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1From the Center for Neurobiology and Vaccine Development, Ophthalmology Research, Cedars-Sinai Medical Center Burns and Allen Research Institute, Los Angeles, California; 2The Eye Institute, University of California Irvine, School of Medicine, Irvine, California; 3Division of Infectious Diseases, Cedars-Sinai Medical Center, San Diego, California; and 5La Jolla Institute for Molecular Medicine, San Diego, California.
PURPOSE. To assess the relative impact of antibodies specific for HSV-1 glycoproteins on eye disease in response to HSV-1 infection, the composition of antibodies specific for 10 of the viral glycoproteins, and the effect of antiglycoprotein (g)D and antigK antibodies on antibody-dependent enhancement (ADE).
METHODS. In a prospective case-control study, sera from patients with a history of herpes stromal keratitis (HSK) were compared with sera from nonocular HSV-1seropositive and HSV-seronegative control subjects. HSV-1 neutralizing antibody titer and type-specific IgG and IgM were measured. In addition, the presence of antiHSV-1 gD and gK antibodies in the sera of all patients also was determined by ELISA using gD and gK antigens. Finally, the role of antigD- and gK-specific antibodies to ADE was investigated.
RESULTS. Average neutralizing antibody titers and levels of HSV-1 IgG were similar between HSK- and nonHSK-seropositive patients. However, the contribution of gD to the neutralizing antibody titer in HSK sera was significantly lower than that in nonHSK-seropositive patients, despite higher antigD ELISA titers. Overall, sera from patients with HSK had higher antigK antibody titers and induced ADE in vitro compared with nonHSK or seronegative sera. The ADE response in HSK sera was attributed to antigK antibody.
CONCLUSIONS. These results suggest that sera from HSK patients had higher antigD and gK antibody titers than sera from seropositive patients who had no history of HSK despite similar levels of neutralizing antibody titers and HSV-1 IgG, that HSK sera induced ADE whereas sera from nonHSK patients did not induce ADE, and that antigD antibody in sera of HSK patients contributed less to the HSV-1 neutralization antibody titer than did sera from nonHSK patients.
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