Cokić-Damjanović J, Horvat E, Balog A
Med Pregl. 2001 Sep-Oct;54(9-10):432-7.
Primary herpes simplex virus (HSV) infections of female genital tract usually end with remission, while the virus remains in the organism--almost in the sacral ganglion in a latent form, protected from humoral and cellular immunity. Stress induces the virus and the result is recurrent genital infection. Frequent exacerbations damage some parts of vital cellular structures without cytolysis, but stimulate malignant transformations.
Vulvar (portio vaginalis uteri) and endometrial tumor tissue samples were analyzed for HSV by direct and indirect fluorescent antibody technique (FAT). Pre and postoperative sera samples were analyzed for presence of anti-HSV antibodies--IgM and IgG by Elisa-Enzygnost method. Acellular filtrates obtained by ultrasonic destruction of malignant tissues were used as inoculum for rabbit corneal scarification.
Out of 63 tissue samples, 42 were positive for HSV antigen i.e. 67.3%. According to location 50% of vulvar, 76% PVU and 65% of endometrial tissues were positive. This antigen induces production of virus specific antibodies. Two types of antigens are known: the so-called T-antigen persisting in the cell nucleus and cell-surface antigen--product of the viral genome and can be evidenced by immunofluorescence method. Anti HSV antibodies were present in 63 preoperative serum samples and belonged to IgG group, but not one to IgM, implying a long and chronic course of infection excluding acute primary. Out of 38 postoperative serums the titer of antibodies decreased in 36 evidently, but in two samples remained unchanged. Two samples of endometrial and one from PVU origin contained HSV antigen type one. In the remaining 16 samples HSV 2 antigen was present. Rabbit corneal scarification was the proof of complete infectious virus in malignant tissues. Acellular filtrate of malignant tissues served as inoculum. Corneas of examined rabbits showed a mild inflammation after 24 hours which disappeared in the next 24 hours. We could not isolate the infectious virus by rabbit corneal scarification. Instead of herpetic changes, mild inflammation was evident. This abortive, incomplete symptomatology was probably caused by nonstructural early protein, which is a product of viral genome incorporated in malignant cells.
On the basis of our results, we can conclude that HSV can have, beside other factors, a very important, maybe an initial role in development of malignant changes of female genital tract, not only on vulva and PVU, but on endometrium as well. HSV I can cause genital infections and have some role in malignant changes as well as HSV 2. However, complete infective virion couldn't be isolated from malignant tissues.
女性生殖道原发性单纯疱疹病毒（HSV）感染通常以缓解告终，而病毒会留存于机体中——几乎以潜伏形式存在于骶神经节，免受体液免疫和细胞免疫的影响。压力会诱发该病毒，结果导致复发性生殖器感染。频繁发作会损害重要细胞结构的某些部分而不引起细胞溶解，但会刺激恶性转化。
采用直接和间接荧光抗体技术（FAT）对外阴（子宫阴道部）和子宫内膜肿瘤组织样本进行HSV分析。通过酶联免疫吸附测定法（Elisa-Enzygnost法）分析术前和术后血清样本中抗HSV抗体——IgM和IgG的存在情况。通过超声破坏恶性组织获得的无细胞滤液用作兔角膜划痕接种物。
在63个组织样本中，42个HSV抗原呈阳性，即67.3%。根据位置，50%的外阴组织、76%的子宫阴道部组织和65%的子宫内膜组织呈阳性。这种抗原会诱导病毒特异性抗体的产生。已知有两种类型的抗原：所谓的T抗原存在于细胞核中，以及细胞表面抗原——病毒基因组的产物，可通过免疫荧光法证实。63份术前血清样本中存在抗HSV抗体，且属于IgG组，但无一属于IgM组，这意味着感染病程长且为慢性，排除了急性原发性感染。在38份术后血清中，36份抗体滴度明显下降，但有两份样本保持不变。两份子宫内膜样本和一份子宫阴道部样本含有1型HSV抗原。在其余16份样本中存在2型HSV抗原。兔角膜划痕证明恶性组织中存在完整的感染性病毒。恶性组织的无细胞滤液用作接种物。受试兔的角膜在24小时后出现轻度炎症，在接下来的24小时内消失。我们无法通过兔角膜划痕分离出感染性病毒。没有出现疱疹样变化，而是明显的轻度炎症。这种流产性、不完全的症状可能是由非结构性早期蛋白引起的，该蛋白是整合到恶性细胞中的病毒基因组的产物。
根据我们的研究结果，可以得出结论，除其他因素外，HSV在女性生殖道恶性病变的发生发展中可能具有非常重要的，也许是初始作用，不仅在外阴和子宫阴道部，在子宫内膜也如此。1型HSV可引起生殖器感染，并在恶性病变中发挥一定作用，2型HSV也是如此。然而，无法从恶性组织中分离出完整的感染性病毒粒子。
