Di Nardo Walter, Anzivino Roberta, Cattani Paola, Santangelo Rosaria, De Corso Eugenio, Paludetti Gaetano
a Department of Head and Neck Surgery, Institute of Otorhinolaryngology , Catholic University of Sacred Heart , Rome , Italy.
b Department of Diagnostic and Laboratory Medicine, Institute of Microbiology , Catholic University of Sacred Heart , Rome , Italy.
Acta Otolaryngol. 2017 Aug;137(8):791-796. doi: 10.1080/00016489.2017.1293292. Epub 2017 Mar 23.
The detection of cytomegalovirus (CMV) and herpes simplex virus-1 (HSV-1) genome in perilymph of patients with negative serology or clinical history for congenital infections supports the hypothesis that Herpesviridae, even after acquired postnatal infections, could remain in latent phase in the spiral ganglion and damage the cochlea by a possible subsequent reactivation. Further studies are needed to identify the markers of such reactivation.
To identify the presence of certain viral species in the endolabyrinthic fluid of deaf patients with non-congenital infection. The research of viral DNA within the inner ear is the only direct way to increase our knowledge about the viral role in postnatal damage to the cochlea.
Thirty-six patients (1-69 years) suffering from bilateral sensorineural hearing loss (SNHL) were subjected, during cochlear implant (CI) surgery, to a sample taking of inner ear fluid. Several types of viral genome (HSV, VZV, CMV, EBV and Enterovirus) were investigated in each sample through multiplex polymerase chain reaction (PCR) and reverse transcriptase-polymerase chain reaction (RT-PCR). Radiological exams, serology (specific IgG and IgM) and PCR of peripheral blood were also performed.
While the research of the viral genome in peripheral blood was negative in all patients, multiplex PCR on endolabyrinthic fluid samples was positive in three patients (two cases of CMV-DNA and one case of HSV-1 DNA).
对于先天性感染血清学或临床病史为阴性的患者,在其外淋巴中检测到巨细胞病毒(CMV)和单纯疱疹病毒1型(HSV-1)基因组,这支持了以下假说:疱疹病毒科即使在出生后获得感染后,仍可能在螺旋神经节中处于潜伏状态,并可能通过随后的再激活损伤耳蜗。需要进一步研究来确定这种再激活的标志物。
确定非先天性感染的耳聋患者内淋巴液中某些病毒种类的存在情况。内耳内病毒DNA的研究是增加我们对病毒在出生后耳蜗损伤中作用了解的唯一直接方法。
36例(年龄1至69岁)双侧感音神经性听力损失(SNHL)患者在人工耳蜗(CI)手术期间接受内耳液取样。通过多重聚合酶链反应(PCR)和逆转录聚合酶链反应(RT-PCR)对每个样本中的几种病毒基因组(HSV、VZV、CMV、EBV和肠道病毒)进行研究。还进行了影像学检查、血清学检查(特异性IgG和IgM)以及外周血PCR检测。
所有患者外周血病毒基因组检测均为阴性,而对内耳液样本进行的多重PCR在3例患者中呈阳性(2例CMV-DNA和1例HSV-1 DNA)。