Case of Varicella-zoster Pneumonia with Bronchioalveolar Lavage Confirmed by the Detection of VZV DNA in the Bronchial Washing by the Polymerase Chain Reaction

Saito, Shunichi; Yano, Tokujiro; Koga, Hideyuki; Arikawa, Keisuke; Koyanagi, Nobuhiro; Ōizumi, Kōtaro

doi:10.11150/kansenshogakuzasshi1970.73.346

Cited by 6 publications

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“…Primary infection with varicella-zoster virus (VZV) occurs mainly at the respiratory epithelium (1)(2)(3). Although numerous case studies have documented varicella pneumonia in adults during primary infection as well as the presence of VZV DNA in BAL fluid during reactivation (6,(59)(60)(61), the difficulty associated with obtaining human respiratory mucosal samples has resulted in an incomplete understanding of the immune response to VZV infection in the lung. Previous studies from our laboratory have demonstrated that intrabronchial infection of rhesus macaques with the closely related simian varicella virus (SVV) recapitulates the hallmarks of VZV infection in humans (25).…”

Section: Discussionmentioning

confidence: 99%

Intrabronchial Infection of Rhesus Macaques with Simian Varicella Virus Results in a Robust Immune Response in the Lungs

Haberthur

Meyer

Arnold

et al. 2014

J Virol

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Varicella-zoster virus (VZV) is the etiological agent of varicella (chickenpox) and herpes zoster (shingles). Primary VZV infection is believed to occur via the inhalation of virus either in respiratory droplets or from shedding varicella lesions or by direct contact with infectious vesicular fluid. However, the ensuing immune response in the lungs remains incompletely understood. We have shown that intrabronchial inoculation of rhesus macaques with simian varicella virus (SVV), a homolog of VZV, recapitulates the hallmarks of acute and latent VZV infection in humans. In this study, we performed an in-depth analysis of the host immune response to acute SVV infection in the lungs and peripheral blood. We report that acute SVV infection results in a robust innate immune response in the lungs, characterized by the production of inflammatory cytokines, chemokines, and growth factors as well as an increased frequency of plasmacytoid dendritic cells (DCs) that corresponded with alpha interferon (IFN-␣) production and a rapid decrease in viral loads in the lungs. This is followed by T and B cell proliferation, antibody production, T cell differentiation, and cytokine production, which correlate with the complete cessation of viral replication. Although terminally differentiated CD8 T cells became the predominant T cell population in bronchoalveolar lavage cells, a higher percentage of CD4 T cells were SVV specific, which suggests a critical role for these cells in the resolution of primary SVV infection in the lungs. Given the homology between SVV and VZV, our data provide insight into the immune response to VZV within the lung. IMPORTANCEAlthough primary VZV infection occurs primarily via the respiratory route, the host response in the lungs and its contribution to the cessation of viral replication and establishment of latency remain poorly understood. The difficulty in accessing lung tissue and washes from individuals infected with VZV has hampered efforts to address this knowledge gap. SVV infection of rhesus macaques is an important model of VZV infection of humans; therefore, we utilized this animal model to gain a comprehensive view of the kinetics of the immune response to SVV in the lung and its relationship to the resolution of acute infection in respiratory tissues. These data not only advance our understanding of host immunity to VZV, a critical step in developing new vaccines, but also provide additional insight into immunity to respiratory pathogens. P rimary infection with varicella-zoster virus (VZV), a neurotropic alphaherpesvirus, occurs primarily through the inhalation of virus-laden saliva droplets (1, 2) or airborne virions from varicella lesions (3) or by contact with infectious vesicular fluid (4). The incubation period of varicella can range from 10 to 21 days and usually results in a benign self-limiting disease characterized by the appearance of vesicular exanthem, fever, and malaise (5). Current evidence suggests VZV can infect and replicate within the respiratory mucosal epithelium....

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Section: Discussionmentioning

confidence: 99%

Intrabronchial Infection of Rhesus Macaques with Simian Varicella Virus Results in a Robust Immune Response in the Lungs

Haberthur

Meyer

Arnold

et al. 2014

J Virol

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“…In recent years, as a definitive diagnostic procedure of varicella pneumonia, direct proof of VZV-DNA by PCR has been reported in some reports. Three cases were diagnosed using bronchoalveolar lavage (7), and another was diagnosed using a specimen from a transbronchial lung biopsy; all four cases reached a definitive diagnosis through the direct detection of viral DNA by PCR (8). In addition, specimen collection in all four cases was performed early after the onset, when cutis symptoms were present.…”

Section: Discussionmentioning

confidence: 99%

Varicella-zoster Virus Related Pulmonary Granulomas in Which Varicella-zoster Virus DNA Was Demonstrated in a Thoracoscopic Lung Biopsy Specimen

et al. 2019

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A 43-year-old man with malignant lymphoma who had been treated with the cyclosphamide, vincrstine, procarbazine, and prednisolone (C-MOPP) regimen was admitted to our hospital with skin eruption. He was diagnosed to have varicella, and treatment with acyclovir and immune globulin was started. Chest computed tomography revealed multiple nodules in the both lung fields. Diagnostic thoracoscopic lung biopsy specimens revealed granuloma formation, and polymerase chain reaction testing revealed the presence of varicella-zoster virus DNA in the granulomatous tissue. It was unusual for the lung nodule in varicella pneumonia to increase in size over time in a patient who had undergone antiviral therapy, while also demonstrating multiple granulomas.

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Infectious Complications of Cancer Therapy

2006

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Case of Varicella-zoster Pneumonia with Bronchioalveolar Lavage Confirmed by the Detection of VZV DNA in the Bronchial Washing by the Polymerase Chain Reaction

Cited by 6 publications

References 0 publications

Intrabronchial Infection of Rhesus Macaques with Simian Varicella Virus Results in a Robust Immune Response in the Lungs

Intrabronchial Infection of Rhesus Macaques with Simian Varicella Virus Results in a Robust Immune Response in the Lungs

Varicella-zoster Virus Related Pulmonary Granulomas in Which Varicella-zoster Virus DNA Was Demonstrated in a Thoracoscopic Lung Biopsy Specimen

Infectious Complications of Cancer Therapy

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