Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA.
Athens Veterinary Diagnostic Laboratory, University of Georgia College of Veterinary Medicine, Athens, GA, USA.
Vet Pathol. 2020 May;57(3):409-417. doi: 10.1177/0300985820911458. Epub 2020 Mar 23.
Investigations describing the ocular and lacrimal gland lesions associated with rabies are sparse. Here we characterize the pathological changes and distribution of rabies viral antigen in the eye, optic nerve, and lacrimal gland of 18 rabies cases from different mammalian species. Histology and immunohistochemistry for rabies virus, CD3, CD20, and Iba1 were performed on tissue sections of eye, optic nerve, and lacrimal gland. Polymerase chain reaction (PCR) for rabies was performed on all cases, including 7 formalin-fixed, paraffin-embedded (FFPE) and 11 frozen tissue samples of eye and lacrimal gland. Pathological changes in the eye consisted of retinal necrosis (12/18 cases) with occasional viral inclusions within ganglion cells (8/12 cases). Immunohistochemically, viral antigen was detected within the nerve fiber layer, ganglion cells, and inner plexiform layer in all 12 cases with retinal lesions and in 2 cases with no retinal lesions, as well as optic nerve (6/18 cases) and lacrimal gland epithelium (3/18 cases). CD3 T lymphocytes were present in the retina (11/18 cases), optic nerve (2/18 cases), and lacrimal gland (11/18 cases). No CD20 B lymphocytes or Iba1 macrophages were detected. PCR for rabies virus was positive in 9 of 11 frozen samples but in only 2 of 7 FFPE samples. Five samples that were negative for rabies by PCR were positive by immunohistochemistry, and 2 samples were negative by both tests. These results provide evidence that rabies virus infection extends to the eye, likely via the ocular nerve, and that the lacrimal gland might be a source of viral infection.
描述狂犬病相关眼部和泪腺病变的研究很少。在这里，我们描述了来自不同哺乳动物物种的 18 例狂犬病病例的眼部、视神经和泪腺中的狂犬病病毒抗原的病理变化和分布。对眼部、视神经和泪腺组织切片进行了狂犬病病毒、CD3、CD20 和 Iba1 的组织学和免疫组织化学检查。对所有病例（包括 7 例福尔马林固定、石蜡包埋（FFPE）和 11 例眼部和泪腺冷冻组织样本）进行了狂犬病聚合酶链反应（PCR）。眼部的病理变化包括视网膜坏死（18 例中有 12 例），偶尔在神经节细胞内可见病毒包涵体（12 例中有 8 例）。免疫组织化学检查显示，在所有 12 例有视网膜病变和 2 例无视网膜病变的病例中，病毒抗原均存在于神经纤维层、神经节细胞和内丛状层，以及视神经（18 例中有 6 例）和泪腺上皮（18 例中有 3 例）。CD3 T 淋巴细胞存在于视网膜（18 例中有 11 例）、视神经（18 例中有 2 例）和泪腺（18 例中有 11 例）。未检测到 CD20 B 淋巴细胞或 Iba1 巨噬细胞。11 例冷冻样本中狂犬病病毒 PCR 阳性，7 例 FFPE 样本中仅 2 例阳性。5 例 PCR 检测狂犬病病毒阴性的样本免疫组化检测阳性，2 例样本两种检测均为阴性。这些结果表明，狂犬病病毒感染可延伸至眼部，可能通过眼神经传播，而泪腺可能是病毒感染的来源。
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