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Niemeyer CS, Traina-Dorge V, Doyle-Meyers L, Das A, Looper J, Mescher T, Feia B, Medina E, Nagel MA, Mahalingam R, Bubak AN. Simian varicella virus infection and reactivation in rhesus macaques trigger cytokine and Aβ40/42 alterations in serum and cerebrospinal fluid. J Neurovirol 2024; 30:86-99. [PMID: 38453879 DOI: 10.1007/s13365-024-01196-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 03/09/2024]
Abstract
Simian varicella virus (SVV) produces peripheral inflammatory responses during varicella (primary infection) and zoster (reactivation) in rhesus macaques (RM). However, it is unclear if peripheral measures are accurate proxies for central nervous system (CNS) responses. Thus, we analyzed cytokine and Aβ42/Aβ40 changes in paired serum and cerebrospinal fluid (CSF) during the course of infection. During varicella and zoster, every RM had variable changes in serum and CSF cytokine and Aβ42/Aβ40 levels compared to pre-inoculation levels. Overall, peripheral infection appears to affect CNS cytokine and Aβ42/Aβ40 levels independent of serum responses, suggesting that peripheral disease may contribute to CNS disease.
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Affiliation(s)
- Christy S Niemeyer
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
| | - Vicki Traina-Dorge
- Division of Microbiology, Tulane National Primate Research Center, Tulane University, 18703 Three Rivers Road, Covington, LA, 70433, USA
| | - Lara Doyle-Meyers
- Division of Veterinary Medicine, Tulane National Primate Research Center, Tulane University, 18703 Three Rivers Road, Covington, LA, 70433, USA
| | - Arpita Das
- Division of Microbiology, Tulane National Primate Research Center, Tulane University, 18703 Three Rivers Road, Covington, LA, 70433, USA
| | - Jayme Looper
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, 70803, USA
| | - Teresa Mescher
- Department of Psychiatry Behavioral Health and Wellness Program, University of Colorado School of Medicine, Aurora, Co, 80045, USA
| | - Brittany Feia
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
| | - Eva Medina
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
| | - Maria A Nagel
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Co, 80045, USA
| | - Ravi Mahalingam
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA
| | - Andrew N Bubak
- Department of Neurology, University of Colorado School of Medicine, 12700 E. 19th Avenue, Mail Stop B182, Aurora, Co, 80045, USA.
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Elhalag RH, Motawea KR, Talat NE, Rouzan SS, Reyad SM, Elsayed SM, Chébl P, Abowafia M, Shah J. Herpes Zoster virus infection and the risk of developing dementia: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34503. [PMID: 37904465 PMCID: PMC10615483 DOI: 10.1097/md.0000000000034503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/05/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Herpes Zoster, commonly known as shingles, is a viral infection that affects a significant portion of the adult population; however, its potential role in the onset or progression of neurodegenerative disorders like dementia remains unclear. METHODS We searched the following databases: PubMed, Scopus, Cochrane library, and Web of Science. We included any randomized control trials and controlled observational studies as Cross-sectional, prospective, or retrospective cohort and case-control studies that investigated the prevalence of dementia in Herpes Zoster Virus (HZV)-infected patients and HZV-free control group or if the study investigated the prevalence of HZV in demented patients. Also, if the studies measured the levels of dementia biomarkers in patients with HZV compared with a healthy control group. RESULTS After the complete screening, 9 studies were included in the meta-analysis. In the outcome of the incidence of HZV, the pooled analysis showed no statistically significant difference between the dementia group and the No dementia group (RR = 1.04% CI = 0.86-1.25, P = .70). In the outcome of incidences of dementia and Alzheimer's disease, the pooled analysis showed no statistically significant difference between the HZV group and the incidence of dementia (RR = 0.99, 95% CI = 0.92-1.08, P = .89), (RR = 3.74, 95% CI = 0.22-62.70, P = .36) respectively. In the outcome of incidences of Herpes Zoster ophthalmicus (HZO), the generic inverse variance showed a statistically significant association between patients who have HZO and increased incidence of dementia (RR = 6.26, 95% CI = 1.30-30.19, P = .02). CONCLUSION Our study showed no significant association between HZV and the incidence of dementia or Alzheimer's disease, but it shows a significant association between HZO and the incidence of dementia. More multicenter studies are needed to establish the actual association between the HZV and dementia.
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Affiliation(s)
| | | | | | - Samah S. Rouzan
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Sarraa M. Reyad
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Pensée Chébl
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Marwan Abowafia
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Bubak AN, Coughlan C, Posey J, Saviola AJ, Niemeyer CS, Lewis SWR, Lopez SB, Solano A, Tyring SK, Delaney C, Neeves KB, Mahalingam R, Hansen KC, Nagel MA. Zoster-Associated Prothrombotic Plasma Exosomes and Increased Stroke Risk. J Infect Dis 2023; 227:993-1001. [PMID: 36200236 PMCID: PMC10319974 DOI: 10.1093/infdis/jiac405] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/14/2022] Open
Abstract
Herpes zoster (HZ; shingles) caused by varicella zoster virus reactivation increases stroke risk for up to 1 year after HZ. The underlying mechanisms are unclear, however, the development of stroke distant from the site of zoster (eg, thoracic, lumbar, sacral) that can occur months after resolution of rash points to a long-lasting, virus-induced soluble factor (or factors) that can trigger thrombosis and/or vasculitis. Herein, we investigated the content and contributions of circulating plasma exosomes from HZ and non-HZ patient samples. Compared with non-HZ exosomes, HZ exosomes (1) contained proteins conferring a prothrombotic state to recipient cells and (2) activated platelets leading to the formation of platelet-leukocyte aggregates. Exosomes 3 months after HZ yielded similar results and also triggered cerebrovascular cells to secrete the proinflammatory cytokines, interleukin 6 and 8. These results can potentially change clinical practice through addition of antiplatelet agents for HZ and initiatives to increase HZ vaccine uptake to decrease stroke risk.
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Affiliation(s)
- Andrew N Bubak
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Christina Coughlan
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Janelle Posey
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Anthony J Saviola
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Christy S Niemeyer
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Serena W R Lewis
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Sara Bustos Lopez
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Adriana Solano
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Stephen K Tyring
- Center for Clinical Studies and Department of Dermatology, McGovern School of Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Cassidy Delaney
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Keith B Neeves
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ravi Mahalingam
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kirk C Hansen
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Maria A Nagel
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Gallego Villarejo L, Bachmann L, Marks D, Brachthäuser M, Geidies A, Müller T. Role of Intracellular Amyloid β as Pathway Modulator, Biomarker, and Therapy Target. Int J Mol Sci 2022; 23:ijms23094656. [PMID: 35563046 PMCID: PMC9103247 DOI: 10.3390/ijms23094656] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023] Open
Abstract
The β- and γ-secretase-driven cleavage of the amyloid precursor protein (APP) gives rise to the amyloid β peptide, which is believed to be the main driver of neurodegeneration in Alzheimer’s disease (AD). As it is prominently detectable in extracellular plaques in post-mortem AD brain samples, research in recent decades focused on the pathological role of extracellular amyloid β aggregation, widely neglecting the potential meaning of very early generation of amyloid β inside the cell. In the last few years, the importance of intracellular amyloid β (iAβ) as a strong player in neurodegeneration has been indicated by a rising number of studies. In this review, iAβ is highlighted as a crucial APP cleavage fragment, able to manipulate intracellular pathways and foster neurodegeneration. We demonstrate its relevance as a pathological marker and shed light on initial studies aiming to modulate iAβ through pharmacological treatment, which has been shown to have beneficial effects on cognitive properties in animal models. Finally, we display the relevance of viral infections on iAβ generation and point out future directions urgently needed to manifest the potential relevance of iAβ in Alzheimer’s disease.
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Affiliation(s)
- Lucia Gallego Villarejo
- Department of Molecular Biochemistry, Cell Signalling, Ruhr University Bochum, 44801 Bochum, Germany; (L.G.V.); (L.B.); (D.M.); (M.B.); (A.G.)
| | - Lisa Bachmann
- Department of Molecular Biochemistry, Cell Signalling, Ruhr University Bochum, 44801 Bochum, Germany; (L.G.V.); (L.B.); (D.M.); (M.B.); (A.G.)
| | - David Marks
- Department of Molecular Biochemistry, Cell Signalling, Ruhr University Bochum, 44801 Bochum, Germany; (L.G.V.); (L.B.); (D.M.); (M.B.); (A.G.)
| | - Maite Brachthäuser
- Department of Molecular Biochemistry, Cell Signalling, Ruhr University Bochum, 44801 Bochum, Germany; (L.G.V.); (L.B.); (D.M.); (M.B.); (A.G.)
| | - Alexander Geidies
- Department of Molecular Biochemistry, Cell Signalling, Ruhr University Bochum, 44801 Bochum, Germany; (L.G.V.); (L.B.); (D.M.); (M.B.); (A.G.)
| | - Thorsten Müller
- Department of Molecular Biochemistry, Cell Signalling, Ruhr University Bochum, 44801 Bochum, Germany; (L.G.V.); (L.B.); (D.M.); (M.B.); (A.G.)
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, 80336 Munich, Germany
- Correspondence:
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Bubak AN, Como CN, Hassell JE, Mescher T, Frietze SE, Niemeyer CS, Cohrs RJ, Nagel MA. Targeted RNA Sequencing of VZV-Infected Brain Vascular Adventitial Fibroblasts Indicates That Amyloid May Be Involved in VZV Vasculopathy. Neurol Neuroimmunol Neuroinflamm 2021; 9:9/1/e1103. [PMID: 34759019 PMCID: PMC8587729 DOI: 10.1212/nxi.0000000000001103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/09/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVES Compared with stroke controls, patients with varicella zoster virus (VZV) vasculopathy have increased amyloid in CSF, along with increased amylin (islet amyloid polypeptide [IAPP]) and anti-VZV antibodies. Thus, we examined the gene expression profiles of VZV-infected primary human brain vascular adventitial fibroblasts (HBVAFs), one of the initial arterial cells infected in VZV vasculopathy, to determine whether they are a potential source of amyloid that can disrupt vasculature and potentiate inflammation. METHODS Mock- and VZV-infected quiescent HBVAFs were harvested at 3 days postinfection. Targeted RNA sequencing of the whole-human transcriptome (BioSpyder Technologies, TempO-Seq) was conducted followed by gene set enrichment and pathway analysis. Selected pathways unique to VZV-infected cells were confirmed by enzyme-linked immunoassays, migration assays, and immunofluorescence analysis (IFA) that included antibodies against amylin and amyloid-beta, as well as amyloid staining by Thioflavin-T. RESULTS Compared with mock, VZV-infected HBVAFs had significantly enriched gene expression pathways involved in vascular remodeling and vascular diseases; confirmatory studies showed secretion of matrix metalloproteinase-3 and -10, as well increased migration of infected cells and uninfected cells when exposed to conditioned media from VZV-infected cells. In addition, significantly enriched pathways involved in amyloid-associated diseases (diabetes mellitus, amyloidosis, and Alzheimer disease), tauopathy, and progressive neurologic disorder were identified; predicted upstream regulators included amyloid precursor protein, apolipoprotein E, microtubule-associated protein tau, presenilin 1, and IAPP. Confirmatory IFA showed that VZV-infected HBVAFs contained amyloidogenic peptides (amyloid-beta and amylin) and intracellular amyloid. DISCUSSION Gene expression profiles and pathway enrichment analysis of VZV-infected HBVAFs, as well as phenotypic studies, reveal features of pathologic vascular remodeling (e.g., increased cell migration and changes in the extracellular matrix) that can contribute to cerebrovascular disease. Furthermore, the discovery of amyloid-associated transcriptional pathways and intracellular amyloid deposition in HBVAFs raise the possibility that VZV vasculopathy is an amyloid disease. Amyloid deposition may contribute to cell death and loss of vascular wall integrity, as well as potentiate chronic inflammation in VZV vasculopathy, with disease severity and recurrence determined by the host's ability to clear virus infection and amyloid deposition and by the coexistence of other amyloid-associated diseases (i.e., Alzheimer disease and diabetes mellitus).
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Affiliation(s)
- Andrew N Bubak
- From the Department of Neurology (A.N.B., C.N.C., J.E.H., T.M., C.S.N., R.J.C., M.A.N.), University of Colorado; Department of Medical Laboratory Sciences (S.E.F.), University of Vermont, Burlington, VT; Department of Immununology & Microbiology (R.J.C.), University of Colorado; and Department of Ophthalmology (M.A.N.), University of Colorado, Aurora, CO
| | - Christina N Como
- From the Department of Neurology (A.N.B., C.N.C., J.E.H., T.M., C.S.N., R.J.C., M.A.N.), University of Colorado; Department of Medical Laboratory Sciences (S.E.F.), University of Vermont, Burlington, VT; Department of Immununology & Microbiology (R.J.C.), University of Colorado; and Department of Ophthalmology (M.A.N.), University of Colorado, Aurora, CO
| | - James E Hassell
- From the Department of Neurology (A.N.B., C.N.C., J.E.H., T.M., C.S.N., R.J.C., M.A.N.), University of Colorado; Department of Medical Laboratory Sciences (S.E.F.), University of Vermont, Burlington, VT; Department of Immununology & Microbiology (R.J.C.), University of Colorado; and Department of Ophthalmology (M.A.N.), University of Colorado, Aurora, CO
| | - Teresa Mescher
- From the Department of Neurology (A.N.B., C.N.C., J.E.H., T.M., C.S.N., R.J.C., M.A.N.), University of Colorado; Department of Medical Laboratory Sciences (S.E.F.), University of Vermont, Burlington, VT; Department of Immununology & Microbiology (R.J.C.), University of Colorado; and Department of Ophthalmology (M.A.N.), University of Colorado, Aurora, CO
| | - Seth E Frietze
- From the Department of Neurology (A.N.B., C.N.C., J.E.H., T.M., C.S.N., R.J.C., M.A.N.), University of Colorado; Department of Medical Laboratory Sciences (S.E.F.), University of Vermont, Burlington, VT; Department of Immununology & Microbiology (R.J.C.), University of Colorado; and Department of Ophthalmology (M.A.N.), University of Colorado, Aurora, CO
| | - Christy S Niemeyer
- From the Department of Neurology (A.N.B., C.N.C., J.E.H., T.M., C.S.N., R.J.C., M.A.N.), University of Colorado; Department of Medical Laboratory Sciences (S.E.F.), University of Vermont, Burlington, VT; Department of Immununology & Microbiology (R.J.C.), University of Colorado; and Department of Ophthalmology (M.A.N.), University of Colorado, Aurora, CO
| | - Randall J Cohrs
- From the Department of Neurology (A.N.B., C.N.C., J.E.H., T.M., C.S.N., R.J.C., M.A.N.), University of Colorado; Department of Medical Laboratory Sciences (S.E.F.), University of Vermont, Burlington, VT; Department of Immununology & Microbiology (R.J.C.), University of Colorado; and Department of Ophthalmology (M.A.N.), University of Colorado, Aurora, CO
| | - Maria A Nagel
- From the Department of Neurology (A.N.B., C.N.C., J.E.H., T.M., C.S.N., R.J.C., M.A.N.), University of Colorado; Department of Medical Laboratory Sciences (S.E.F.), University of Vermont, Burlington, VT; Department of Immununology & Microbiology (R.J.C.), University of Colorado; and Department of Ophthalmology (M.A.N.), University of Colorado, Aurora, CO.
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Lophatananon A, Mekli K, Cant R, Burns A, Dobson C, Itzhaki R, Muir K. Shingles, Zostavax vaccination and risk of developing dementia: a nested case-control study-results from the UK Biobank cohort. BMJ Open 2021; 11:e045871. [PMID: 34625411 PMCID: PMC8504358 DOI: 10.1136/bmjopen-2020-045871] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the association between shingles and dementia, and between Zostavax vaccination and dementia. DESIGN Nested case-control study. SETTINGS Data were drawn from the UK Biobank cohort study with a total of 228 223 participants with Hospital Episodes Statistics and primary care linkage health records. PARTICIPANTS The analyses included 2378 incident dementia cases and 225 845 controls. Inclusion criteria for incident cases were a dementia diagnosis 3 years or more after the first assessment date derived from all sources including International Classification of Diseases (ICD)-10, ICD-9, self-report and primary care linkage records. Subjects with no dementia code from all sources were coded as controls. Both shingles and Zostavax vaccination were investigated for their association with dementia risk. RESULTS There was a small but non-significant increase in the risk of dementia in subjects with shingles diagnosed 3 years or more prior to dementia diagnosis (OR: 1.088 with 95% CI: 0.978 to 1.211). In those subjects who had had Zostavax vaccination, the risk of dementia significantly decreased (OR: 0.808 with 95% CI: 0.657 to 0.993). CONCLUSION A history of shingles was not associated with an increased risk of dementia. In subjects who were eligible for the immunisation and vaccinated with Zostavax, we saw reduced risk of developing dementia.
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Affiliation(s)
- Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care,School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Krisztina Mekli
- Division of Population Health, Health Services Research and Primary Care,School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Rachel Cant
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alistair Burns
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Curtis Dobson
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Ruth Itzhaki
- The Oxford Institute of Population Ageing, University of Oxford, Oxford, UK
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care,School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Mescher T, Boyer PJ, Bubak AN, Hassell JE, Nagel MA. Detection of varicella zoster virus antigen and DNA in two cases of cerebral amyloid angiopathy. J Neurol Sci 2021; 422:117315. [PMID: 33503519 DOI: 10.1016/j.jns.2021.117315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/16/2020] [Accepted: 01/06/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Varicella zoster virus (VZV) vasculopathy and cerebral amyloid angiopathy (CAA) have similar clinical presentations: both affect cerebrovasculature in the elderly, produce hemorrhage, and can have a protracted course of cognitive decline and other neurological deficits. The cause of CAA is unknown, but amyloid-beta (Aβ) is found within arterial walls. Recent studies show that VZV induces Aβ and amylin expression and an amyloid-promoting environment. Thus, we determined if VZV was present in CAA-affected arteries. METHODS Two subjects with pathologically-verified CAA were identified postmortem and frontal lobes analyzed by immunohistochemistry for arteries containing VZV, Aβ, and amylin and H&E for pathological changes. VZV antigen detection was confirmed by PCR for VZV DNA in the same region. RESULTS In both CAA cases, sections with cerebral arteries containing VZV antigen with corresponding VZV DNA were identified; VZV antigen co-localized with Aβ in media of arteries with histological changes characteristic of CAA. Amylin was also seen in the intima of a VZV-positive artery in the diabetic subject. Not all Aβ-containing arteries had VZV, but all VZV-positive arteries contained Aβ. CONCLUSIONS VZV antigen co-localized with Aβ in some affected arteries from two CAA cases, suggesting a possible association between VZV infection and CAA.
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Affiliation(s)
- Teresa Mescher
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, United States.
| | - Philip J Boyer
- Department of Pathology, East Carolina University Brody School of Medicine, Greenville, NC 27934, United States.
| | - Andrew N Bubak
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, United States.
| | - James E Hassell
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, United States.
| | - Maria A Nagel
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, United States; Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, United States.
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8
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Bubak AN, Beseler C, Como CN, Coughlan CM, Johnson NR, Hassell JE, Burnet AM, Mescher T, Schmid DS, Coleman C, Mahalingam R, Cohrs RJ, Boyd TD, Potter H, Shilleh AH, Russ HA, Nagel MA. Amylin, Aβ42, and Amyloid in Varicella Zoster Virus Vasculopathy Cerebrospinal Fluid and Infected Vascular Cells. J Infect Dis 2020; 223:1284-1294. [PMID: 32809013 DOI: 10.1093/infdis/jiaa513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Varicella zoster virus (VZV) vasculopathy is characterized by persistent arterial inflammation leading to stroke. Studies show that VZV induces amyloid formation that may aggravate vasculitis. Thus, we determined if VZV central nervous system infection produces amyloid. METHODS Aβ peptides, amylin, and amyloid were measured in cerebrospinal fluid (CSF) from 16 VZV vasculopathy subjects and 36 stroke controls. To determine if infection induced amyloid deposition, mock- and VZV-infected quiescent primary human perineurial cells (qHPNCs), present in vasculature, were analyzed for intracellular amyloidogenic transcripts/proteins and amyloid. Supernatants were assayed for amyloidogenic peptides and ability to induce amyloid formation. To determine amylin's function during infection, amylin was knocked down with small interfering RNA and viral complementary DNA (cDNA) was quantitated. RESULTS Compared to controls, VZV vasculopathy CSF had increased amyloid that positively correlated with amylin and anti-VZV antibody levels; Aβ40 was reduced and Aβ42 unchanged. Intracellular amylin, Aβ42, and amyloid were seen only in VZV-infected qHPNCs. VZV-infected supernatant formed amyloid fibrils following addition of amyloidogenic peptides. Amylin knockdown decreased viral cDNA. CONCLUSIONS VZV infection increased levels of amyloidogenic peptides and amyloid in CSF and qHPNCs, indicating that VZV-induced amyloid deposition may contribute to persistent arterial inflammation in VZV vasculopathy. In addition, we identified a novel proviral function of amylin.
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Affiliation(s)
- Andrew N Bubak
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Cheryl Beseler
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Christina N Como
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Christina M Coughlan
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Noah R Johnson
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - James E Hassell
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Anna M Burnet
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Teresa Mescher
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - D Scott Schmid
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Colin Coleman
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Ravi Mahalingam
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Randall J Cohrs
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA.,Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Timothy D Boyd
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Huntington Potter
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Ali H Shilleh
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Holger A Russ
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Maria A Nagel
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA.,Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA
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