Solomon Isaac H, Docken William P, Padera Robert F
From the Department of Pathology, and Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
I.H. Solomon, MD, PhD, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School; W.P. Docken, MD, Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; R.F. Padera Jr., MD, PhD, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School.
J Rheumatol. 2019 Dec;46(12):1614-1618. doi: 10.3899/jrheum.180912. Epub 2019 Mar 1.
A variety of infectious agents, including varicella zoster virus (VZV), have been hypothesized to play a role in the pathogenesis of giant cell arteritis (GCA). The detectability of the virus in patients with GCA is debatable. To further investigate an association between GCA and VZV infection, 10 years of GCA cases were evaluated for VZV by immunohistochemistry (IHC).
All temporal artery biopsies and ascending aortic resections positive for GCA from 2007 to 2017 at Brigham and Women's Hospital were immunostained using a VZV antibody cocktail (SG1-1, SG1-SG4, NCP-1, and IE-62).
Forty-one temporal artery biopsies and 47 ascending aortic resections positive for GCA were identified, all of which were found to be negative for VZV by IHC. Twelve temporal artery biopsies in this cohort were previously analyzed by unbiased metagenomics sequencing and were negative for VZV DNA.
These results argue against a clinically relevant association between VZV infection and GCA, and support neither routine testing for VZV nor treatment with antiviral drugs.
多种感染因子，包括水痘带状疱疹病毒（VZV），被认为在巨细胞动脉炎（GCA）的发病机制中起作用。GCA患者中该病毒的可检测性存在争议。为了进一步研究GCA与VZV感染之间的关联，通过免疫组织化学（IHC）对10年的GCA病例进行了VZV评估。
使用VZV抗体混合物（SG1-1、SG1-SG4、NCP-1和IE-62）对2007年至2017年期间在布莱根妇女医院所有GCA阳性的颞动脉活检标本和升主动脉切除术标本进行免疫染色。
共鉴定出41例GCA阳性的颞动脉活检标本和47例GCA阳性的升主动脉切除术标本，所有标本经IHC检测VZV均为阴性。该队列中的12例颞动脉活检标本先前已通过非偏倚宏基因组测序进行分析，VZV DNA检测为阴性。
这些结果表明VZV感染与GCA之间不存在临床相关关联，既不支持对VZV进行常规检测，也不支持使用抗病毒药物治疗。
