High Prevalence of Herpes Simplex Virus DNA in Temporal
High Prevalence of Herpes Simplex Virus DNA in Temporal
Giant cell arteritis (GCA) affecting the cranial arteries is a disease of unknown cause that causes blindness, stroke, and other morbidity. Its sudden onset and segmental distribution are suggestive of diseases that involve viral reactivation, and cranial arteries are known to be innervated by ganglia that harbor herpes simplex virus (HSV). We used a high-sensitivity polymerase chain reaction assay to test for HSV DNA in specimens from 39 consecutive temporal artery biopsies performed for suspected GCA. HSV DNA was detected in 21 (88%) of 24 histologically positive and 8 (53%) of 15 histologically negative specimens (P = .027; Fisher exact test). Analysis of 10 renal artery samples from age-matched control subjects using the same assay showed no detectable HSV DNA. We conclude that detectable HSV DNA is correlated with histologically confirmed GCA in this patient population.
Giant cell arteritis (GCA) is an idiopathic cranial vasculitis that is a significant cause of blindness, stroke, and other morbidity. Immunologic and infectious causes have been proposed. The disease frequently involves the temporal arteries, which are biopsied routinely to establish a histologic diagnosis. The sudden onset and segmental distribution that characterize GCA are reminiscent of recurrent herpetic lesions. In addition, some factors postulated to contribute to reactivation of latent herpes simplex virus (HSV), eg, sunlight and hormonal disturbances, are possible triggering factors for GCA. The temporal arteries receive a portion of their innervation from the trigeminal ganglia, which are a major repository of latent HSV. Therefore, we hypothesized that reactivation of latent HSV might contribute to the pathogenesis of GCA involving the temporal arteries (temporal arteritis [TA]).
The present study sought to determine whether histologically confirmed GCA is associated with the presence of HSV DNA sequences detectable by polymerase chain reaction (PCR) in archival temporal artery biopsy specimens.
Giant cell arteritis (GCA) affecting the cranial arteries is a disease of unknown cause that causes blindness, stroke, and other morbidity. Its sudden onset and segmental distribution are suggestive of diseases that involve viral reactivation, and cranial arteries are known to be innervated by ganglia that harbor herpes simplex virus (HSV). We used a high-sensitivity polymerase chain reaction assay to test for HSV DNA in specimens from 39 consecutive temporal artery biopsies performed for suspected GCA. HSV DNA was detected in 21 (88%) of 24 histologically positive and 8 (53%) of 15 histologically negative specimens (P = .027; Fisher exact test). Analysis of 10 renal artery samples from age-matched control subjects using the same assay showed no detectable HSV DNA. We conclude that detectable HSV DNA is correlated with histologically confirmed GCA in this patient population.
Giant cell arteritis (GCA) is an idiopathic cranial vasculitis that is a significant cause of blindness, stroke, and other morbidity. Immunologic and infectious causes have been proposed. The disease frequently involves the temporal arteries, which are biopsied routinely to establish a histologic diagnosis. The sudden onset and segmental distribution that characterize GCA are reminiscent of recurrent herpetic lesions. In addition, some factors postulated to contribute to reactivation of latent herpes simplex virus (HSV), eg, sunlight and hormonal disturbances, are possible triggering factors for GCA. The temporal arteries receive a portion of their innervation from the trigeminal ganglia, which are a major repository of latent HSV. Therefore, we hypothesized that reactivation of latent HSV might contribute to the pathogenesis of GCA involving the temporal arteries (temporal arteritis [TA]).
The present study sought to determine whether histologically confirmed GCA is associated with the presence of HSV DNA sequences detectable by polymerase chain reaction (PCR) in archival temporal artery biopsy specimens.