RESUMO
Herpes simplex virus type 1 is one of the most frequent causes of oral infection in humans, especially during early childhood. Several experimental models have been developed to study the pathogenesis of this virus but all of them employed adult animals. In this work, we developed an experimental model that uses mice younger than 4 days old, to more closely resemble human infection. Mice were infected subcutaneously with the prototype strain McIntyre of Herpes simplex-1, and the progression of infection was studied by immunoperoxidase. All animals died within 24-72 h post-infection, while viral antigens were found in the oral epithelium, nerves and brain. The most striking result was the finding of viral antigens in the nucleus and cytoplasm of cells belonging to striated muscles. Organotypic cultures of striated muscles were performed, and viral replication was observed in them by immunocytochemistry, electron microscopy and viral isolation. We conclude that the infection of striated muscles is present from the onset of oral infection and, eventually, could explain some clinical observations in humans.
Assuntos
Herpesvirus Humano 1/fisiologia , Músculo Estriado/virologia , Estomatite Herpética/virologia , Língua/virologia , Animais , Animais Recém-Nascidos , Antígenos Virais/análise , Encéfalo/virologia , Causas de Morte , Núcleo Celular/virologia , Chlorocebus aethiops , Citoplasma/virologia , Modelos Animais de Doenças , Progressão da Doença , Camundongos , Camundongos Endogâmicos BALB C , Mucosa Bucal/virologia , Células Musculares/virologia , Músculo Estriado/inervação , Fibras Nervosas/virologia , Neurônios/virologia , Organismos Livres de Patógenos Específicos , Estomatite Herpética/imunologia , Técnicas de Cultura de Tecidos , Língua/inervação , Células Vero , Replicação Viral/fisiologiaRESUMO
OBJECTIVE: The objective of this study was to determine the clinical characteristics of oral ulcers in pediatric oncology patients undergoing chemotherapy and their relation with the presence of Herpes Simplex Virus (HSV) type 1 and Candida albicans. STUDY DESIGN: The sample consisted of 20 ulcerative lesions from 15 children treated with chemotherapy in the Pediatric Service of the Regional Hospital of Concepción, Chile. Two calibrated clinicians performed clinical diagnosis of the ulcers and registered general data from the patients (age, general diagnosis, absolute neutrophil count, and number of days after chemotherapy) and clinical characteristic of the ulcers: number, size, location, presence or absence of pain and inflammatory halo, edge characteristics, and exudate type. Additional to clinical diagnosis, culture for Candida albicans (C) and polymerase chain reaction (PCR) for Herpes Simplex Virus type 1 was performed. RESULTS: Ten ulcers occurred in patients with acute lymphoblastic leukemia, five in patients with acute myeloblastic leukemia and five in patients with other neoplastic diseases. Eight ulcers were HSV (+) / C (-), 6 HSV (-) / C (-), 4 HSV (+) / C (+) and 2 HSV (-) / C (+). Preferential location was the hard palate. Most lesions were multiple, painful, with inflammatory halo, irregular edges and fibrinous exudate. The average size was 6,5 millimeters, and the mean number of days after chemotherapy was 7.5 days. CONCLUSIONS: Oral ulcers in children with oncological diseases did not present a specific clinical pattern. They were strongly associated with HSV.
Assuntos
Antineoplásicos/efeitos adversos , Herpesvirus Humano 1/patogenicidade , Leucemia/tratamento farmacológico , Úlceras Orais/virologia , Estomatite Herpética/etiologia , Adolescente , Candida albicans/patogenicidade , Criança , Pré-Escolar , DNA Viral/análise , Feminino , Humanos , Hospedeiro Imunocomprometido , Lactente , Masculino , Úlceras Orais/imunologia , Úlceras Orais/microbiologia , Úlceras Orais/patologia , Estomatite Herpética/imunologiaRESUMO
Se realizó un estudio en 30 niños atendidos en el Servicio de Cirugía Maxilofacial del Hospital Pediátrico William Soler con el diagnóstico de gingivoestomatitis herpética aguda (GEHA) con el objetivo de conocer su estado de inmunocompetencia celular. La edad promedio fue de 3,7 años; se afectaron ambos sexos por igual, con un promedio de los enfermos de raza blanca sobre los de raza negra. Encontramos el 83 por ciento de los pacientes con algún grado de defecto en los marcadores de inmunidad estudiados (rosetas activa y espontánea), de los cuales 22 mostraron cifras anormalmente bajas en los 2 marcadores y 3 en 1 marcador. Entre los pacientes que presentaron enfermedad de debut, en total 9, hubo 5 con valores dentro de límites normales y los restantes con ambos marcadores afectados. En los casos de recidiva, que fueron 21, el 100 por ciento presentó al menos 1 marcador afectado. Puede considerarse, por lo tanto, el déficit inmunológico celular como factor predisponente o secundario a la infección por herpes simple tipo I(AU)
30 children who received medical attention at the Maxillofacial Surgery Service of William Soler Pediatric Hospital with the diagnosis of acute herpetic gingivostomatitis (AHGS) were studied in order to know their cellular immunocompetence state. Average age was 3.7 years old. Both sexes were affected. A prevalence of white patients was observed. 83 percent of the patients had some degree of defect in the studied immunity markers (active and spontaneous rosettes). 22 of them showed abnormally low figures in the 2 markers, and 3 in only one. 5 of the 9 patients with debut disease had values within the normal limits, whereas the rest had both markers affected. Among the patients with relapse that were 21, 100 %, presented at least one affected marker. herefore, the cellular immunological deficit may be considered as a predisposing or secondary factor to the infection caused by herpex simplex type 1(AU)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Formação de Roseta/métodos , Estomatite Herpética/imunologia , Herpes Labial/diagnóstico , Imunidade CelularRESUMO
Oral manifestations often found in HIV-infected children are frequently the first clinical sign of the infection. This article aims to report the prevalence of oral manifestations in soft tissues and their relationship with the degree of immunosuppression in 80 HIV-infected patients (average age 6.30 +/- 3.32 years old) at the IPPMG-UFRJ. Thirty children (38%) presented some type of oral lesion and the percentage of CD4 was lower than that found in lesion-free children (p < 0.05); 22.5% presented candidiasis, 17.5% gingivitis, 8.8% enlargement of parotids, 1.3% herpes simplex and 1.3% hairy leukoplakia. Of the 30 children with lesions, 70% showed severe immunosuppression, 23.3% moderate immunosuppression and in only 6.7% was immunosuppression absent. Oral manifestations were directly related to the degree of immunosuppression and such lesions can be considered as indicators of the progression of the HIV infection in children.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções por HIV/complicações , Infecções por HIV/imunologia , Hospedeiro Imunocomprometido , Doenças da Boca/etiologia , Doenças da Boca/imunologia , Contagem de Linfócito CD4 , Candidíase Bucal/etiologia , Candidíase Bucal/imunologia , Criança , Pré-Escolar , Feminino , Gengivite/etiologia , Gengivite/imunologia , Humanos , Hiperplasia/etiologia , Hiperplasia/imunologia , Leucoplasia Pilosa/etiologia , Leucoplasia Pilosa/imunologia , Masculino , Doenças Parotídeas/etiologia , Doenças Parotídeas/imunologia , Estomatite Herpética/etiologia , Estomatite Herpética/imunologiaRESUMO
BACKGROUND: Oral lesions are common findings in HIV-related disease, but little is known about their significance in predicting immune suppression among a representative group of HIV-infected persons. METHODS: Oral examinations were performed on 454 patients who came to an outpatient dental clinic for dental care. CD4+ cell counts were obtained within 2 months of the examination. RESULTS: In persons with a specific lesion and a CD4+ cell count below 200 cells/mm3 the corresponding mean CD4+ cell counts and predictive values were 149.5 cells/mm3 and 69.9% for candidiasis, 143.3 cells/mm3 and 70.1% for oral hairy leukoplakia, 126.0 cells/mm3 and 69.4% for xerostomia, 51.8 cells/mm3 and 95.1% for necrotizing ulcerative periodontitis, 98.7 cells/mm3 and 87.0% for long-standing herpes simplex virus infections, 66.6 cells/mm3 and 93.6% for Kaposi's sarcoma, and 33.7 cells/mm3 and 100% for major aphthous ulcers. The mean CD4+ cell count declined with increased numbers of different concurrent lesions. CONCLUSION: The presence of specific oral manifestations and the number of different concurrent intraoral lesions among HIV-infected persons are associated with severe immune suppression and AIDS. Oral examinations are an essential component for early recognition of disease progression and comprehensive evaluation of HIV-infected patients.