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Friday, August 31, 2012

Herpes linked to Alzheimer's disease: 'Cold sores' connected to cognitive decline

ScienceDaily (Apr. 4, 2011) — Laboratories at the University of New Mexico (UNM), Brown University, and House Ear Institute (HEI) have developed a new technique to observe herpes simplex virus type 1 (HSV1) infections growing inside cells. HSV1, the cause of the common cold sore, persists in a latent form inside nerve cells. Re-activation and growth of HSV1 infections contribute to cognitive decline associated with Alzheimer's disease.

Details are published in the March 31 issue of PLoS ONE.

"Herpes infects mucous membranes, such as the lip or eye, and generates viral particles," submits study Principal Investigator Elaine Bearer, M.D., Ph.D., Harvey Family Professor and Vice Chair for Research, Department of Pathology, UNM School of Medicine. "These viral particles burst out of the cells of the mucous membrane and enter sensory nerve cells where they travel inside the nerve toward the brain. We now can see this cellular transportation system and watch how the newly formed virus engages cellular APP on its journey out of the cell."

Tagging herpes virus inside cells with green fluorescent protein, scientists used live confocal imaging to watch HSV1 particles emerge from infected cells. Newly produced viral particles exit the cell nucleus and then bud into cellular membranes containing amyloid precursor protein (APP). Electron microscopy at HEI detailed the ultrastructural relationship between HSV1 particles and APP.

This dance between viral particles and cellular APP results in changes in cellular architecture and the distribution of APP, the major component of senile plaques found in the brains of Alzheimer's disease patients. Results from this study indicate that most intracellular HSV1 particles undergo frequent, dynamic interplay with APP, which facilitates viral transport while interfering with normal APP transport and distribution. This dynamic interaction reveals a mechanism by which HSV1 infection leads to Alzheimer's disease.

In developed countries such as the U.S., approximately 20 percent of children are infected with HSV1 prior to the age of five. By the second and third decades of life, as much as 60 percent of the population is infected, and late-in-life infection rate reaches 85 percent.

Symptoms of primary HSV1 infection include painful blisters of the mouth, lips or eyes. After infection, HSV1 persists in nerve cells by becoming latent. Upon re-awakening, new viral particles are made in the neuron and then travel back out its pathways to re-infect the mucous membrane. Many infected people experience sporadic episodes of viral outbreaks as the well-known recurrent cold sore.

"Clinicians have seen a link between HSV1 infection and Alzheimer's disease in patients, so we wanted to investigate what might be going on in the body that would account for this," adds Dr. Shi-Bin Cheng, post-doctoral associate, Department of Pathology and Laboratory Medicine, Alpert Medical School, Brown University. "What we were able to see in the lab strongly suggests a causal link between HSV1 and Alzheimer's Disease."

"It's no longer a matter of determining whether HSV1 is involved in cognitive decline, but rather how significant this involvement is," Bearer asserts. "We'll need to investigate anti-viral drugs used for acute herpes treatment to determine their ability to slow or prevent cognitive decline."

Researchers recommend people treat a cold sore as quickly as possible to minimize the amount of time the virus is actively traveling through a person's nervous system. The faster a cold sore is treated, the faster the HSV1 returns to a dormant stage.

Additional Authors include: Paulette Ferland, senior research assistant, UNM; Paul Webster, House Ear Institute, Los Angeles, CA; participation of Kathleen Kilpatrck, UNM; and many undergraduate students at Brown who contributed to this project are acknowledged.

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Shi-Bin Cheng, Paulette Ferland, Paul Webster, Elaine L. Bearer. Herpes Simplex Virus Dances with Amyloid Precursor Protein while Exiting the Cell. PLoS ONE, 2011; 6 (3): e17966 DOI: 10.1371/journal.pone.0017966

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Thursday, August 30, 2012

Gene is first linked to herpes-related cold sores

ScienceDaily (Nov. 29, 2011) — A team of researchers from the University of Utah and the University of Massachusetts has identified the first gene associated with frequent herpes-related cold sores.

The findings were published in the Dec. 1, 2011, issue of the Journal of Infectious Diseases.

Herpes simplex labialis (HSL) is an infection caused by herpes simplex virus type 1 (HSV-1) that affects more than 70 percent of the U.S. population. Once HSV-1 has infected the body, it is never removed by the immune system. Instead, it is transported to nerve cell bodies, where it lies dormant until it is reactivated. The most common visible symptom of HSV-1 reactivation is a cold sore on or around the mouth. Although a majority people are infected by HSV-1, the frequency of cold sore outbreaks is extremely variable and the causes of reactivation are uncertain.

"Researchers believe that three factors contribute to HSV-1 reactivation -- the virus itself, exposure to environmental factors, and genetic susceptibility," says John D. Kriesel, M.D., research associate professor of infectious diseases at the University of Utah School of Medicine and first author on the study. "The goal of our investigation was to define genes linked to cold sore frequency."

Kriesel and his colleagues previously had identified a region of chromosome 21 containing six genes significantly linked to HSL disease using DNA collected from 43 large families to map the human genome. In the current study, Kriesel and his colleagues performed intensive analysis of this chromosome region using single nucleotide polymorphism (SNP) genotyping, a test which identifies differences in genetic make-up between individuals.

"Using SNP genotyping, we were able to identify 45 DNA sequence variations among 618 study participants, 355 of whom were known to be infected with HSV-1," says Kriesel. "We then used two methods called linkage analysis and transmission disequilibrium testing to determine if there was a genetic association between particular DNA sequence variations and the likelihood of having frequent cold sore outbreaks."

Kriesel and his colleagues discovered that an obscure gene called C21orf91 was associated with susceptibility to HSL. They identified five major variations of C21orf91, two of which seemed to protect against HSV-1 reactivation and two of which seemed to increase the likelihood of having frequent cold sore outbreaks.

"There is no cure for HSV-1 and, at this time, there is no way for us to predict or prevent cold sore outbreaks," says Kriesel. "The C21orf91 gene seems to play a role in cold sore susceptibility, and if this data is confirmed among a larger, unrelated population, this discovery could have important implications for the development of drugs that affect cold sore frequency."

Kriesel's University of Utah collaborators include Maurine R. Hobbs, Ph.D., research assistant professor of internal medicine and adjunct assistant professor of human genetics, and Mark F. Leppert, Ph.D., distinguished professor and former chair of human genetics.

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The above story is reprinted from materials provided by University of Utah Health Sciences.

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J. D. Kriesel, B. B. Jones, N. Matsunami, M. K. Patel, C. A. St. Pierre, E. A. Kurt-Jones, R. W. Finberg, M. Leppert, M. R. Hobbs. C21orf91 Genotypes Correlate With Herpes Simplex Labialis (Cold Sore) Frequency: Description of a Cold Sore Susceptibility Gene. Journal of Infectious Diseases, 2011; 204 (11): 1654 DOI: 10.1093/infdis/jir633

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Wednesday, August 29, 2012

Drug against AIDS could be effective against herpesvirus

ScienceDaily (Sep. 24, 2010) — Scientists at the Institute for Research in Biomedicine (IRB Barcelona) headed by the coordinator of the Structural and Computational Biology Programme, Miquel Coll, have published a new study that demonstrates that raltegravir, the drug approved in 2007 for the treatment of AIDS that is sold by Merck under the name Isentress, cancels the function of an essential protein for the replication of one kind of herpes virus. This study, published in the journal Proceedings of the National Academies of Sciences (PNAS), is the first step towards the development of a drug against the entire herpesvirus family.

"These results have a clear medical impact for three reasons," explains Miquel Coll, also a CSIC research professor. "First, humans do not have the viral protein that is affected, thus this would allow a highly specific drug that does not show the secondary effects that other drugs may have. Second, the inhibitor is not toxic for humans when administered at therapeutic concentrations because it is already on the market and thus toxicity tests are facilitated; and third, we have data that indicate that all herpes viruses have this protein. Therefore, it could be a valid target against all Herpesviridae."

Herpesviruses include pathogens such as herpes simplex 1 and 2, the virus that causes chickenpox otherwise known as zoster virus, the Epstein-Barr virus -associated with several types of cancer -, the roseola virus, the cytomegalovirus and the herpes virus associated with Kaposi sarcoma -in AIDS patients -. The human cytomegalovirus (HCMV), on which the study was performed, causes neurological defects in 1% of neonates in developed countries. It also produces retinitis that deteriorates into blindness in 25% of subjects with AIDS, defects in the brains and central nervous systems of young adults, inflammation of the colon -also in those with AIDS -, mononucleosis and serious diseases of the throat. Although 90% of adults carry HCMV, this virus is opportunistic, acting in people with weakened immune systems such as in cancer and AIDS patients, recipients of organ transplants and neonates.

Blocking viral replication

To replicate, the herpes virus enters the nucleus of a cell where it uses the cell machinery to copy its DNA several times into a single large chain. Once this copy has been made, acts a complex called terminase, formed by three protein subunits. The terminase cuts the new DNA into small fragments, the size of a single viral genome, and introduces these into empty shells (capsids) that have developed in the cell nucleus. Then, the new viruses leave the cell to continue infection. The researchers resolved the 3D structure of one part of the terminase and when they observed that it resembled the integrase of the AIDS virus, for which drugs are available, they tested it against the herpes virus protein. Thus they discovered that raltegravir acts on the subunit UL89 of the terminase and cancels the scissor function, which is required for viral replication.

The assays were performed directly on the protein in test tubes. "Now we must do the assays on whole infected cells, improve the effect of the drug and validate that it is also effective for other kinds of herpes viruses," explains Miquel Coll, whose lab has patented this second application for raltegravir. To resolve the 3D structure of the target protein, the scientists have used a state-of-the-art high-performance protein expression technique, with the collaboration with Darren Hart's group at EMBL in Grenoble, where 18,000 clones or different fragments of the protein have been tested. They have also used the Grenoble synchrotron to obtain the structural data. The study has lasted five years and forms part of the European project SPINE-2 complexes.

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Journal Reference:

M. Nadal, P. J. Mas, A. G. Blanco, C. Arnan, M. Sola, D. J. Hart, M. Coll. Structure and inhibition of herpesvirus DNA packaging terminase nuclease domain. Proceedings of the National Academy of Sciences, 2010; 107 (37): 16078 DOI: 10.1073/pnas.1007144107

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Monday, August 27, 2012

Microbicide gel: Reduced risk of HIV and herpes infections in women, study shows

ScienceDaily (July 20, 2010) — Researchers have achieved an important scientific breakthrough in the fight against HIV and genital herpes with a vaginal gel that significantly reduces a woman's risk of being infected with these viruses. The results of the ground-breaking safety and effectiveness study of an antiretroviral microbicide gel study were reported by the Centre for the AIDS Programme of Research in South Africa (CAPRISA) at the XVIII International AIDS Conference in Vienna, Austria.

The microbicide containing 1% tenofovir -- an antiretroviral drug widely used in the treatment of HIV -- was found to be 39% effective in reducing a woman's risk of becoming infected with HIV during sex and 51% effective in preventing genital herpes infections in the women participating in the trial. Should other studies of tenofovir gel confirm these results, widespread use of the gel, at this level of protection, could prevent over half a million new HIV infections in South Africa alone over the next decade.

"Tenofovir gel could fill an important HIV prevention gap by empowering women who are unable to successfully negotiate mutual faithfulness or condom use with their male partners," said study co- principal investigator, Dr. Quarraisha Abdool Karim, Associate Director of CAPRISA and Associate Professor of Epidemiology at Columbia University. "This new technology has the potential to alter the course of the HIV epidemic, especially in southern Africa where young women bear the brunt of this devastating disease."

Tenofovir works by preventing HIV from growing inside human cells. Taken in pill form, tenofovir is a common component of various three-drug cocktails that are used to treat HIV infections. The new results now indicate that tenofovir formulated as a topical gel and inserted into the female genital tract also has great promise for use in HIV and herpes simplex virus type-2 (HSV-2) prevention.

The CAPRISA 004 trial of tenofovir gel involved 889 women at high risk of HIV infection at an urban and a rural site in KwaZulu-Natal, South Africa. Overall, 98 women out of the 889 became HIV positive during the trial -- with 38 in the tenofovir gel group and 60 in the placebo gel group. Out of the 434 women who tested negative for herpes at the start of the trial, 29 became infected in the tenofovir group and 58 became infected in the placebo group. The reduced rates of HIV and herpes infections among the women who used the tenofovir gel are statistically significant.

"Tenofovir gel has a potential dual effect in preventing HIV. Since women with genital herpes are much more likely to become infected with HIV, the additional protection of tenofovir gel against herpes creates a second mechanism whereby the gel may have a bigger impact in preventing HIV," said study co-principal investigator, Dr Salim S. Abdool Karim, Director of CAPRISA and Pro Vice-Chancellor (Research) of the University of KwaZulu-Natal, South Africa. "The trial results are a significant first step toward establishing the effectiveness of antiretroviral drugs for HIV and genital herpes prevention; confirmatory studies are now urgently needed."

During monthly visits, all participants were provided with HIV risk-reduction counseling, condoms and treatment for sexually transmitted infections, and each was clinically examined for potential side effects and tested for HIV infection. The study was double-blinded and neither the researchers nor the participating women knew whether a woman in the study received tenofovir gel or placebo gel. Women in the study were advised to use the gel up to 12 hours before sex and soon after having sex for a maximum of two doses in 24 hours -- a dosing strategy referred to as BAT24. Participants used the gel for a minimum of one year and a maximum of two and a half years. The trial team observed no substantive safety concerns from use of the gel. Further, no increase in risky behavior was observed in the women.

The CAPRISA researchers also found that the protective effect against HIV and genital herpes increased as use of the tenofovir gel increased. Women who used the gel in more than 80% of their sex acts had a 54% reduction in HIV infections, whereas those who used the gel in less than half of their sex acts had a 28% reduction in HIV infections. Among those women who became infected, tenofovir gel had no effect on the amount of HIV in their bloodstream at the time of infection. Also, none of the women who became infected with HIV showed resistance to tenofovir.

All volunteers to the study who tested HIV positive were provided care including ARV treatment at the CAPRISA clinics and women who became infected during the study were enrolled into CAPRISA studies and/or the CAPRISA AIDS treatment program at their respective sites for ongoing care and support.

This study was jointly funded by the Governments of South Africa and the United States, through the Technology Innovation Agency (TIA) and the US Agency for International Development (USAID), respectively. USAID provided $16.5M and TIA provided $1.1 for the study. "USAID is proud to be the major donor of this first-ever proof of concept that a vaginal microbicide can effectively and safely reduce the risk of HIV transmission from men to vulnerable women. The success of the CAPRISA 004 trial perfectly complements the Global Health Initiative and our focus on women's health, both in prevention and sustainable health delivery systems," stated USAID Administrator Raj Shah.

The promising findings of the CAPRISA 004 study is only a first step in determining if tenofovir gel is effective in preventing HIV and herpes infection; additional studies are urgently needed to confirm and extend the findings of the CAPRISA study. Important information is expected from current studies such as the Microbicide Trials Network's VOICE study, which is currently assessing daily tenofovir gel as well as daily tenofovir and Truvada tablets in women in several African countries. Studies of daily Truvada tablets are underway in intravenous drug users, young high-risk women and men who have sex with men.

"We are proud to have partnered with CAPRISA and CONRAD on this important study. We see it as a major victory in the field of HIV prevention research. This is the first evidence that an antiretroviral drug in a gel form -- a microbicide -- can reduce HIV and genital herpes infection in women," said Ward Cates, President of FHI. "The next step is to see whether other studies underway confirm these exciting results."

Only after drug regulatory authorities determine that tenofovir gel is safe and effective for HIV prevention, can the gel be made available to the public for HIV prevention. Since this process can take several years, TIA and U.S.-based CONRAD are working together to address the challenges to making the gel available first to women in South Africa.

"CONRAD has given the rights to manufacture this gel to the government of South Africa to get this much needed product to women in South Africa as rapidly as possible," said Dr. Henry Gabelnick, Executive Director of CONRAD, who provided the gel for the study. "The Technology Innovation Agency (TIA) is working closely with the South African government, CAPRISA and CONRAD to ensure that this important innovation makes an impact in preventing the spread of HIV/AIDS," said Dr. Mamphela Ramphele, Chairperson of TIA.

Ambassador Eric Goosby, U.S. Global AIDS Coordinator said, "The results of the CAPRISA trial provide new hope and direction for not only HIV prevention, but also broader efforts under the Global Health Initiative. We recognize that microbicides will be a great asset to HIV prevention efforts, and the U.S. Government is pleased to support this important research."

Professor Malegapuru Makgoba, Vice-Chancellor of the University of KwaZulu-Natal stated, "This piece of research is a significant milestone for women in the thirty year history of the HIV/AIDs epidemic, microbicides and antiretroviral research. The research represents that which is best in science with direct translation into prevention policy, bringing a message of hope and empowerment to women, policymakers and scientists. These research findings will not only significantly alter the shape and form but also the future direction of this devastating epidemic."

"The trial's findings create a new vision for the opportunity for prevention of HIV and re-define the public health approach to HIV control," added Dr Linda Fried, Dean of the Mailman School of Public Health of Columbia University, New York.

The trial was conducted by CAPRISA in partnership with the U.S.-based organizations FHI and CONRAD with funding from USAID. Gilead Sciences donated the active ingredient for the manufacture of the tenofovir gel.

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Tansy may be used to treat herpes, study suggests

ScienceDaily (Apr. 14, 2011) — A folk remedy may be an effective treatment for the sexually transmitted disease herpes according to Dr Solomon Habtemariam from the University of Greenwich's School of Science and Professor Francisco Parra at the Universidad de Oviedo in Spain.

Tansy, Tanacetum Vulgare, is a flowering plant found across mainland Europe and Asia. From the Middle Ages onwards the plant, whose folk names include Golden Buttons and Mugwort, has been used as a remedy for various conditions, from fevers to rheumatism. However, its supposed medical benefits have always been questioned.

Joint work between research groups led by Dr Habtemariam from the School of Science at the University of Greenwich at Medway and Professor Francisco Parra at the Universidad de Oviedo in Spain, published in Phytotherapy Research, has revealed the clear potential of tansy as a treatment for herpes.

Dr Solomon Habtemariam says: "We have identified several compounds in the plant with strong antioxidant potential. Antioxidants are important for healing wounds and can be used to treat the skin eruptions and blister-like lesions or cold sores that are the symptoms of herpes. The drugs currently available to treat the disease are becoming less effective as the virus is developing resistance to them. Diseases such as genital herpes are also increasing due to immunosuppressive illnesses such as AIDS.

"Our studies have proved the scientific basis for many traditional medicinal plants. We are now able to identify even more structurally complex natural products and those that are present in plants in minute concentrations with our state-of-the-art analytical facilities. In collaboration with our international partners, we are searching for novel antidiabetic, antimicrobial, anticancer, anti-inflammatory and neuroprotective agents from natural sources."

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The above story is reprinted from materials provided by University of Greenwich, via AlphaGalileo.

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Ángel L. Álvarez, Solomon Habtemariam, Malindra Juan-Badaturuge, Caroline Jackson, Francisco Parra. In vitro anti HSV-1 and HSV-2 activity of Tanacetum vulgare extracts and isolated compounds: An approach to their mechanisms of action. Phytotherapy Research, 2010; DOI: 10.1002/ptr.3382

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Saturday, August 25, 2012

Novel RNA transport mechanism: Ribonucleoprotein granules exit the nucleus via a budding mechanism

ScienceDaily (May 10, 2012) — The movement of genetic materials, such as RNA and ribosomes, from the nucleus to the cytoplasm is a critical component in a cell's ability to make the proteins necessary for essential biological functions. Until now, it was believed the nuclear pore complex was the sole pathway between the cell nucleus and cytoplasm for these materials.

New evidence published in Cell by Vivian Budnik, PhD, professor of neurobiology, Melissa J. Moore, PhD, the Eleanor Eustis Farrington Chair in Cancer Research, Howard Hughes Medical Institute Investigator and professor of biochemistry & molecular pharmacology, and colleagues, reveals a novel budding mechanism, similar to the process used by some viruses, capable of exporting large ribonucleoprotein (RNP) particles from the nucleus to the cytoplasm.

"The findings in this paper fundamentally change our understanding of mRNA export from the nucleus," said Dr. Moore. "In addition to the canonical pathway of mRNA export going through the nuclear pore complex, we now know that large RNA transport granules can be assembled in the cell nucleus and exported via a budding mechanism previously thought to only be used by the herpes virus."

This study has helped to unravel how RNAs support the development of the post-synaptic apparatus, said Dr. Budnik. "It provides new evidence about communication between the nucleus and cytoplasm that has implications for diseases that affect the nuclear envelope such as muscular dystrophies and herpes-type infections such as shingles."

Found along the surface of the nuclear envelope, nuclear pores are small openings that allow certain molecules, such as messenger RNA, transfer RNA and ribosomes, to be transported across this physical barrier that separates a cell's nucleus and DNA from its cytoplasm. Once in the cytoplasm, these genetic materials are the factories and blueprints used by the cell to create proteins. In some cells, these RNAs are bound together in large clusters known as transport granules, which are carried to precise locations within a cell to synthesize specific proteins needed at that site.

"When we look at these transport granules to scale, we see that they're too large to pass through the nuclear pore complex," said Moore. "An open question has been, where are these transport granules first assembled? And if it's in the nucleus, how do they make their way to the cytoplasm?"

Working to understand how synapses develop and communicate with neighboring muscle cells, Budnik discovered a new method whereby these large granules, in the form of RNP particles, were transported across the nuclear envelope. Specifically, Budnik and colleagues were investigating how the Wnt/wingless (Wg) protein secreted by the motor neuron initiates a reaction involving the DFrizzled2 (DFz2) receptor on the nearby muscle cell. This interaction between Wg and DFz2 eventually leads a portion of the DFz2 into the muscle cell nucleus where it accumulates around large RNP granules containing messenger RNAs. Once they reach their final destination in the muscle cell cytoplasm, these RNAs are responsible for making the synaptic proteins critical to increasing the size of the junction between motor neuron and muscle cell.

It was while investigating this process that Budnik and colleagues witnessed these large granules exiting the muscle cell's nucleus in an unusual manner. "What was so surprising," said Sean D. Speese, PhD, former postdoctoral fellow in the Budnik lab and currently research assistant professor at Oregon Health and Sciences University, "was that the nuclear DFz2-large-RNPs utilized a novel mechanism for exiting the nucleus, which appeared independent of the nuclear pores and resembled the egress of herpes-type viruses from the nuclear envelope."

During infection, herpes virus particles are assembled in the nucleus. But they are much too large to exit through the nuclear pores. Instead, they bud through the double membranes of the nuclear envelope. To exit the nucleus, the protein shell surrounding the virus disrupts the lamina, a fibrous component located beneath the inner nuclear membrane which, among other properties, anchors the nuclear pore complexes to the nuclear membranes. This allows the virus to bud into the space between the inner and the outer nuclear membrane, becoming enveloped by the inner nuclear membrane. Fusion of this coat with the outer nuclear membrane then allows the virus to be released into the cytoplasm.

"Similarly, we found that DFz2C-RNPs used the same mechanism and viral machinery to reach the cytoplasm," said Dr. Speese. Once inside the muscle cell nucleus, the DFz2C RNPs recruit proteins, such as kinase C, to disrupt the lamins, which allows them to bud into the inner nuclear membrane. "In both cases, this process was dependent on an A-type lamina protein, which in humans is associated with a number of muscular dystrophies and early aging syndromes when mutated," said Speese.

Collectively, these discoveries have significant ramifications for our understanding of multiple biological questions including RNA transport, synapse development and the herpes virus, which causes chicken pox and shingles as well as Epstein-Barr virus, which causes mononucleosis.

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The above story is reprinted from materials provided by University of Massachusetts Medical School. The original article was written by Jim Fessenden.

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Sean D. Speese, James Ashley, Vahbiz Jokhi, John Nunnari, Romina Barria, Yihang Li, Bulent Ataman, Alex Koon, Young-Tae Chang, Qian Li, Melissa J. Moore, Vivian Budnik. Nuclear Envelope Budding Enables Large Ribonucleoprotein Particle Export during Synaptic Wnt Signaling. Cell, 2012; 149 (4): 832 DOI: 10.1016/j.cell.2012.03.032

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Friday, August 24, 2012

To spread, nervous system viruses sabotage cell, hijack transportation

ScienceDaily (May 30, 2012) — Herpes and other viruses that attack the nervous system may thrive by disrupting cell function in order to hijack a neuron's internal transportation network and spread to other cells.

Princeton University researchers made the first observation in neurons that common strains of the herpes virus indirectly take control of a cell's mitochondria, the mobile organelles that regulate a cell's energy supply, communication with other cells, and self-destruction response to infection. The team reports in the journal Cell Host and Microbe that viral infection elevates neuron activity, as well as the cell's level of calcium -- a key chemical in cell communication -- and brings mitochondrial motion to a halt in the cell's axon, which connects to and allows communication with other neurons.

The authors propose that the viruses then commandeer the proteins that mitochondria typically use to move about the cell. The pathogens can then freely travel and reproduce within the infected neuron and more easily spread to uninfected cells. When the researchers made the mitochondria less sensitive to calcium the viruses could not spread as quickly or easily.

These findings reveal a previously unknown and highly efficient mechanism that some of the most common strains of herpes viruses in humans may use to proliferate in the nervous system, said lead author Tal Kramer, a doctoral student in the lab of the paper's co-author Lynn Enquist, the Henry L. Hillman Professor of Molecular Biology and chair of Princeton's molecular biology department.

Kramer and Enquist used rat neurons to study two herpes viruses in the alpha-herpes virus subfamily: pseudorabies virus (PRV), a model alpha-herpes virus that infects animals, and herpes simplex virus 1 (HSV-1), an extremely common human virus that causes cold sores and other lesions. Other human alpha-herpes viruses are responsible for causing diseases such as chicken pox and shingles.

"No one before has looked carefully at mitochondrial motion during alpha-herpes virus infection in neurons. We provide new insight into how these viruses damage cells in the nervous system in ways that are important for the virus to propagate," Kramer said.

"If mitochondria are stopped in their tracks and can't go anywhere, that is potentially very bad," he said. "They are not only the power plants of the cell, but regulate important processes. The virus likely acts to interfere with many of those processes."

Beyond herpes, the Princeton findings present a possible explanation for how other neurotropic viruses such as rabies, West Nile and polio attack and disrupt the nervous system, Kramer said. Although these viruses are different from the herpes family, the fact that HSV-1 and PRV had a similar effect on mitochondrial motion and function suggests that other pathogens could corrupt mitochondria in the same way, he said.

In addition, the paper lays out the implications of distorted mitochondrial function on neuron health. Mitochondrial malfunction is a known factor in non-infectious neurodegenerative conditions such as Alzheimer's disease and Parkinson's disease, Kramer said, though the pathway to this disruption is not entirely known.

"Our model raises some new and exciting possibilities for future research on other important human viruses that can invade the nervous system and cause disease," Kramer said.

"And the fact that alpha-herpes infection damages the same key cellular function as neurodegenerative disorders also is striking," he said. "Understanding how viral infection damages neurons might give us insight into how diseases like Alzheimer's do the same. The viruses we study hijack well-studied cellular pathways that might make an effective target for future therapeutic strategies."

In a healthy neuron, mitochondria move throughout the cell's elongated, tree-like structure to provide energy for various processes that occur throughout the cell. For the strenuous task of long distance intercellular communication, mitochondria move along the axon and synapses, sites of cell-to-cell contact where signaling occurs.

Calcium plays a key role in this cell communication, Kramer explained. A neuron experiences a spike in calcium levels in the axon and synapses when it receives a signal from another neuron. Though a natural rover, mitochondria contain a protein called Miro that detects this rush of calcium and stops the organelles in the synapse. The mitochondria then provide energy as the cell passes a signal along to the next neuron.

Through live-cell imaging of neurons grown in the Enquist lab, Kramer and Enquist observed how this process becomes corrupted by HSV-1 and PRV -- and how the viruses need the process to spread.

The chaos begins when the virus ramps up the neuron's firing of electrical signals, as was first reported in a 2009 paper published in the journal PLoS Pathogens by Enquist; first author Kelly McCarthy, a past member of Enquist's lab who received her doctoral degree from Princeton in 2011; and David Tank, the Henry L. Hillman Professor of Molecular Biology and co-director of the Princeton Neuroscience Institute.

In the latest research, Kramer and Enquist found that this spike in electrical activity floods the axon and synapses with calcium. As a consequence, the Miro proteins detect the increase in calcium and stop mitochondrial motion. The virus' control over the cell immediately dropped off, however, when Kramer and Enquist interfered with Miro's ability to respond to the uptick in calcium levels. Though the viral infection was not completely disrupted, it could not spread within or to other cells with the same efficiency.

Based on these observations, Kramer and Enquist suggest that viruses such as HSV-1 and PRV may bring mitochondria to a standstill in order to hijack their transportation. Mitochondria move about the neuron on the backs of motor proteins dynein and kinesin-1. During viral infection, mitochondria shed these proteins to stop moving when Miro detects an upsurge in cellular calcium.

Previous research has shown that HSV-1 and PRV also use kinesin-1 specifically for transport within an infected cell. Thus, Kramer said, his and Enquist's work suggests that it is very likely that the viruses disrupt mitochondrial motility so that they can hitch themselves to the now available kinesin-1 proteins and move through the nervous system more efficiently.

James Alwine, a University of Pennsylvania professor of cancer biology, said that the Princeton research is a significant contribution to a growing body of research that describes how viruses seize cellular motor proteins such as kinesin-1.

While the findings have therapeutic potential -- particularly in helping show how balancing cellular calcium might subdue viral infection -- the demonstration that viruses can move through an infected cell with the ease of something as essential as mitochondria is notable in itself, said Alwine, who is familiar with the research but had no role in it.

"Determining the specific mechanism by which Miro function is abrogated may provide additional therapeutic avenues, but this also is marvelous basic research that does not have to be justified by its therapeutic potential," he said.

"To disrupt the loading of mitochondria to motor proteins so that virions [complete virus particles] can load instead is a clever way for a virus to be transported and is a great new idea provoked by this data," Alwine said. "While other neurotropic viruses would have to be tested specifically, movement in nerve cells is required by all of them. Thus, this observation provides a starting place and a model mechanism for research with those other pathogens."

This research was published May 17 in the journal Cell Host and Microbe, and supported by the National Institutes of Health and a National Science Foundation Graduate Research Grant.

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Tal Kramer, Lynn W. Enquist. Alphaherpesvirus Infection Disrupts Mitochondrial Transport in Neurons. Cell Host & Microbe, 2012; 11 (5): 504 DOI: 10.1016/j.chom.2012.03.005

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Thursday, August 23, 2012

Herpes virus' tactical maneuver visualized in 3-D

ScienceDaily (Jan. 10, 2011) — For the first time, researchers have developed a 3-D picture of a herpes virus protein interacting with a key part of the human cellular machinery, enhancing our understanding of how it hijacks human cells to spread infection and opening up new possibilities for stepping in to prevent or treat infection. This discovery uncovers one of the many tactical maneuvres employed by the virus.

The Biotechnology and Biological Sciences Research Council (BBSRC)-funded team, led by The University of Manchester, have used NMR -- a technique related to the one used in MRI body scanners and capable of visualizing molecules at the smallest scales -- to produce images of a herpes virus protein interacting with a mouse cellular protein. These images were then used to develop a 3-D model of this herpes virus protein interacting with human protein. The research is published in PLoS Pathogens.

Lead researcher Dr. Alexander Golovanov from Manchester's Interdisciplinary Biocentre and Faculty of Life Sciences said: "There are quite a few types of herpes viruses that cause problems as mild as cold sores through to some quite serious illnesses, such as shingles or even cancer. Viruses cannot survive or replicate on their own -- they need the resources and apparatus within a human cell to do so. To prevent or treat diseases caused by viruses we need to know as much as possible about how they do this so that we can spot weak points or take out key tactical maneuvres."

The 3-D model shows how the viral protein piggybacks onto the molecular machinery components inside human cells, promoting virus replication and spread of infection through the body.

"When you look at the image, it's like a backpack on an elephant: the small compact fragment of viral protein fits nicely on the back of the human protein," said Dr. Golovanov.

By studying the images along with biochemical experiments using the human version of the cellular protein, the team has uncovered the mechanism by which the viral and cellular proteins work together to guide the viral genetic material out of the cell's nucleus. Once there, the genetic material can be utilized to make proteins that are used as building blocks for new viruses. The researchers have also confirmed that this relationship between the two proteins exists for related herpes viruses that infect monkeys.

Dr. Golovanov continued: "Our discovery gives us a whole step more detail on how herpes viruses use the human cell to survive and replicate. This opens up the possibilities for asking new questions about how to prevent or treat the diseases they cause."

Professor Janet Allen, BBSRC Director of Research said: "This new research gives us an important piece of the jigsaw for how a particular viral infection works on a molecular level, which is great news. Understanding the relationship between a human, animal or plant -- the host -- and the organisms that cause disease -- pathogens -- is a fundamental step toward successful strategies to minimize the impact of infection. To study host-pathogen relationships we have to look in detail at the smallest scale of molecules -- as this study does -- and also right through to the largest scale of how diseases work in whole systems -- a crop disease in the context of a whole area of agricultural land, for example. BBSRC's broad portfolio of research into host-pathogen relationships facilitates this well."

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Richard B. Tunnicliffe, Guillaume M. Hautbergue, Priti Kalra, Brian R. Jackson, Adrian Whitehouse, Stuart A. Wilson, Alexander P. Golovanov. Structural Basis for the Recognition of Cellular mRNA Export Factor REF by Herpes Viral Proteins HSV-1 ICP27 and HVS ORF57. PLoS Pathogens, 2011; 7 (1): e1001244 DOI: 10.1371/journal.ppat.1001244

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Tuesday, August 21, 2012

Genetically reprogrammed HSV given systemically shrinks distant sarcomas

ScienceDaily (July 8, 2010) — Scientists have used a genetically reprogrammed herpes virus and an anti-vascular drug to shrink spreading distant sarcomas designed to model metastatic disease in mice -- still an elusive goal when treating humans with cancer, according to a study in the July 8 Gene Therapy.

Less than 30 percent of patients with metastatic cancer survive beyond five years, despite the aggressive use of modern combination therapies, including chemotherapy. This creates a significant need for new sarcoma therapies to treat metastatic disease, said Timothy Cripe, M.D., Ph.D., a physician/researcher in the division of Hematology/Oncology at Cincinnati Children's Hospital Medical Center and the study's senior investigator.

The study results are even more significant because the oncolytic herpes virus, HSV-rRp450, was given to the mice systemically to attack tumors via the blood stream instead of being injected directly into tumors.

"Systemic bio-distribution has been a major stumbling block for using virus vectors in gene transfer and virotherapy to treat cancer, but we show that viruses can be used systemically by giving them intravenously to get an anti-tumor effect," Dr. Cripe said.

Also important to results of the current study was using the virus in conjunction with a drug (bevacizumab) that blocks the growth of tumor feeding-blood vessels. In the current study, researchers focused on spreading Ewing sarcoma and Rhabdomyosarcoma -- cancers that form in muscle, bone and connective tissue.

Anti-angiogenic agents like bevacizumab are usually given first in combination cancer therapies because they help enlarge intercellular openings to tumor cells and ease the delivery of drugs, such as chemotherapies. In this study, however, the researchers discovered that bevacizumab has to be given after the virus to maximize the anti-tumor effect of the combined therapy. In fact, giving bevacizumab first lowered the virus's uptake in cancer cells.

The rRp450 oncolytic virus used in the study was derived from herpes simplex type 1. The virus was genetically modified by scientists by removing a gene that makes the virus unable to replicate efficiently in dormant cells. This causes the virus to selectively target and replicate in rapidly growing cancer cells while leaving normally dormant healthy tissue cells alone.

After removing the one gene from the virus, researchers replaced it with a gene that encodes an enzyme that activates a class of anti-tumor chemotherapies called oxazaphosphorines. The overall therapeutic approach is for the virus to infect and degrade the cancer cells and then activate chemotherapy agents as anti-angiogenic agents cut off vascular growth and blood supply to the tumors.

In the current study, however, researchers treated the mice only with rRp450 and the anti-angiogenic drug bevacizumab. This allowed them to test whether the virus could be given systemically, how anti-angiogenic drugs affected virus tumor uptake and the impact this had on tumor growth.

In mice receiving bevacizumab prior to the rRp450, overall tumor shrinkage averaged 40 percent. In mice receiving rRp450 before bevacizumab, tumor size was reduced by an average of 75 percent. The researchers also reported that mice treated with rRp450 before bevacizumab had longer survival rates.

Results of the current study could be used immediately to help design subsequent research into treatment protocols for oncolytic viruses, particularly clinical trials involving combination therapeutic strategies, Dr. Cripe said. Clinical trials are underway in the United States and Europe using oncolytic herpes viruses similar to the one used in the current study.

Other researchers involved in the current study include the first author, Francis Eshun, M.D., and Mark Currier, Rebecca Gillespie, Jillian Fitzpatrick and William Baird, all of the Division of Hematology/Oncology at Cincinnati Children's and its Cancer and Blood Diseases Institute. Funding support for the study from the Cincinnati Children's Division of Hematology/Oncology, teeoffagainstcancer.org, the Katie Linz Foundation, the Limb Preservation Foundation, the American Cancer Society and the National Institutes of Health.

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Sunday, August 19, 2012

Zoster vaccine associated with lower risk of shingles in older adults

ScienceDaily (Jan. 12, 2011) — Vaccination for herpes zoster, a painful rash commonly known as shingles, among a large group of older adults was associated with a reduced risk of this condition, regardless of age, race or the presence of chronic diseases, according to a study in the January 12 issue of JAMA.

"The pain of herpes zoster is often disabling and can last for months or even years, a complication termed postherpetic neuralgia. Approximately 1 million episodes of herpes zoster occur in the United States annually, but aside from age and immunosuppression, risk factors for this condition are not known," the authors write. Although prelicensure data provided evidence that herpes zoster vaccine works in a select study population under idealized circumstances, the vaccine needs to be evaluated in field conditions to show whether benefits of the vaccine can be generalized to conditions of clinical practice, according to background information in the article. The researchers note that this is particularly important for the herpes zoster vaccine, given the medical and physiological diversity in the elderly population for whom the vaccine is indicated.

Hung Fu Tseng, Ph.D., M.P.H., of Southern California Kaiser Permanente, Pasadena, Calif., and colleagues evaluated the risk of herpes zoster after receipt of herpes zoster vaccine among individuals in general practice settings. The study included community-dwelling adults, age 60 years or older, who were members of a managed care organization. There were 75,761 members in the vaccinated cohort, who were age matched (1:3) to 227,283 unvaccinated members.

Compared with the unvaccinated cohort, individuals in the vaccinated cohort were more likely to be white, women, and to have had more outpatient visits, and a lower prevalence of chronic diseases. There were 5,434 herpes zoster cases identified in the study (6.4 cases per 1,000 persons per year among vaccinated individuals and 13.0 cases per 1,000 persons per year among unvaccinated individuals). In the fully adjusted analysis, vaccination was associated with reduced risk of herpes zoster. The reduction in risk did not vary by age at vaccination, sex, race, or with presence of chronic diseases. Herpes zoster vaccine recipients had reduced risks of ophthalmic herpes zoster and hospitalizations coded as herpes zoster. Overall, the vaccine was associated with a 55 percent reduction in incidence of herpes zoster.

"Herpes zoster vaccine was licensed recently, which means the durability of its protection needs to be assessed in future studies. Meanwhile, however, this vaccine has the potential to annually prevent tens of thousands of cases of herpes zoster and postherpetic neuralgia nationally. To date, herpes zoster vaccine uptake has been poor due to weaknesses in the adult vaccine infrastructure and also due to serious barriers to the vaccine among clinicians and patients. Solutions to these challenges need to be found so that individuals seeking to receive herpes zoster vaccine will be able to reduce their risk of experiencing this serious condition," the authors conclude.

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H. F. Tseng, N. Smith, R. Harpaz, S. R. Bialek, L. S. Sy, S. J. Jacobsen. Herpes Zoster Vaccine in Older Adults and the Risk of Subsequent Herpes Zoster Disease. JAMA: The Journal of the American Medical Association, 2011; 305 (2): 160 DOI: 10.1001/jama.2010.1983

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Antiviral drugs may slow Alzheimer's progression

ScienceDaily (Oct. 20, 2011) — Antiviral drugs used to target the herpes virus could be effective at slowing the progression of Alzheimer's disease (AD), a new study shows.

The University of Manchester scientists have previously shown that the herpes simplex virus type 1 (HSV1) is a risk factor for Alzheimer's when it is present in the brains of people who have a specific genetic risk to the disease.

AD is an incurable neurodegenerative condition affecting about 18 million people worldwide. The causes of the disease or of the abnormal protein structures seen in AD brains -- amyloid plaques and neurofibrillary tangles -- are completely unknown.

The Manchester team has established that the herpes virus causes accumulation of two key AD proteins -- ß-amyloid (Aß) and abnormally phosphorylated tau (P-tau) -- known to be the main components of plaques and tangles respectively. Both proteins are thought by many scientists to be involved in the development of the disease.

"We have found that the viral DNA in AD brains is very specifically located within amyloid plaques," said Professor Ruth Itzhaki, who led the team in the University's Faculty of Life Sciences. "This, together with the production of amyloid that the virus induces, suggests that HSV1 is a cause of toxic amyloid products and of plaques.

"Our results suggest that HSV1, together with the host genetic factor, is a major risk for AD, and that antiviral agents might be used for treating patients to slow disease progression."

Currently available antiviral agents act by targeting replication of HSV1 DNA, and so the researchers considered that they might be successful in treating AD only if the accumulation of ß-amyloid and P-tau accumulation caused by the virus occurs at or after the stage at which viral DNA replication occurs.

"If these proteins are produced independently of HSV1 replication, antivirals might not be effective," said Professor Itzhaki. "We investigated this and found that treatment of HSV1-infected cells with acyclovir, the most commonly used antiviral agent, and also with two other antivirals, did indeed decrease the accumulation of ß-amyloid and P-tau, as well as decreasing HSV1 replication as we would expect.

"This is the first study investigating antiviral effects on AD-like changes and we conclude that since antiviral agents reduce greatly ß-amyloid and P-tau levels in HSV1-infected cells, they would be suitable for treating Alzheimer's disease. The great advantage over current AD therapies is that acyclovir would target only the virus, not the host cell or normal uninfected cells. Further, these agents are very safe and are relatively inexpensive.

"Also, by targeting a cause of Alzheimer's disease, other viral damage, besides ß-amyloid and P-tau, which might be involved in the disease's pathogenesis, would also be inhibited.

"The next stage of our research -- subject to funding -- will focus on finding the most suitable antiviral agent -- or combination of two agents that operate via different mechanisms -- for use as treatment. We then need to investigate the way in which the virus and the genetic risk factor interact to cause the disease, as that might lead to further novel treatments.

"Eventually, we hope to begin clinical trials in humans but this is still some way off yet and again will require new funding."

The study, carried out with Dr Matthew Wozniak and other colleagues in the Faculty of Life Sciences, is published in the Public Library of Science (PLoS) One journal.

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Matthew A. Wozniak, Alison L. Frost, Chris M. Preston, Ruth F. Itzhaki. Antivirals Reduce the Formation of Key Alzheimer's Disease Molecules in Cell Cultures Acutely Infected with Herpes Simplex Virus Type 1. PLoS ONE, 2011; 6 (10): e25152 DOI: 10.1371/journal.pone.0025152

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Saturday, August 18, 2012

Possible origin of chronic lymphatic leukemia identified

ScienceDaily (Apr. 11, 2012) — Up until now the causes of the development of chronic lymphatic leukemia, the most common form of cancer of the blood in Europe, have been unknown. At present a cure is not possible. A research group at the MedUni Vienna led by Christoph Steininger of the University Department of Internal Medicine I has now however discovered a lead on the origin of this disease. Says Steiniger: "This could influence the therapy approach taken in treating chronic lymphatic leukemia."

For approximately 20 years it has been suspected that chronic lymphatic leukemia occurs through the stimulation of B cells with other factors also playing a part. In the current research study, which has been published in the journal "Blood," the scientists were looking for an antigen that attaches itself to the leukemia cell receptors and they were able to identify the protein pUL32 of the human cytomegalovirus.

Virus "conceals" itself in cells

The cytomegalovirus, a member of the herpes family of viruses, is carried by approximately 60 to 70 percent of the Austrian population without them getting ill from it and without them even noticing that they are carrying the virus. In most cases people are infected with the virus during childhood. After being infected, the virus goes on to survive in the cells of the immune system their whole life long. The virus conceals itself within the cells and in addition it confuses the immune system with its own chemical messengers.

Only when the immune system in an infected person is weakened, for example by medical suppression as part of an organ transplant or in an HIV-illness, can the virus make someone ill. Whether this virus infection can trigger leukemia, or whether the connection observed between leukemia and the cytomegalovirus points to another mechanism, independent of the virus, in the origin of the cancer is now the subject of several follow-up studies.

One of the follow-up studies is looking at whether an antiviral treatment against the cytomegalovirus can prevent the leukemia cells from being stimulated and so prevent the further advance of the disease.

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C. Steininger, G. F. Widhopf, E. M. Ghia, C. S. Morello, K. Vanura, R. Sanders, D. Spector, D. Guiney, U. Jager, T. J. Kipps. Recombinant antibodies encoded by IGHV1-69 react with pUL32, a phosphoprotein of cytomegalovirus and B-cell superantigen. Blood, 2012; 119 (10): 2293 DOI: 10.1182/blood-2011-08-374058

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Friday, August 17, 2012

Study challenges concerns on effectiveness of administering pneumococcal, shingles vaccines together

ScienceDaily (May 11, 2011) — Administering both the pneumococcal and the herpes zoster vaccines to patients during the same visit is beneficial and does not appear to compromise the protective effect of the zoster vaccine, according to a Kaiser Permanente study published in the journal Vaccine.

The study's findings challenge information in the zoster vaccine manufacturer's package insert. This new information is important to patients who find it more convenient and less costly to receive both vaccines from their health care providers during the same visit.

A revision to the zoster vaccine package insert, approved in 2009, stated that the zoster vaccine and the pneumococcal vaccine should not be given together because such concurrent use reduced the ability of the zoster vaccine to generate an immune response.

"Our study found no evidence that receiving the zoster vaccine and pneumococcal vaccine on the same day would compromise the immune response necessary to protect against herpes zoster, also known as shingles," noted study lead author Hung Fu Tseng, PhD, MPH, a research scientist with the Kaiser Permanente Department of Research & Evaluation in Pasadena, Calif.

The study was conducted from Jan. 1, 2007, to June 30, 2010, starting from the date of receipt of the zoster vaccine for two groups of Kaiser Permanente Southern California members, 60 years of age and older. The incidence of herpes zoster after vaccination with a zoster vaccine in the population receiving both vaccines on the same day was compared to that in the population receiving a pneumococcal vaccine from one year to 30 days before the zoster vaccine. Vaccinations and the incidence of herpes zoster cases were identified by electronic health records.

Included in the study were two groups or cohorts: 7,187 people who received both vaccines at the same time and 7,179 people who received the two vaccines at different times (nonconcurrently). There were 114 herpes zoster cases identified in the study: 56 cases in the concurrent group, and 58 cases in the nonconcurrent vaccination group. The study found no statistically significant difference in incidence of shingles between the two groups.

Dr. Tseng adds, "Ideally, when a new vaccine is introduced to the public, one should consider giving it at the same time as other vaccines to increase coverage levels and minimize administration costs, if there are no immune response issues or safety concerns."

According to the Centers for Disease Control and Prevention, pneumococcal polysaccharide vaccine protects against 23 types of pneumococcal bacteria, including those most likely to cause serious disease. Pneumococcal disease can result in long-term problems such as like brain damage, hearing loss and limb loss, and in some cases can be fatal. Most healthy adults who get the vaccine develop protection to most or all of these types within two to three weeks of getting the shot.

The risk of developing shingles during a lifetime is about 30 percent, and there are more than 1 million episodes of shingles every year in the United States. Shingles is a painful condition that can last months or years and can seriously impact quality of life. Less than 7 percent of the eligible U.S. population was vaccinated for herpes zoster by the end of 2008.

The CDC continues to recommend that the zoster vaccine and pneumococcal vaccine be administered at the same visit if the person is eligible for both vaccines.

The FDA approved the package label change in 2009 based on a research study by Merck that found antibody levels to the herpes zoster virus were lowered if the vaccine was administered concomitantly with pneumonia vaccine. However that study used the antibody level as the marker of protection, but it is the cell-mediated immunity against the herpes virus, instead of the antibody level that protects against the disease explained Dr. Tseng.

"This new study provides even stronger data because it relies on the measurement of the occurrence of disease rather than intermediate markers of immunity," Tseng said.

This study is the latest in a series of published Kaiser Permanente studies undertaken to better understand vaccine effectiveness and safety:

A study of 300,000 people published in JAMA earlier this year by Dr. Tseng found that receiving the herpes zoster vaccine was associated with a 55 percent reduced risk of developing shingles.Another Tseng study published in JAMA last year found the pneumococcal pneumonia vaccination is not associated with a reduced risk of heart attacks or strokes.Another Kaiser Permanente study found the combination vaccine for measles, mumps, rubella and chickenpox (MMRV) is associated with double the risk of febrile seizures for 1- to 2-year-old children compared to same-day administration of the separate vaccine for MMR (measles, mumps, rubella) and the varicella (V) vaccine for chickenpox.Other recent published Kaiser Permanente studies found children of parents who refuse vaccines are nine times more likely to get chickenpox and 23 times more likely to get whooping cough compared to fully immunized children. A study published last year found that herpes zoster, also known as shingles, is very rare among children who have been vaccinated against chickenpox.

Co-authors of the paper include Hung Fu Tseng, PhD, MPH, Ning Smith, PhD, Lina S. Sy, MPH, and Steven J. Jacobsen, MD, PhD, with Kaiser Permanente Department of Research & Evaluation.

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Journal Reference:

Hung Fu Tseng, Ning Smith, Lina S. Sy, Steven J. Jacobsen. Evaluation of the incidence of herpes zoster after concomitant administration of zoster vaccine and polysaccharide pneumococcal vaccine. Vaccine, 2011; 29 (20): 3628 DOI: 10.1016/j.vaccine.2011.03.018

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Wednesday, August 15, 2012

Cold sore virus may contribute to cognitive and brain abnormalities in schizophrenia

ScienceDaily (May 29, 2010) — Exposure to the common virus that causes cold sores may be partially responsible for shrinking regions of the brain and the loss of concentration skills, memory, coordinated movement and dexterity widely seen in patients with schizophrenia, according to research led by Johns Hopkins scientists.

"We're finding that some portion of cognitive impairment usually blamed solely on the disease of schizophrenia might actually be a combination of schizophrenia and prior exposure to herpes simplex virus 1 infection, which reproduces in the brain," says study leader David J. Schretlen, Ph.D., an associate professor in the Department of Psychiatry at Johns Hopkins University School of Medicine.

The research, described in the May Schizophrenia Research, could lead to new ways to treat or prevent the cognitive impairment that typically accompanies this mental illness, including with antiviral drugs, the scientists say.

Doctors have long known that cognitive impairment, including problems with psychomotor speed, concentration, learning, and memory, are prevalent features of schizophrenia, which affects an estimated one percent of the U.S. population. Cognitive deficits often surface months to years before symptoms that are traditionally used to diagnose this disease, such as delusions or hallucinations.

Some previous studies have shown that schizophrenic patients with antibodies to herpes simplex virus 1 (HSV-1), the virus that causes cold sores, often have more severe cognitive deficits than patients without these antibodies. Other studies have shown that patients with HSV-1 antibodies have decreased brain volumes compared to patients without the antibodies. However, it has been unclear whether the cognitive deficits are directly related to the decreased brain volume.

To investigate, Schretlen and his colleagues recruited 40 schizophrenic patients from outpatient clinics at the Johns Hopkins and Sheppard Enoch Pratt hospitals in Baltimore, Md. Blood tests showed that 25 of the patients had antibodies for HSV-1 and 15 didn't. The researchers gave all of the patients tests to measure speed of coordination, organizational skills and verbal memory. The patients then underwent MRI brain scans to measure the volume of particular regions of their brains.

As in previous studies, results showed that patients with antibodies to HSV-1 performed significantly worse on the cognitive tests than patients without the antibodies. But expanding on those earlier studies, analysis of the brain scans showed that the same patients who performed poorly on the tests also had reduced brain volume in the anterior cingulate, which controls processing speed and the ability to switch tasks. There was also shrinkage in the cerebellum, which controls motor function.

These results suggest that HSV-1 might be directly causing the cognitive deficits by attacking these brain regions, Schretlen says.

Though the researchers aren't sure why schizophrenia might make brains more vulnerable to a viral assault, Schretlen says the results already suggest new ways of treating the disorder. Data from other studies has shown that antiviral medications can reduce psychiatric symptoms in some patients with schizophrenia. "If we can identify schizophrenic patients with HSV-1 antibodies early on, it might be possible to reduce the risk or the extent of cognitive deficits," he adds.

Other Johns Hopkins researchers who participated in this study include Tracy D. Vannorsdall, Ph.D., Jessica M. Winicki, B.A., Takatoshi Hikida, M.D., Akira Sawa, M.D., Ph.D., Robert H. Yolken, M.D., and Nicola G. Cascella, M.D.

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David J. Schretlen, Tracy D. Vannorsdall, Jessica M. Winicki, Yaser Mushtaq, Takatoshi Hikida, Akira Sawa, Robert H. Yolken, Faith B. Dickerson, Nicola G. Cascella. Neuroanatomic and cognitive abnormalities related to herpes simplex virus type 1 in schizophrenia. Schizophrenia Research, 2010; 118 (1-3): 224 DOI: 10.1016/j.schres.2010.01.008

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Tuesday, August 14, 2012

Patients with COPD have higher risk of shingles, study finds

ScienceDaily (Feb. 23, 2011) — Patients with chronic obstructive pulmonary disease (COPD) are at greater risk of shingles compared with the general population, according to a study published in CMAJ (Canadian Medical Association Journal). The risk is greatest for patients taking oral steroids to treat COPD.

Shingles, or herpes zoster, is a reactivation of the chicken pox virus resulting in a painful rash with lesions.

People with a compromised immune system are at greater risk of developing shingles although it has not been previously studied in patients with COPD.

There is increasing evidence that COPD is an autoimmune disease. "Given that various immune-mediated diseases, such as rheumatoid arthritis and inflammatory bowel disease, have been reported to be associated with an increased risk of herpes zoster, it is reasonable to hypothesize that immune dysregulation found in COPD may put patients at higher risk of developing herpes zoster," writes Dr. Hui-Wen Lin, Taipei Medical University, Taiwan with coauthors.

This study, using data from the Taiwan Longitudinal Health Insurance Database, included 8486 patients with COPD and 33 944 subjects from the comparison cohort. Of the total sample of 42 430 patients, 1080 had incident of herpes zoster during the follow-up period. There were 321 cases of shingles identified in the COPD cohort, 16.4 per 1000 person years, and 759 cases in the comparison cohort, 8.8 per 1000 person years.

"Our cohort study demonstrated that patients with COPD are at an increased risk of developing herpes zoster compared with the general population, after controlling for other herpes zoster risk factors," write the authors. "The risk of herpes zoster associated with COPD is greater for patients with inhaled or oral corticosteroids therapy than patients without."

The authors conclude it is possible that "increased disease severity further contributes to the increased risk of herpes zoster associated with COPD."

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Yang, Ya-Wen, Chen, Yi-Hua, Wang, Kuo-Hsien, Wang, Chen-Yi, Lin, Hui-Wen. Risk of herpes zoster among patients with chronic obstructive pulmonary disease: a population-based study. Canadian Medical Association Journal, 2011; DOI: 10.1503/cmaj.101137

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Pain of shingles (herpes zoster) significantly interferes with daily life

ScienceDaily (Oct. 4, 2010) — Acute herpes zoster, or shingles, interferes with all health areas for people with the condition, including sleep, enjoyment of life and general activities, according to a study published in CMAJ (Canadian Medical Association Journal).

Herpes zoster is a reactivation of the chicken pox (varicella-zoster) virus which results in pain and a rash with small blisters. It occurs in people who have had chicken pox and is most common in people over the age of 50, although younger people can have the condition. The lifetime risk of developing shingles is about 30%, but may increase as life expectancies increase.

Policymakers are being asked to consider implementing vaccination programs for the herpes zoster vaccine which is available as a preventative tool but more information is needed about the impact of shingles.

The MASTER study (Monitoring and Assessing Shingles Through Education and Research) was conducted in Canada to provide an in-depth understanding of the impact of shingles. The multi-centre study involved outpatients recruited through general practitioners or specialists across Canada.

"Acute herpes zoster significantly affected quality-of-life and functional status," writes Dr. Marc Brisson, Laval University, with coauthors. "Sleeping, enjoyment of life, general activities, mood, normal work and quality-of-life domains of pain/discomfort and usual activities were particularly diminished. This was consistently observed across all age groups."

The discomfort of shingles can also persist for months after the acute phase, with 24% of people in the study developing pain (postherpetic neuralgia) after the rash healed. The risk increased for older people.

The researchers conclude that this study reinforces "the need for effective prevention strategies, such as vaccination, and additional early intervention to reduce the burden of herpes zoster and postherpetic neuralgia."

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The above story is reprinted from materials provided by Canadian Medical Association Journal, via EurekAlert!, a service of AAAS.

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Sunday, August 12, 2012

Persons with herpes simplex virus type 2, but without symptoms, still shed virus

ScienceDaily (Apr. 13, 2011) — Persons who have tested positive for herpes simplex virus type 2 (HSV-2) but do not have symptoms or genital lesions still experience virus shedding during subclinical (without clinical manifestations) episodes, suggesting a high risk of transmission from persons with unrecognized HSV-2 infection, according to a study in the April 13 issue of JAMA, a theme issue on infectious disease and immunology.

Anna Wald, M.D., M.P.H., of the University of Washington and Fred Hutchinson Cancer Research Center, Seattle, presented the findings of the study at a JAMA media briefing at the National Press Club in Washington, D.C.

"Herpes simplex virus type 2 is one of the most frequent sexually transmitted infections worldwide, with global estimates of 536 million infected persons and an annual incidence of 23.6 million cases among persons aged 15 to 49 years. In the United States, 16 percent of adults are HSV-2 seropositive, but only 10 percent to 25 percent of persons with HSV-2 infection have recognized genital herpes. Moreover, most HSV-2 infections are acquired from persons without a clinical history of genital herpes," according to background information in the article. Thus, the risk of sexual transmission does not correlate with the recognition of clinical signs and symptoms of HSV-2 but most likely correlates with the activity of the virus on the genital skin or mucosa (viral shedding).

Dr. Wald and colleagues compared the rates and patterns of genital HSV shedding in 498 immunocompetent HSV-2-seropositive persons between March 1992 and April 2008. Each participant obtained daily self-collected swabs of genital secretions for at least 30 days. The rate of viral shedding (the presence of virus that is actively replicating, and can thereby be transmitted to another person) was measured by polymerase chain reaction (testing method for viral DNA) from the swabs.

Among the findings of the researchers, HSV-2 was detected on 4,753 of 23,683 days (20.1 percent) in 410 persons with symptomatic genital HSV-2 infection compared with 519 of 5,070 days (10.2 percent) in 88 persons with asymptomatic infection. Genital HSV was detected at least once in 342 of 410 persons (83.4 percent) with symptomatic HSV-2 infection and in 60 of 88 (68.2 percent) persons with asymptomatic HSV-2 infection during the 2 month study.

Subclinical genital shedding rates were higher in persons with symptomatic infection compared with asymptomatic infection (2,708 of 20,735 [13.1 percent] vs. 434 of 4,929 [8.8 percent]). "However, the median [midpoint] amount of HSV detected during subclinical genital shedding episodes was similar in persons with symptomatic and asymptomatic infection," the authors write.

Persons with symptomatic infection had more frequent genital shedding episodes compared with persons with asymptomatic infection (median 17.9 vs. 12.5 episodes per year). Days with lesions accounted for 2,045 of 4,753 days (43.0 percent) with genital viral shedding among persons with symptomatic genital HSV-2 infection compared with 85 of 519 days (16.4 percent) among persons with asymptomatic infection. This indicates that the bulk of days of shedding in persons with asymptomatic HSV-2 is unrecognized, and people may engage in sexual activity not knowing that they are at risk for transmitting the virus to sexual partners.

"Our findings suggest that 'best practices' management of HSV-2-infected persons who learn that they are infected from serologic testing should include anticipatory guidance with regard to genital symptoms, as well as counseling about the potential for transmission. The issue of infectivity is both a patient management and a public health concern. The primary concern of many HSV-2-seropositive persons is the risk of transmission to sexual partners; in our experience this is the main source of angst in patients with genital herpes."

The researchers note that several methods have been identified that partly reduce the risk of HSV-2 transmission to sexual partners. "Condom use, daily valacyclovir therapy, and disclosure of HSV-2 serostatus each approximately halve the risk of HSV-2 transmission. However, these approaches reach a small portion of the population and have not had an influence on HSV-2 seroprevalence in the last decade. One of the reasons for such a limited effect is that few people are aware of their genital HSV-2 infection, and routine serologic testing, although available commercially, is recommended only in limited settings. We hope that these data will result in further discussions regarding control programs for HSV-2 in the United States."

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Journal Reference:

E. Tronstein, C. Johnston, M.-L. Huang, S. Selke, A. Magaret, T. Warren, L. Corey, A. Wald. Genital Shedding of Herpes Simplex Virus Among Symptomatic and Asymptomatic Persons With HSV-2 Infection. JAMA: The Journal of the American Medical Association, 2011; 305 (14): 1441 DOI: 10.1001/jama.2011.420

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Shingles may be related to elevated risk of multiple sclerosis

ScienceDaily (June 9, 2011) — Taiwanese investigators have found that there can be a significantly higher risk of multiple sclerosis (MS) occurring in the year following a shingles, or herpes zoster, attack. The findings, which support a long-held view on how MS may develop, are published in The Journal of Infectious Diseases and now available online.

MS is an autoimmune disease that affects the brain and spinal cord, leading to inflammation and nerve damage as the body's immune cells attack the nervous system. Possible causes that may trigger the inflammation include environmental, genetic, and viral factors. One virus that has been associated with MS is varicella zoster virus, the cause of herpes zoster.

In a study conducted by Herng-Ching Lin, PhD, and colleagues at Taipei Medical University in Taiwan, 315,550 adults with herpes zoster and a control group of 946,650 subjects were tracked and then evaluated for MS occurrence during a one-year follow-up period. The control group was selected randomly from a pool of subjects who had not been diagnosed with herpes zoster or other viral diseases. After adjusting for monthly income and geographic region, the authors found that the group with herpes zoster had a 3.96 times higher risk of developing MS than the control group. The authors noted that this risk, although increased, was still low, as is the frequency of MS in general. The study also noted an interval of approximately 100 days between a herpes zoster event and occurrence of MS.

Although the study was limited almost entirely to Han Chinese adults, the large scope of this nationwide case-controlled study, 1.26 million sampled patients, provides strong epidemiological evidence for a possible role for herpes zoster in the development of MS. The authors also point out that MS has a lower prevalence in Asian compared to Western populations and, thus, it may be difficult to project their findings to other populations.

In an accompanying editorial, Teresa Corona, MD, and Jose Flores, MD, of the National Institute of Neurology and Neurosurgery in Mexico noted that "The evidence provided in this study…allows us to better understand the role of these viral factors as an MS risk among certain genetically susceptible individuals," and that the study should be corroborated in other parts of the world to help clarify the role of this and other viruses in MS.

Fast Facts:

There is epidemiological evidence that some herpes viruses may contribute to multiple sclerosis (MS) occurrence.The rate of MS prevalence varies by geographical location and income.In this study, investigators found a significantly higher -- but still low -- risk for MS occurring in the year following a shingles, or herpes zoster, attack compared to a control population.There is evidence that 30 percent of relapses in MS patients may be associated with an infectious disease.Share this story on Facebook, Twitter, and Google:

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The above story is reprinted from materials provided by Infectious Diseases Society of America, via EurekAlert!, a service of AAAS.

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Journal References:

Jiunn-Horng Kang, Jau-Jiuan Sheu, Senyeong Kao and Herng-Ching Lin. Increased Risk of Multiple Sclerosis Following Herpes Zoster: A Nationwide, Population-Based Study. Journal of Infectious Diseases, June 7, 2011 DOI: 10.1093/infdis/jir239Teresa Corona and José Flores. Herpes Zoster and Multiple Sclerosis. Journal of Infectious Diseases, June 7, 2011 DOI: 10.1093/infdis/jir243

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Saturday, August 11, 2012

Genital herpes more virulent in Africa than in US, report finds

ScienceDaily (Apr. 15, 2011) — Strains of genital herpes in Africa are far more virulent than those in the United States, researchers at Harvard Medical School report, a striking insight into a common disease with important implications for preventing HIV transmission in a region staggered by the HIV/AIDS epidemic. The researchers arrived at this finding by testing mouse model strains of the disease against vaccine candidates. All vaccines were far more efficacious in abating the U.S. strain.

The researchers say identification of the properties of the African viruses would open the door to developing a more potent vaccine against an infection now rampant in sub-Saharan Africa. This is important, they say, because genital herpes patients are more vulnerable to HIV/AIDS infection, as the open sores symptomatic of herpes contain a high concentration of immune cells that are targeted by HIV.

The challenge lies in formulating either a single vaccine that protects against both types of strains of the genital herpes virus or two different vaccines. The vaccine farthest along in development -- it is headed for clinical trials in about a year -- works best against the U.S. isolates of herpes simplex 2, but it also protects laboratory animals from the African viral strains if given in five-fold-higher doses.

This research, which appears online on April 15 in The Journal of Infectious Diseases, is led by David M. Knipe, the Higgins Professor of Microbiology and Molecular Genetics and vice chair of that department at Harvard Medical School, and Clyde Crumpacker, professor of medicine at Harvard Medical School and a physician in division of infectious disease at Beth Israel Deaconnes Medical Center. Their collaborators are former Knipe lab members Timothy E. Dudek, currently of the Ragon Institute of Massachusetts General Hospital, and Ernesto Torres-Lopez, now of the Universidad Autonoma in Monterrey, Mexico.

Live-virus vaccine

In southern Africa, infection rates among adults for genital herpes are exceedingly high -- from 80 percent to 90 percent in some groups compared to slightly less than 20 percent in the United States.

In evolutionary terms, the herpes viruses are very old. They have honed their talents to become efficient parasites in humans, often persisting for decades while causing limited or no disease symptoms -- although they can be deadly in immunocompromised persons and in newborns.

The herpes virus that causes ordinary cold sores, herpes simplex 1, is present in about 70 percent of the U.S. population. These stealthy viruses hide in nerve cells but can emerge over and over again, prompting repeated cold sore outbreaks.

Despite decades of research, there is no commercially available vaccine for herpes. But Knipe says their prototype vaccines are being tested in animals, and one such vaccine has been licensed to the French pharmaceutical firm Sanofi Pasteur.

According to Knipe, animal tests demonstrate clearly that the strains of herpes virus seen in sub-Saharan Africa are more virulent than the herpes simplex 2 virus strains seen in the United States. That difference suggests that an effective vaccine will probably have to be given to people in Africa in larger or more frequent doses. So far, says Knipe, results of animal tests are heartening.

Part of the promise in this work lies in the strong chance that a vaccine against herpes simplex 2 can help reduce the impact of HIV/AIDS in southern Africa. Epidemiological studies have shown that genital herpes infection is associated with a three-fold increase in the risk of HIV infection.

"If the rate of herpes infection can be reduced, it's conceivable the rate of HIV/AIDS infection will also come down, perhaps reducing the death rate," says Knipe.

Knipe's approach to vaccine development is based on using abnormal, live, mutant viruses to stimulate protective immune responses. These disabled viruses cannot multiply inside cells or cause symptomatic disease, but they do contain enough of the right proteins and molecules needed to arouse detection by a healthy immune system. Knipe's strategy is to trigger a strong immune response without causing disease.

"The candidate vaccine, ACAM529, is under development by Sanofi Pasteur, and under the current plan will enter phase I clinical testing in 2012," said Jim Tartaglia, a company respresentative. Phase I testing involves giving vaccine to a few human volunteers and watching for signs of toxicity. Trials for efficacy come later.

Although it has been difficult to create a vaccine for genital herpes, vaccines against a closely related herpes virus -- varicella zoster virus, the cause of chicken pox and shingles -- proved successful and are now widely used. This gives reason for optimism about a genital herpes vaccine.

The researchers do caution that, previously, two well-executed trials of Acyclovir, an effective, safe, antiviral drug for herpes, did decease the occurrence of genital herpes infections but failed to prevent transmission of HIV-1 in African study participants.

This research was funded by the National Institutes of Health.

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Journal Reference:

T. E. Dudek, E. Torres-Lopez, C. Crumpacker, D. M. Knipe. Evidence for Differences in Immunologic and Pathogenesis Properties of Herpes Simplex Virus 2 Strains From the United States and South Africa. Journal of Infectious Diseases, 2011; 203 (10): 1434 DOI: 10.1093/infdis/jir047

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