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Specific antibody production in herpes keratitis: intraocular inflammation and corneal neovascularisation as predicting factors

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Abstract

Purpose

The purpose of the study is to investigate whether analysis of specific antibody synthesis can aid the diagnosis of herpes keratitis.

Methods

Aqueous humor was collected from 39 patients with presumed recurrent herpes keratitis, including 23 consulting for keratitis and 16 patients scheduled for penetrating keratoplasty. Local antibody production was ascertained by analysis of paired aqueous humor/serum samples, using a modified micro-ELISA technique.

Results

Local production of antibodies was found in 32 patients (82%): anti-herpes simplex virus (HSV) antibodies in 26 (67%) and anti-varicella zoster virus (VZV) antibodies in 11 (28%). Twenty of 23 patients with active keratitis (87%), and 12 of 16 undergoing keratoplasty (75%), tested positive. Five patients had local production of both anti-HSV and anti-VZV antibodies, whereas seven patients tested negative. Local antibody production was significantly associated with intraocular inflammation (P<0.05), corneal neovascularisation (P<0.05), and positive response to anti-viral treatment (P<0.05). No complications were encountered in sampling aqueous humor.

Conclusions

Assessment of local anti-HSV and -VZV antibody production is a safe and reliable diagnostic procedure for recurrent herpes keratitis. It might be particularly helpful in patients presenting with intraocular inflammation and neovascularisation since it discriminates between herpes and non-herpes pathologies and may therefore be useful for preventive and therapeutic strategies.

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References

  1. Baron A, Desmond G (1959) L'examen sérologique de l'humeur aqueuse au cours des uvéites. Bull Soc Ophtalmol Fr 59:793–796

    Google Scholar 

  2. Biswas S, Suresh P, Bonshek RE, Corbitt G, Tullo AB, Ridgway AE (2000) Graft failure in human donor corneas due to transmission of herpes simplex virus. Br J Ophthalmol 84:701–705

    Article  PubMed  CAS  Google Scholar 

  3. Bloch-Michel E, Nussenblatt RB (1987) International Uveitis Study Group recommendations for the evaluation of intraocular inflammatory disease. Am J Ophthalmol 103:234–235

    PubMed  CAS  Google Scholar 

  4. Borderie VM, Meritet JF, Chaumeil C, Rozenberg F, Baudrimont M, Touzeau O, Bourcier T, Laroche L (2004) Culture-proven herpetic keratitis after penetrating keratoplasty in patients with no previous history of herpes disease. Cornea 23:118–124

    Article  PubMed  Google Scholar 

  5. Cantin EM, Chen J, McNeill J, Willey DE, Openshaw H (1991) Detection of herpes simplex virus DNA sequences in corneal transplant recipients by polymerase chain reaction assays. Curr Eye Res 10:15–21

    Article  PubMed  Google Scholar 

  6. Davis JL, Feuer W, Culbertson WW, Pflugfelder SC (1995) Interpretation of intraocular and serum antibody levels in necrotizing retinitis. Retina 15:233–240

    Article  PubMed  CAS  Google Scholar 

  7. Dussaix E, Cerqueti PM, Pontet F (1987) New approaches to the detection of locally produced antiviral antibodies in the aqueous of patients with endogenous uveitis. Ophthalmologica 194:145–149

    PubMed  CAS  Google Scholar 

  8. Easton HG (1970) Zoster sine herpete causing acute trigeminal neuralgia. Lancet 2:1065–1066

    Article  PubMed  CAS  Google Scholar 

  9. Felgenhauer K (1982) Differentiation of the humoral immune response in inflammatory diseases of the central nervous system. J Neurol 228:223–247

    Article  PubMed  CAS  Google Scholar 

  10. Goldman H, Witmer R (1954) Antikörper im Kammerwasser. Ophthalmologica 127:323–330

    Article  PubMed  Google Scholar 

  11. Group HEDS (1998) Acyclovir for the prevention of recurrent herpes simplex virus eye disease. N Engl J Med 339:300–306

    Article  PubMed  Google Scholar 

  12. Hartmann C, Felgenhauer K, Hanssen C (1983) Filtration und lokale Synthese von Proteinen im Kammerwasser und Liquor Cerebrospinalis. Fortschr Ophthalmol 80:103–107

    PubMed  CAS  Google Scholar 

  13. Kaye SB, Lynas C, Patterson A, Risk JM, McCarthy K, Hart CA (1991) Evidence for herpes simplex viral latency in the human cornea. Br J Ophthalmol 75:195–200

    Article  PubMed  CAS  Google Scholar 

  14. Kijlstra A, Onkosuwito J, Wienesenvan Doom M (1997) Serological and PCR analysis of ocular fluids is an important tool in the diagnostic workup of a uveitis patient presenting as a diagnostic dilemma. Ophthalmic Res 30:98

    Google Scholar 

  15. Lairson DR, Begley CE, Reynolds TF, Wilhelmus KR (2003) Prevention of herpes simplex virus eye disease: a cost-effectiveness analysis. Arch Ophthalmol 121:108–112

    PubMed  Google Scholar 

  16. Lausch RN, Monteiro C, Kleinschradt WR, Oakes JE (1987) Superiority of antibody versus delayed hypersensitivity in clearance of HSV-1 from eye. Investig Ophthalmol Vis Sci 28:565–570

    CAS  Google Scholar 

  17. Liekfeld A, Jaeckel C, Pleyer U, Robert PY, Hartmann C (2001) Kammerwasseranalyse in Keratoplastikpatienten mit Keratitiden. Erste Resultate. Ophthalmologie 98:456–459

    Article  CAS  Google Scholar 

  18. Liekfeld A, Schweig F, Jaeckel C, Wernecke KD, Hartmann C, Pleyer U (2000) Intraocular antibody production in intraocular inflammation. Graefe Arch Clin Exp Ophthalmol 238:222–227

    Article  CAS  Google Scholar 

  19. Metcalf J, Koga J, Chatterjee S, Whitley RW (1987) Passive immunization with monoclonal antibodies against herpes simplex virus glycoproteins protects mice against herpetic ocular disease. Curr Eye Res 6:173

    Article  PubMed  CAS  Google Scholar 

  20. Meyers-Elliott RH, Pettit TH, Maxwell WA (1980) Viral antigens in the immune ring of Herpes simplex stromal keratitis. Arch Ophthalmol 98:897–904

    PubMed  Google Scholar 

  21. Pavan-Langston D, Dunkel E (1996) Varicella-zoster virus diseases: anterior segment of the eye. In: JS Pepose, GN Holland, KR Wilhelmus (eds) Ocular infection and immunity. Mosby, St Louis, pp 933–957

    Google Scholar 

  22. Quentin CD, Reiber H (2004) Fuchs heterochromic cyclitis: rubella virus antibodies and genome in aqueous humor. Am J Ophthalmol 138:46–54

    Article  PubMed  Google Scholar 

  23. Rezende RA, Uchoa UB, Raber IM, Rapuano CJ, Laibson PR, Cohen EJ (2004) New onset of herpes simplex virus epithelial keratitis after penetrating keratoplasty. Am J Ophthalmol 137:415–419

    Article  PubMed  Google Scholar 

  24. Sarkies N, Gregor Z, Forsey T, Darougar S (1986) Antibodies to herpes simplex virus type I in intraocular fluids of patients with acute retinal necrosis. Br J Ophthalmol 70:81–84

    Article  PubMed  CAS  Google Scholar 

  25. Schwartz GS, Harrison AR, Holland EJ (1998) Etiology of immune stromal (interstitial) keratitis. Cornea 17:278–281

    Article  PubMed  CAS  Google Scholar 

  26. Staats H, Oakes JE, Lausch RN (1991) Anti-glycoprotein D monoclonal antibody protects against herpes simplex virus type 1-induced diseases in mice functionally depleted of selected T-cell subsets of asialo GM1+ cells. J Virol 65:6008

    PubMed  CAS  Google Scholar 

  27. Tambasco FP, Cohen EJ, Nguyen LH, Rapuano CJ, Laibson PR (1999) Oral acyclovir after penetrating keratoplasty for herpes simplex keratitis. Arch Ophthalmol 117:445–449

    PubMed  CAS  Google Scholar 

  28. Timsit JC, Fortier B, Pontet F (1982) Value of the immunoenzyme method (ELISA) in determining serum and aqueous humor antiherpes immunoglobulin levels. J Fr Ophtalmol 5:669–674

    PubMed  CAS  Google Scholar 

  29. Uchoa UBC, Rezende RA, Carrasco MA, Rapuano CJ, Laibson PR, Cohen EJ (2003) Long-term Acyclovir use to prevent recurrent ocular herpes simplex virus infection. Arch Ophthalmol 121:1702–1704

    Article  PubMed  CAS  Google Scholar 

  30. Van der Lelij A, Rothova A (1997) Diagnostic anterior chamber paracentesis in uveitis: a safe procedure? Br J Ophthalmol 81:976–979

    Article  PubMed  Google Scholar 

  31. van Gelderen BE, Van der Lelij A, Treffers WF, van der Gaag R (2000) Detection of herpes simplex virus type 1, 2 and varicella zoster virus DNA in recipient corneal buttons. Br J Ophthalmol 84:1238–1243

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was supported by Association Française des Amblyopes Unilatéraux, Société Française d'Ophtalmologi, Banque Française des Yeux, and Deutsche Forschungsgemeinschaft (Pl 150/14-1). We thank Pierre-Marie Preux, Department of Biostatistics, Limoges, for his kind assistance.

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Correspondence to Uwe Pleyer.

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Robert, PY., Liekfeld, A., Metzner, S. et al. Specific antibody production in herpes keratitis: intraocular inflammation and corneal neovascularisation as predicting factors. Graefe's Arch Clin Exp Ophthalmo 244, 210–215 (2006). https://doi.org/10.1007/s00417-005-0014-7

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  • DOI: https://doi.org/10.1007/s00417-005-0014-7

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