HHV-7/CD-3 double staining de Vries et al. Arch Dermatol Res 299: 213, 2007

  14. HHV-7 DNA and protein positive cellsbefore and after lichen planus remission before treatment after remission de Vries et al. Arch Dermatol Res 299: 213, 2007

  15. Conclusions • 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 replicates in plasmacytoid dendritic cells • HHV-7 replication in lichen planus stops after remission

  16. HHV-7 and lichen planus hypothesis Skin Immune System, Bos JD ed. 3rd edition, 2005 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

  17. How to prove a causative viral association? viral “innocent bystander” Koch’s postulates geographic variation in viral distribution differences in laboratory protocols virus-virus interactions association with skin diseases? or candidates in search of a disease?

  18. Acknowledgement • Jan van Marle • electronmicroscopy • Jan Weel • virology • Fokla Zorgdrager and Marion Cornelissen • molecular biology • Daisy Picavet and Marcel Teunissen • immunohistochemistry

More Related