Trinita Araullo-Cruz

Prolonged Recoverability of Desiccated Adenovirus Type 19 from Various Surfaces

Epidemic keratoconjunctivitis is a highly contagious disease whose transmission has been linked to the ophthalmologists office. The authors studied the ability of adenovirus 19 (ADV 19) to survive on surfaces commonly found in the office setting. An initial in vitro laboratory experiment demonstrated that ADV 19 in a desiccated state could be recovered up to 8 days from paper, and up to 10 days from cloth, metal, and plastic. The amount of recovered ADV 19 was significantly greater (analysis of variance, P less than 0.0001) from nonporous surfaces (plastic, metal) compared with porous surfaces (cloth, paper). A second experiment demonstrated that 35 days was the maximum length of time that desiccated ADV 19 could be recovered from a nonporous surface (plastic). The authors conclude that despite drying, ADV 19 is a hearty virus that remains potentially infectious for a long time on various surfaces that may be found in an ophthalmologists office.

A Comparison of Enzyme Immunoassay and Polymerase Chain Reaction with the Clinical Examination for Diagnosing Ocular Herpetic Disease

PURPOSE The results of two laboratory diagnostic herpes simplex virus (HSV) tests, an enzyme immunoassay (improved Herpchek [iHC]) and the polymerase chain reaction (PCR), were compared with the clinical examination in the diagnosis of HSV. We determined when diagnostic laboratory tests provided the initial diagnosis of HSV ocular disease and when they were only confirmatory. METHODS The sensitivity and specificity of iHC and PCR were determined using 22 HSV culture-positive clinical samples, 10 adenovirus culture-positive clinical samples, 5 samples from normal conjunctivas, 4 bacterial samples, and 1 sample containing Varicella zoster virus. The medical history of the 22 patients with positive HSV cultures were reviewed to determine the initial diagnosis by clinical examination and the initial therapy. RESULTS For typical presentations of ocular HSV disease, the clinical examination is as accurate as iHC (P = 0.99) and PCR (P = 0.24). However, for atypical presentations of ocular HSV disease, iHC (P = 0.000005) or PCR (P = 0.00006) were more accurate in detecting HSV infection than the clinical examination. CONCLUSION Laboratory diagnosis of HSV from ocular samples was most useful to the clinician in atypical presentations of herpetic ocular disease.

Host species and strain differences affect the ability of an HSV-1 ICP0 deletion mutant to establish latency and spontaneously reactivate in vivo

HSV-1 latency and reactivation were studied in vivo by spontaneous and iontophoresis-induced ocular viral shedding in New Zealand rabbits, Balb/c and A/J mice latently infected with wild-type KOS, and dl x 3.1, a progeny ICP0 deletion mutant. The presence of trigeminal ganglionic latency was demonstrated by the in vitro methods of cocultivation and in situ hybridization. Although the efficiency of ganglionic latency was significantly less (P less than .0001) for dl x 3.1 than for KOS in both mice and rabbits, only dl x 3.1 shed spontaneously in the NZ rabbit. Iontophoresis of adrenergic agents failed to induce reactivation and ocular viral shedding of KOS or dl x 3.1 in mice or rabbits. The establishment of latency and reactivation of KOS and dl x 3.1 was dependent on the host animal. We conclude that host factors as exemplified by host species and host strain differences significantly affected the ability of KOS and dl x 3.1 to establish latency, to reactivate, and to shed spontaneously. ICP0 expression was not required for the establishment or maintenance of latency, nor was it required for the reactivation of latent HSV-1. Furthermore, the biological activity of KOS and dl x 3.1 during latency in vivo did not correlate with latency studies based on in vitro methods.

Sequence changes in the human adenovirus type 5 DNA polymerase associated with resistance to the broad spectrum antiviral cidofovir

Although there is currently no FDA approved antiviral treatment for adenovirus (Ad) infections, the broad spectrum antiviral cidofovir (CDV) has demonstrated potent inhibitory activity against many Ad serotypes in vitro and in an in vivo ocular replication model. The clinical potential of CDV prompted the assessment for the emergence of CDV resistance in Ad5. Serial passage of Ad5 in increasing concentrations of CDV resulted in derivation of four different Ad5 variants with increased resistance to CDV. CDV resistance was demonstrated by ability to replicate viral DNA in infected cells at CDV concentrations that inhibit the parental virus, by ability to form plaques in CDV concentrations of >20 microg/ml and by increased progeny release following infection and growth in media containing CDV. Using marker rescue, the loci for CDV resistance in variant R1 was shown to be mediated by one residue change L741S, one of two mutations within the R1 encoded DNA polymerase. The CDV-resistant variants R4, R5 and R6 also contained mutations in their respective DNA polymerase sequences, but these were different from R1; variant R4 contained two changes (F740I and V180I), whereas both R5 and R6 variants contained the non-conserved mutation A359E. R6 contained additional alterations L554F and V817L. The location of the R1 change is close to a region of the DNA polymerase which is conserved with other polymerases that is predicted to involve nucleotide binding.

The proportion of trigeminal ganglionic neurons expressing herpes simplex virus type 1 latency-associated transcripts correlates to reactivation in the New Zealand rabbit ocular model

Abstract• Background: The purpose of this study was to determine the proportion of neurons expressing herpes simplex virus typel (HSV-1) latency-associated transcripts (LATs) in trigeminal ganglia for different HSV-1 wild-type strains and to correlate this measurement with the ability of each virus to reactivate. • Methods: Latent infections were established in New Zealand white rabbits following bilateral ocular inoculation with one of three different HSV-1 strains: W F, and KOS. The in vivo ability of each virus to reactivate was determined by (1) detection of induced ocular shedding of HSV-1 following 6-hydroxydopamine/ epinephrine iontophoresis and intrastromal injection of sterile water, and (2) explantation and cocultivation of trigeminal ganglia (TGs). The proportion of neurons expressing the HSV-1 LAT transcripts was determined by in situ hybridization. • Results: Significant differences among the three HSV-1 wt strains W F, and KOS in the proportions of LAT-expressing neurons (4.70%, 0.70%, 0.15% , respectively) were found. A positive correlation between the proportion of LAT-expressing neurons and the ability of an HSV-1 strain to reactivate following induction (73%, 36%, 0%) was indicated. Recovery following cocultivation was 82%, 18%, and 13% for W F, and KOS, respectively. •Conclusion: The proportion of TG neurons expressing the HSV-1 LATs is an important measure of the viral genetic factors involved in reactivation. For analysis of factors affecting post-latenc-events, similar proportions of LAT-positive neurons should be established for viruses under comparison.

Recovery of a latent HSV-1 thymidine kinase negative strain following iontophoresis and co-cultivation in the ocularly-infected rabbit model.

Previous studies in the mouse and guinea pig have reported little or no colonization of sensory ganglia by strains of herpes simplex type 1 failing to express the enzyme, thymidine kinase (TK). The current study in the rabbit demonstrated trigeminal ganglionic colonization and reactivation of a latent thymidine kinase negative strain of HSV-1 by two independent methods: iontophoresis-induced ocular shedding and co-cultivation. Treatment with topical steroids during the acute infection did not enhance the latency rate. Following reactivation, back mutation with phenotypic reversion to thymidine kinase positive was demonstrated in a few recovered isolates. The current study also emphasized the importance of species differences to explain differing experimental results in studies of HSV-1 TK negative latency.

The effect of alpha blockade on iontophoresis-induced ocular shedding of latent HSV-1 W in different host animals

Previous studies demonstrated that non-specific beta blockade promoted ocular shedding of latent HSV-1 in the mouse and rabbit iontophoresis models. The present study examined the effect of topical alpha blockers, thymoxamine and corynanthine, on reactivation and induced ocular shedding of latent HSV-1 W in different host animals. Latent trigeminal ganglionic infection was established in Balb/c mice and New Zealand rabbits following corneal inoculation with HSV-1 W strain, and later confirmed by co-cultivation. Treatment with coded eye drops (thymoxamine, corynanthine or BSS was begun one day prior to iontophoresis induction and continued BID OU for 5 days. Reactivation and recovery of latent HSV-1 was determined by daily ocular swabs, and characteristic HSV-1 cytopathic effect in Vero cells. In Balb/c mice, topical administration of thymoxamine 0.5% or corynanthine 5% significantly reduced the number of virus-positive eyes, virus-positive mice, and total virus-positive swabs per experiment, whereas the inhibitory effect was minimal in NZ rabbits. We conclude that alpha blockade may alter the reactivation signal that is mediated via the adrenergic system, and that different host factors (as expressed in different species) may play an important role in this process.

REPLICATION OF OCULAR ISOLATES OF HUMAN ADENOVIRUS IS SEROTYPE-DEPENDENT IN RABBIT CORNEAL ORGAN CULTURE

The goal of the present in vitro study was to determine the ability of unadapted human adenoviral ocular isolates to replicate in the rabbit cornea. Rabbit corneas grown in organ culture (24 well plate) were inoculated topically with 50 microliters (5 x 10(5) pfu) of different ocular adenoviral serotypes (ATCC and clinical isolates). Control wells (no cornea present) were inoculated in a similar fashion. Viral replication was determined by serial aliquots titrated on A549 cells. We demonstrated sustained viral replication over time of all isolates (100%) of Ad1, 2, 5, 6, 8, 9, 11 and 37 tested. No isolates (0%) of Ad3, 7A, 19, and 4 demonstrated replication in our model. Peak titers varied among successful serotypes from 10(2) pfu/ml (Ad11) to 10(5) PFU/ml (Ad5), and among different isolates of a given serotype. We conclude that the ability of unadapted human Ad serotypes to replicate in rabbit corneas was serotype-dependent, and that subgroup C (Ad1, 2, 5, and 6) appeared to be the most successful subgroup.

Vanadate promotes reactivation and ionotophoresis-induced ocular shedding of latent HSV-1 W in different host animals

Vanadate is a potent inhibitor of calcium stimulated ATPase, Na, K-ATPase, and may have adrenergic activity. Using the iontophoresis method, we compared vanadate to a BSS control and the standard iontophoresis model (6-hydroxydopamine/epinephrine) by measuring induced ocular shedding of latent HSV-1 in different host animals. Latent trigeminal ganglionic infections were established in Balb/c mice and New Zealand rabbits following corneal inoculation with HSV-1 [W] strain, and later confirmed by cocultivation. Latently-infected animals (greater than 1 month post-infection) were divided into three treatment groups. Each group was iontophoresed with BSS, vanadate 1% or 6-HD 1%, and then treated topically for 10 days with BSS, vanadate or epinephrine respectively. Reactivation and recovery of latent HSV-1 was detected by daily ocular swabbing, plating, and observing progressive viral growth in Vero cells. The vanadate group had more virus-positive eyes than the BSS control group in mice, (8/32 vs. 1/32 P less than .01), and also in rabbits (14/20 vs 6/22 P less than .01). Virus-positive animals and total positive swabs were also higher for vanadate than BSS in both mice and rabbits. Furthermore, while vanadate was associated with fewer virus-positive eyes than 6-HD & EPI (8/32 vs. 17/32 P less than .02) in mice, there were no significant differences in rabbits. We conclude that vanadate promotes ocular shedding of latent HSV-1, and may act through an adrenergic mechanism.

Efficacy of glycoprotein inhibitors alone and in combination with trifluridine in the treatment of murine herpetic keratitis

The present study examined the anti-herpetic effect of the glycoprotein inhibitors, hydroxynorvaline and 2-deoxyglucose, alone and in combination with trifluridine on murine ocular herpes. Following ocular inoculation with a large dose of HSV-1 RE strain (10(6) pfu), ICR mice were treated during the acute infection with different therapeutic regimens, and their efficacy was evaluated by ocular virus titers, clinical grading of blepharo-conjunctivitis and histological evaluation of stromal keratitis and iridocyclitis. The results following a large dose HSV-1 inoculum demonstrated that trifluridine was the best single therapeutic agent. Hydroxynorvaline and 2-deoxyglucose had no effect at all. Combination therapy of the glycoprotein inhibitors with trifluridine was no better than trifluridine alone. The mouse HSV-1 keratitis model proved to be an effective, economical alternative to the rabbit model for the evaluation of new antiviral agents.