[Objectives]To observe the clinical efficacy of external application of Scorzonera Herpes Ointment combined with Methylprednisolone Sodium Succinate for Injection in the treatment of herpes zoster oticus(HZO).[Methods...[Objectives]To observe the clinical efficacy of external application of Scorzonera Herpes Ointment combined with Methylprednisolone Sodium Succinate for Injection in the treatment of herpes zoster oticus(HZO).[Methods]A total of 100 HZO patients admitted to the 988 th Hospital of the Joint Logistics Support Force and Henan Provincial People's Hospital from June 2021 to June 2023 were selected.They were divided into a treatment group and a control group using a random number table method,with 50 cases in each group.Both groups received Methylprednisolone Sodium Succinate for Injection.Additionally,the treatment group was treated with external application of Scorzonera Herpes Ointment,while the control group received acyclovir ointment.Both groups were treated for 10 d.The comparisons included clinical efficacy,total symptom and sign scores,pain level[Visual Analogue Scale(VAS)],time for erythema reduction,cessation of blister formation,scab formation,and scab shedding,incidence of post-herpetic neuralgia(PHN),air conduction hearing threshold,and air-bone gap.[Results]After 10 d of treatment,the total effective rate was 98.00%(49/50)in the treatment group and 84.00%(42/50)in the control group,with a statistically significant difference between the two groups(P<0.05).After 10 d of treatment,the total symptom and sign scores and VAS scores of both groups decreased compared to those before treatment.The treatment group had significantly lower scores than the control group(P<0.05).The treatment group showed significantly shorter time for erythema reduction,cessation of blister formation,scab formation,and scab shedding compared to the control group(P<0.05).During the 1-month follow-up after treatment,no PHN cases occurred in the treatment group,while the incidence of PHN in the control group was 24.00%(12/50),showing a statistically significant difference(P<0.05).After 10 d of treatment,both groups showed reduced air conduction hearing thresholds,and the treatment group exhibited significantly lower air conduction thresholds and air-bone gaps compared to the control group(P<0.05).No statistically significant difference was observed in the air-bone gap before and after treatment in the control group(P>0.05).[Conclusions]The combination of external application of Scorzonera Herpes Ointment and Methylprednisolone Sodium Succinate for Injection can alleviate pain and other discomforts,reduce PHN incidence,shorten disease duration,and improve hearing in HZO patients.展开更多
Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection du...Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection during childhood[1].HZ tends to occur more frequently in older adults,in whom cellmediated immunity often declines.The incidence of HZ among immunocompetent unvaccinated individuals aged>50y is 9.92/1000 person-years[2].HZ ophthalmicus(HZO)occurs when HZ involves the first division of the trigeminal nerve,i.e.,the ophthalmic nerve[3].展开更多
Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against her...Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against herpes simplex virus 1(HSV-1).By examining different phases of viral infection in human corneal epithelial cells(HCECs),we found that 30μmol/L quercetin inhibits HSV-1 replication primarily by disrupting viral attachment.RNA-sequencing and subsequent analyses revealed that the nuclear factor E2-related factor 2(Nrf2)was upregulated by quercetin in a dose-dependent manner.Knocking down Nrf2 partially compromised quercetin's antiviral effect.Importantly,topical application of 100μmol/L quercetin alleviated HSK severity in mice,reduced viral titers in tears,and inhibited VP16 expression in the cornea and trigeminal ganglia.These findings demonstrate the antiviral effect of quercetin against HSV-1 and provide a foundation for mechanistic studies to elucidate its therapeutic potential in HSK.展开更多
Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not complet...Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not completely understood.Among the molecular mediators of synaptic and cognitive dysfunction occurring after Herpes simplex virus type-1 infection and reactivation in the brain neuroinflammatory cytokines seem to occupy a central role.Here,we specifically reviewed literature reports dealing with the impact of neuroinflammation on synaptic dysfunction observed after recurrent Herpes simplex virus type-1 reactivation in the brain,highlighting the role of interleukins and,in particular,interleukin 1βas a possible target against Herpes simplex virus type-1-induced neuronal dysfunctions.展开更多
BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses...BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.展开更多
BACKGROUND Facial herpes is a common form of the herpes simplex virus-1 infection and usually presents as vesicles near the mouth,nose,and periocular sites.In contrast,we observed a new facial symptom of herpes on the...BACKGROUND Facial herpes is a common form of the herpes simplex virus-1 infection and usually presents as vesicles near the mouth,nose,and periocular sites.In contrast,we observed a new facial symptom of herpes on the entire face without vesicles.CASE SUMMARY A 33-year-old woman with a history of varicella infection and shingles since an early age presented with sarcoidosis of the entire face and neuralgia without oral lesions.The patient was prescribed antiviral treatment with valacyclovir and acyclovir cream.One day after drug administration,facial skin lesions and neurological pain improved.Herpes simplex without oral blisters can easily be misdiagnosed as pimples upon visual examination in an outpatient clinic.CONCLUSION As acute herpes simplex is accompanied by neuralgia,prompt diagnosis and prescription are necessary,considering the pathological history and health conditions.展开更多
BACKGROUND Erythrodermic psoriasis(EP)is a rare and life-threatening form of psoriasis associated with significant morbidity and mortality.Systemic immunosuppre-ssive therapies are often required but may predispose to...BACKGROUND Erythrodermic psoriasis(EP)is a rare and life-threatening form of psoriasis associated with significant morbidity and mortality.Systemic immunosuppre-ssive therapies are often required but may predispose to opportunistic infections.Disseminated herpes simplex virus type-1(HSV-1)is an unusual complication in otherwise immunocompetent patients and has not been reported in association with ixekizumab therapy for EP.CASE SUMMARY We describe a 49-year-old man with longstanding severe plaque psoriasis,liver cirrhosis,and bipolar disorder who developed EP involving>90%of body surface area[Psoriasis Area and Severity Index(PASI)45].Following initial stabil-ization,he was admitted to the intensive care unit(ICU)with hemodynamic instability,leukocytosis with eosinophilia,and diffuse desquamation.Ixekizumab was initiated with high-dose topical clobetasol.During his ICU stay,he developed recurrent bacteremias and neurologic decline(Glasgow Coma Scale 7/15),fo-llowed by the appearance of widespread vesicles and hemorrhagic crusts.HSV-1 infection was confirmed by polymerase chain reaction(PCR).Immunosuppressive therapy was withheld,and intravenous acyclovir was started,leading to progre-ssive improvement.After ten days,ixekizumab was reintroduced with careful monitoring,resulting in marked clinical improvement(PASI 9.7 at six weeks).The patient remained stable on long-term follow-up with oral acyclovir prophylaxis.CONCLUSION This case highlights the diagnostic and therapeutic challenges of managing EP in the setting of biologic therapy.Disseminated cutaneous HSV-1 should be considered in immunosuppressed patients presenting with new vesicular eruptions,and prompt PCR testing with early antiviral therapy is essential.A multidisciplinary approach is critical to balance immunosuppression for disease control with infection risk.展开更多
Dear Editor,I am Dr.Asako Kodama,affiliated with the Department of Ophthalmology at Eiju General Hospital in Tokyo,Japan.Varicella-zoster virus(VZV)induces two distinct states:the primary infection(varicella)and secon...Dear Editor,I am Dr.Asako Kodama,affiliated with the Department of Ophthalmology at Eiju General Hospital in Tokyo,Japan.Varicella-zoster virus(VZV)induces two distinct states:the primary infection(varicella)and secondary endogenous reactivation of latent VZV in herpes zoster form.While herpes zoster lesions typically manifest on the trunk and abdomen,the most frequently involved cranial nerve is the trigeminal nerve.展开更多
[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mech...[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mechanism.[Methods]96 patients with PHN were divided into the control group(group A)and observation group(group B)(n=48).In group A,the patients were given gabapentin orally and treated by cotton moxibustion.In group B,the patients were treated by the external application of self-prepared Chinese prescription decoction on the basis of the above basic treatment.The total effective rate,apparent time and recurrence rate of the two groups were compared.[Results]The cure rate(72.91%)and total effective rate(95.83%)of patients in group B were higher than those in group A(54.16%,83.33%).The average apparent time[(5.79±1.40)d]and recurrence rate(5.97%)of patients in group B were significantly lower than those in group A[(7.03±4.37)d,10.45%],and the difference between the two groups was statistically significant(P<0.05).[Conclusions]The external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion therapy had a significant curative effect and low recurrence rate.展开更多
Herpes zoster(HZ)is an acute infectious disease caused by varicella-zoster virus.The neurological sequelae of HZ include postherpetic neuralgia(PHN)and postherpetic itch(PHI).Severe pain and recurrent itching seriousl...Herpes zoster(HZ)is an acute infectious disease caused by varicella-zoster virus.The neurological sequelae of HZ include postherpetic neuralgia(PHN)and postherpetic itch(PHI).Severe pain and recurrent itching seriously affect the quality of life of patients.The pathogenesis of PHN is related to the mediation of immune-inflammatory response,activation of neuroglial cells,structural and functional alterations of the brain,aberrant expression of ion channels,and gene mediation.Overall,the immune-inflammatory response is a key factor mediating the pathogenesis of PHN.By reviewing the literature,the authors found that there are few studies on PHN both at home and abroad,so its pathogenesis is still unclear.No new progress has been made in recent years either,resulting in the understanding of PHI remaining in a state of confusion.The pathogenesis of PHI may be related to the loss of epidermal nerves,excitation of itch-specific neurons,absence of itch-inhibitory neurons,the action of itch-causing factors,and the vicious circle of itch and mood disorders.In general,most of them are conjectures,not supported by relevant experimental data.The treatments for PHN are varied and effective,while the pathogenesis of PHI is still unclear,so the treatment is often passive.This paper reviews the pathogenesis of PHN and PHI,expecting to provide new ideas for clinical treatment.展开更多
The aim of our minireview is to provide a brief overview of the diagnosis,clinical aspects,treatment options,management,and current literature available regarding herpes simplex keratitis(HSK).This type of corneal vir...The aim of our minireview is to provide a brief overview of the diagnosis,clinical aspects,treatment options,management,and current literature available regarding herpes simplex keratitis(HSK).This type of corneal viral infection is caused by the herpes simplex virus(HSV),which can affect several tissues,including the cornea.One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea.After the initial infection,the HSV can establish a latent infection in the trigeminal ganglion,a nerve cluster near the eye.The virus may remain dormant for extended periods.Periodic reactivation of the virus can occur,leading to recurrent episodes of HSK.Factors triggering reactivation include stress,illness,immunosuppression,or trauma.Recurrent episodes can manifest in different clinical patterns,ranging from mild epithelial involvement to more severe stromal or endothelial disease.The severity and frequency of recurrences vary among individuals.Severe cases of HSK,especially those involving the stroma and leading to scarring,can result in vision impairment or even blindness in extreme cases.The cornea's clarity is crucial for good vision,and scarring can compromise this,potentially leading to visual impairment.The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization.Antiviral medications,such as oral Acyclovir or topical Ganciclovir,may be prescribed for prophylaxis.The immune response to the virus can contribute to corneal damage.Inflammation,caused by the body's attempt to control the infection,may inadvertently harm the corneal tissues.Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation.In summary,the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.展开更多
Periodontitis is the inflammation of the supporting structures around the dentition.Several microbial agents,mostly bacteria,have been identified as causative factors for periodontal disease.On the other hand,oral cav...Periodontitis is the inflammation of the supporting structures around the dentition.Several microbial agents,mostly bacteria,have been identified as causative factors for periodontal disease.On the other hand,oral cavity is a rich reservoir for viruses since it contains a wide variety of cell types that can be targeted by viruses.Traditionally,the focus of research about the oral flora has been on bacteria because the most widespread oral diseases,like periodontitis and dental caries,are outcomes of bacterial infection.However,recently and especially after the emergence of coronavirus disease 2019,there is a growing tendency toward including viruses also into the scope of oral microbiome investigations.The global high prevalence of periodontitis and viral infections may point out to a concomitant or synergistic effect between the two.Although the exact nature of the mechanism still is not clearly understood,this could be speculated through the manipulation of the immune system by viruses;hence facilitating the furthermore colonization of the oral tissues by bacteria.This review provides an extensive and detailed update on the role of the most common viruses including herpes family(herpes simplex,varicella-zoster,Epstein-Barr,cytomegalovirus),Human papillomaviruses,Human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2 in the initiation,progression and prognosis of periodontitis.展开更多
Genital herpes(GH)is a common sexually transmitted disease,which is primarily caused by herpes simplex virus type 2(HSV-2),and continues to be a global health concern.Although our understanding of the alterations in i...Genital herpes(GH)is a common sexually transmitted disease,which is primarily caused by herpes simplex virus type 2(HSV-2),and continues to be a global health concern.Although our understanding of the alterations in immune cell populations and immunomodulation in GH patients is still limited,it is evident that systemic intrinsic immunity,innate immunity,and adaptive immunity play crucial roles during HSV-2 infection and GH reactivation.To investigate the mechanisms underlying HSV-2 infection and recurrence,single-cell RNA sequencing(scRNA-seq)was performed on immune cells isolated from the peripheral blood of both healthy individuals and patients with recurrent GH.Furthermore,the systemic immune response in patients with recurrent GH showed activation of classical monocytes,CD4þT cells,natural killer cells(NK cells),and plasmacytoid dendritic cells(pDCs),especially of genes associated with the Toll-like receptor signaling pathway and T cell activation.Circulating immune cells in GH patients show higher expression of genes associated with inflammation and antiviral responses both in the scRNA-Seq data set and in independent quantitative real-time polymerase chain reaction(qRT-PCR)analysis and ELISA experiments.This study demonstrated that localized genital herpes,resulting from HSV reactivation,may influence the functionality of circulating immune cells,suggesting a potential avenue for future research into the role of systemic immunity during HSV infection and recurrence.展开更多
Background: One of the most common viral infections occurring in atopic dermatitis (AD) patients is eczema herpeticum (EH): herpes simplex virus (HSV) skin infection. Despite being comparatively uncommon affecting jus...Background: One of the most common viral infections occurring in atopic dermatitis (AD) patients is eczema herpeticum (EH): herpes simplex virus (HSV) skin infection. Despite being comparatively uncommon affecting just 3% of AD patients, EH can progress from a local disease to a potentially fatal systemic infection. Up till now, the pathophysiology of EH is mainly unclear. Case Report: We report the case of a 2-year-old boy who was well-vaccinated and had a history of untreated atopic dermatitis from infancy and presented to the emergency department with increasingly itchy diffuse lesions, red eyes, profuse tearing, chills and malaise. The diagnosis of EH with bilateral ocular involvement was highly suspected. The patient had received intravenous acyclovir with a notable clinical improvement and a complete remission at the two-week follow-up.展开更多
Herpes zoster(HZ)is a painful condition resulting from reactivation of dormant varicella-zoster virus(VZV)in a previously VZV-infected person[1].Typical clinical manifestation of HZ are unilateral radicular pain and a...Herpes zoster(HZ)is a painful condition resulting from reactivation of dormant varicella-zoster virus(VZV)in a previously VZV-infected person[1].Typical clinical manifestation of HZ are unilateral radicular pain and a vesicular rash limited to one side of the body in the distribution of a nerve[2].The most common complication of HZ postherpetic neuralgia(PHN).展开更多
Dear Editor,Corneal endotheliitis,first reported in 1982 as an autoimmune disorder by Khodadoust and Attarzadeh[1],is now recognized to be frequently induced by viral infections,including varicella zoster virus(VZV),c...Dear Editor,Corneal endotheliitis,first reported in 1982 as an autoimmune disorder by Khodadoust and Attarzadeh[1],is now recognized to be frequently induced by viral infections,including varicella zoster virus(VZV),cytomegalovirus(CMV)and herpes simplex virus(HSV),that can cause inflammatory and immune-related injuries or direct damages to corneal endothelial cells[2-3].In cases with this type of endotheliitis of viral origin,manifestations may include conjunctival ciliary congestion or mixed congestion,corneal subepithelial bulla,localized corneal edema,keratic precipitates(KP)characteristic to the edema area,puckered posterior elastic lamina,mild anterior chamber reaction,intraocular pressure(IOP)elevation in presence of inflammation in trabecular meshwork,and endothelial decompensation[3-4].Accurate diagnosis of viral corneal endotheliitis is challenging due to its complex presentation,leading to a high misdiagnosis rate.To the best of our knowledge,there was no previous report of viral corneal endotheliitis presenting with corneal endothelial defects in the English literature.展开更多
AIM:To explore whether unilateral herpes simplex keratitis(HSK)can cause morphological changes of bilateral meibomian glands(MGs)based on artificial intelligence(AI)analytical system.METHODS:In the retrospective study...AIM:To explore whether unilateral herpes simplex keratitis(HSK)can cause morphological changes of bilateral meibomian glands(MGs)based on artificial intelligence(AI)analytical system.METHODS:In the retrospective study,29 patients with unilateral HSK and 29 participants matched in terms of age and sex were included as control group.Meibographic images of the upper eyelid using Keratograph 5M and assessed ocular surface parameters including tear meniscus height and tear break-up time.MG density and vagueness values were automatically analyzed and calculated using an AI analytical system.We compared the differences between the affected and the contralateral unaffected eyes in HSK patients,and the normal control eyes.We employed either the paired t-test or the Wilcoxon signed-rank test to compare significant difference between the affected and unaffected eyes in HSK patients or between the HSK group and control group.RESULTS:The MG density was 0.19±0.09 in the HSKaffected eye and 0.18±0.07 in contralateral unaffected eye,which had no significant difference(P=0.616).The MG density between the affected eye with HSK and the normal control group was statistically significant(P=0.028).There was a significant difference in MG density between the contralateral unaffected eye and the normal control group(P=0.012).However,no significant difference in vagueness value was observed between the eye with HSK and the control group or between HSK eye and contralateral eye.CONCLUSION:The MG density between the HSKaffected eye and the contralateral unaffected eye don’t significantly differ,whereas there is a significant decrease in the HSK group compared to that of the normal participants.Unilateral HSV keratitis may suffer from bilateral changes of MG morphology indicating bilateral dry eye.Therefore,the fellow eye of patients with unilateral HSK should be considered a potential case of MG dysfunction,necessitating early treatment for bilateral dry eye in the clinic.展开更多
BACKGROUND Intestinal obstruction is a common occurrence in clinical practice.However,the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare.In the diagnostic...BACKGROUND Intestinal obstruction is a common occurrence in clinical practice.However,the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare.In the diagnostic and treatment process,clinicians consider it crucial to identify the primary causes of its occurrence to ensure effective treatment and avoiding misdiagnosis.CASE SUMMARY Herein,we present the case of a 40-year-old female patient with intestinal obstruction who underwent laparoscopic appendectomy and developed herpes zoster after surgery.Combining the patient's clinical manifestations and relevant laboratory tests,it was suggested that the varicella zoster virus reactivated during the latent period after abdominal surgery,causing herpes zoster.Subsequently,the herpes virus invaded the visceral nerve fibers,causing gastrointestinal dysfunction and loss of intestinal peristalsis,which eventually led to intestinal obstruction.The patient was successfully treated through conservative treatment and antiviral therapy and subsequently discharged from the hospital.CONCLUSION Pseudo-intestinal obstruction secondary to herpes zoster infection is difficult to distinguish from mechanical intestinal obstruction owing to various causes.In cases of inexplicable intestinal obstructions,considering the possibility of a viral infection is essential to minimize misdiagnosis and missed diagnoses。展开更多
Allicin, an antioxidant, is known for providing garlic with its unique fragrance and taste, as well as for its antimicrobial properties. Black garlic, a fermented form of garlic, contains higher levels of antioxidants...Allicin, an antioxidant, is known for providing garlic with its unique fragrance and taste, as well as for its antimicrobial properties. Black garlic, a fermented form of garlic, contains higher levels of antioxidants than fresh garlic. Antioxidants play a vital role in alleviating cellular stress during viral infections. Viral infections result in oxidative stress through the production of reactive oxidative species (ROS). A prolonged state of oxidative stress can result in cell death, DNA damage, and disease progression. In this study, black garlic extract (BGE) is evaluated for its ability to mitigate cytopathic effects and oxidative stress caused by herpes simplex virus-2 (HSV-2) infections in vitro. Antiviral assays were performed to determine the percent of viral inhibition resulting from treatment with the BGE. ROS-Glo<sup>TM</sup> H<sub>2</sub>O<sub>2</sub> assays were then completed to measure the post-infection ROS levels of BGE-treated virus and cells. The results thus far suggest that BGE may inhibit viral infection and decrease levels of oxidative stress.展开更多
基金Supported by the Joint Construction Project of Medical Science and Technology Research Plan in Henan Province(LHGJ20190879).
文摘[Objectives]To observe the clinical efficacy of external application of Scorzonera Herpes Ointment combined with Methylprednisolone Sodium Succinate for Injection in the treatment of herpes zoster oticus(HZO).[Methods]A total of 100 HZO patients admitted to the 988 th Hospital of the Joint Logistics Support Force and Henan Provincial People's Hospital from June 2021 to June 2023 were selected.They were divided into a treatment group and a control group using a random number table method,with 50 cases in each group.Both groups received Methylprednisolone Sodium Succinate for Injection.Additionally,the treatment group was treated with external application of Scorzonera Herpes Ointment,while the control group received acyclovir ointment.Both groups were treated for 10 d.The comparisons included clinical efficacy,total symptom and sign scores,pain level[Visual Analogue Scale(VAS)],time for erythema reduction,cessation of blister formation,scab formation,and scab shedding,incidence of post-herpetic neuralgia(PHN),air conduction hearing threshold,and air-bone gap.[Results]After 10 d of treatment,the total effective rate was 98.00%(49/50)in the treatment group and 84.00%(42/50)in the control group,with a statistically significant difference between the two groups(P<0.05).After 10 d of treatment,the total symptom and sign scores and VAS scores of both groups decreased compared to those before treatment.The treatment group had significantly lower scores than the control group(P<0.05).The treatment group showed significantly shorter time for erythema reduction,cessation of blister formation,scab formation,and scab shedding compared to the control group(P<0.05).During the 1-month follow-up after treatment,no PHN cases occurred in the treatment group,while the incidence of PHN in the control group was 24.00%(12/50),showing a statistically significant difference(P<0.05).After 10 d of treatment,both groups showed reduced air conduction hearing thresholds,and the treatment group exhibited significantly lower air conduction thresholds and air-bone gaps compared to the control group(P<0.05).No statistically significant difference was observed in the air-bone gap before and after treatment in the control group(P>0.05).[Conclusions]The combination of external application of Scorzonera Herpes Ointment and Methylprednisolone Sodium Succinate for Injection can alleviate pain and other discomforts,reduce PHN incidence,shorten disease duration,and improve hearing in HZO patients.
文摘Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection during childhood[1].HZ tends to occur more frequently in older adults,in whom cellmediated immunity often declines.The incidence of HZ among immunocompetent unvaccinated individuals aged>50y is 9.92/1000 person-years[2].HZ ophthalmicus(HZO)occurs when HZ involves the first division of the trigeminal nerve,i.e.,the ophthalmic nerve[3].
基金supported by the National Natural Science Foundation of China(No.81970848).
文摘Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against herpes simplex virus 1(HSV-1).By examining different phases of viral infection in human corneal epithelial cells(HCECs),we found that 30μmol/L quercetin inhibits HSV-1 replication primarily by disrupting viral attachment.RNA-sequencing and subsequent analyses revealed that the nuclear factor E2-related factor 2(Nrf2)was upregulated by quercetin in a dose-dependent manner.Knocking down Nrf2 partially compromised quercetin's antiviral effect.Importantly,topical application of 100μmol/L quercetin alleviated HSK severity in mice,reduced viral titers in tears,and inhibited VP16 expression in the cornea and trigeminal ganglia.These findings demonstrate the antiviral effect of quercetin against HSV-1 and provide a foundation for mechanistic studies to elucidate its therapeutic potential in HSK.
基金supported by UniversitàCattolica(D1 intramural funds to RP)Italian Ministry of University and Research(PRIN 2022ZYLB7B,P2022YW7BP funds to CG).
文摘Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not completely understood.Among the molecular mediators of synaptic and cognitive dysfunction occurring after Herpes simplex virus type-1 infection and reactivation in the brain neuroinflammatory cytokines seem to occupy a central role.Here,we specifically reviewed literature reports dealing with the impact of neuroinflammation on synaptic dysfunction observed after recurrent Herpes simplex virus type-1 reactivation in the brain,highlighting the role of interleukins and,in particular,interleukin 1βas a possible target against Herpes simplex virus type-1-induced neuronal dysfunctions.
文摘BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.
文摘BACKGROUND Facial herpes is a common form of the herpes simplex virus-1 infection and usually presents as vesicles near the mouth,nose,and periocular sites.In contrast,we observed a new facial symptom of herpes on the entire face without vesicles.CASE SUMMARY A 33-year-old woman with a history of varicella infection and shingles since an early age presented with sarcoidosis of the entire face and neuralgia without oral lesions.The patient was prescribed antiviral treatment with valacyclovir and acyclovir cream.One day after drug administration,facial skin lesions and neurological pain improved.Herpes simplex without oral blisters can easily be misdiagnosed as pimples upon visual examination in an outpatient clinic.CONCLUSION As acute herpes simplex is accompanied by neuralgia,prompt diagnosis and prescription are necessary,considering the pathological history and health conditions.
文摘BACKGROUND Erythrodermic psoriasis(EP)is a rare and life-threatening form of psoriasis associated with significant morbidity and mortality.Systemic immunosuppre-ssive therapies are often required but may predispose to opportunistic infections.Disseminated herpes simplex virus type-1(HSV-1)is an unusual complication in otherwise immunocompetent patients and has not been reported in association with ixekizumab therapy for EP.CASE SUMMARY We describe a 49-year-old man with longstanding severe plaque psoriasis,liver cirrhosis,and bipolar disorder who developed EP involving>90%of body surface area[Psoriasis Area and Severity Index(PASI)45].Following initial stabil-ization,he was admitted to the intensive care unit(ICU)with hemodynamic instability,leukocytosis with eosinophilia,and diffuse desquamation.Ixekizumab was initiated with high-dose topical clobetasol.During his ICU stay,he developed recurrent bacteremias and neurologic decline(Glasgow Coma Scale 7/15),fo-llowed by the appearance of widespread vesicles and hemorrhagic crusts.HSV-1 infection was confirmed by polymerase chain reaction(PCR).Immunosuppressive therapy was withheld,and intravenous acyclovir was started,leading to progre-ssive improvement.After ten days,ixekizumab was reintroduced with careful monitoring,resulting in marked clinical improvement(PASI 9.7 at six weeks).The patient remained stable on long-term follow-up with oral acyclovir prophylaxis.CONCLUSION This case highlights the diagnostic and therapeutic challenges of managing EP in the setting of biologic therapy.Disseminated cutaneous HSV-1 should be considered in immunosuppressed patients presenting with new vesicular eruptions,and prompt PCR testing with early antiviral therapy is essential.A multidisciplinary approach is critical to balance immunosuppression for disease control with infection risk.
文摘Dear Editor,I am Dr.Asako Kodama,affiliated with the Department of Ophthalmology at Eiju General Hospital in Tokyo,Japan.Varicella-zoster virus(VZV)induces two distinct states:the primary infection(varicella)and secondary endogenous reactivation of latent VZV in herpes zoster form.While herpes zoster lesions typically manifest on the trunk and abdomen,the most frequently involved cranial nerve is the trigeminal nerve.
文摘[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mechanism.[Methods]96 patients with PHN were divided into the control group(group A)and observation group(group B)(n=48).In group A,the patients were given gabapentin orally and treated by cotton moxibustion.In group B,the patients were treated by the external application of self-prepared Chinese prescription decoction on the basis of the above basic treatment.The total effective rate,apparent time and recurrence rate of the two groups were compared.[Results]The cure rate(72.91%)and total effective rate(95.83%)of patients in group B were higher than those in group A(54.16%,83.33%).The average apparent time[(5.79±1.40)d]and recurrence rate(5.97%)of patients in group B were significantly lower than those in group A[(7.03±4.37)d,10.45%],and the difference between the two groups was statistically significant(P<0.05).[Conclusions]The external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion therapy had a significant curative effect and low recurrence rate.
文摘Herpes zoster(HZ)is an acute infectious disease caused by varicella-zoster virus.The neurological sequelae of HZ include postherpetic neuralgia(PHN)and postherpetic itch(PHI).Severe pain and recurrent itching seriously affect the quality of life of patients.The pathogenesis of PHN is related to the mediation of immune-inflammatory response,activation of neuroglial cells,structural and functional alterations of the brain,aberrant expression of ion channels,and gene mediation.Overall,the immune-inflammatory response is a key factor mediating the pathogenesis of PHN.By reviewing the literature,the authors found that there are few studies on PHN both at home and abroad,so its pathogenesis is still unclear.No new progress has been made in recent years either,resulting in the understanding of PHI remaining in a state of confusion.The pathogenesis of PHI may be related to the loss of epidermal nerves,excitation of itch-specific neurons,absence of itch-inhibitory neurons,the action of itch-causing factors,and the vicious circle of itch and mood disorders.In general,most of them are conjectures,not supported by relevant experimental data.The treatments for PHN are varied and effective,while the pathogenesis of PHI is still unclear,so the treatment is often passive.This paper reviews the pathogenesis of PHN and PHI,expecting to provide new ideas for clinical treatment.
文摘The aim of our minireview is to provide a brief overview of the diagnosis,clinical aspects,treatment options,management,and current literature available regarding herpes simplex keratitis(HSK).This type of corneal viral infection is caused by the herpes simplex virus(HSV),which can affect several tissues,including the cornea.One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea.After the initial infection,the HSV can establish a latent infection in the trigeminal ganglion,a nerve cluster near the eye.The virus may remain dormant for extended periods.Periodic reactivation of the virus can occur,leading to recurrent episodes of HSK.Factors triggering reactivation include stress,illness,immunosuppression,or trauma.Recurrent episodes can manifest in different clinical patterns,ranging from mild epithelial involvement to more severe stromal or endothelial disease.The severity and frequency of recurrences vary among individuals.Severe cases of HSK,especially those involving the stroma and leading to scarring,can result in vision impairment or even blindness in extreme cases.The cornea's clarity is crucial for good vision,and scarring can compromise this,potentially leading to visual impairment.The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization.Antiviral medications,such as oral Acyclovir or topical Ganciclovir,may be prescribed for prophylaxis.The immune response to the virus can contribute to corneal damage.Inflammation,caused by the body's attempt to control the infection,may inadvertently harm the corneal tissues.Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation.In summary,the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.
文摘Periodontitis is the inflammation of the supporting structures around the dentition.Several microbial agents,mostly bacteria,have been identified as causative factors for periodontal disease.On the other hand,oral cavity is a rich reservoir for viruses since it contains a wide variety of cell types that can be targeted by viruses.Traditionally,the focus of research about the oral flora has been on bacteria because the most widespread oral diseases,like periodontitis and dental caries,are outcomes of bacterial infection.However,recently and especially after the emergence of coronavirus disease 2019,there is a growing tendency toward including viruses also into the scope of oral microbiome investigations.The global high prevalence of periodontitis and viral infections may point out to a concomitant or synergistic effect between the two.Although the exact nature of the mechanism still is not clearly understood,this could be speculated through the manipulation of the immune system by viruses;hence facilitating the furthermore colonization of the oral tissues by bacteria.This review provides an extensive and detailed update on the role of the most common viruses including herpes family(herpes simplex,varicella-zoster,Epstein-Barr,cytomegalovirus),Human papillomaviruses,Human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2 in the initiation,progression and prognosis of periodontitis.
基金supported by grants from the National Natural Science Foundation of China[grant number 82471846,82103740 and 82103743]Medical Science and Technology Project of Zhejiang Province[grant number 2022RC198].
文摘Genital herpes(GH)is a common sexually transmitted disease,which is primarily caused by herpes simplex virus type 2(HSV-2),and continues to be a global health concern.Although our understanding of the alterations in immune cell populations and immunomodulation in GH patients is still limited,it is evident that systemic intrinsic immunity,innate immunity,and adaptive immunity play crucial roles during HSV-2 infection and GH reactivation.To investigate the mechanisms underlying HSV-2 infection and recurrence,single-cell RNA sequencing(scRNA-seq)was performed on immune cells isolated from the peripheral blood of both healthy individuals and patients with recurrent GH.Furthermore,the systemic immune response in patients with recurrent GH showed activation of classical monocytes,CD4þT cells,natural killer cells(NK cells),and plasmacytoid dendritic cells(pDCs),especially of genes associated with the Toll-like receptor signaling pathway and T cell activation.Circulating immune cells in GH patients show higher expression of genes associated with inflammation and antiviral responses both in the scRNA-Seq data set and in independent quantitative real-time polymerase chain reaction(qRT-PCR)analysis and ELISA experiments.This study demonstrated that localized genital herpes,resulting from HSV reactivation,may influence the functionality of circulating immune cells,suggesting a potential avenue for future research into the role of systemic immunity during HSV infection and recurrence.
文摘Background: One of the most common viral infections occurring in atopic dermatitis (AD) patients is eczema herpeticum (EH): herpes simplex virus (HSV) skin infection. Despite being comparatively uncommon affecting just 3% of AD patients, EH can progress from a local disease to a potentially fatal systemic infection. Up till now, the pathophysiology of EH is mainly unclear. Case Report: We report the case of a 2-year-old boy who was well-vaccinated and had a history of untreated atopic dermatitis from infancy and presented to the emergency department with increasingly itchy diffuse lesions, red eyes, profuse tearing, chills and malaise. The diagnosis of EH with bilateral ocular involvement was highly suspected. The patient had received intravenous acyclovir with a notable clinical improvement and a complete remission at the two-week follow-up.
基金supported by the Operation of Public Health Emergency Response Mechanism of the Chinese Center for Disease Control and Prevention(10239322002001,0000017)Research on Vaccine Evaluation Strategy and capacity Building Project(09207).
文摘Herpes zoster(HZ)is a painful condition resulting from reactivation of dormant varicella-zoster virus(VZV)in a previously VZV-infected person[1].Typical clinical manifestation of HZ are unilateral radicular pain and a vesicular rash limited to one side of the body in the distribution of a nerve[2].The most common complication of HZ postherpetic neuralgia(PHN).
文摘Dear Editor,Corneal endotheliitis,first reported in 1982 as an autoimmune disorder by Khodadoust and Attarzadeh[1],is now recognized to be frequently induced by viral infections,including varicella zoster virus(VZV),cytomegalovirus(CMV)and herpes simplex virus(HSV),that can cause inflammatory and immune-related injuries or direct damages to corneal endothelial cells[2-3].In cases with this type of endotheliitis of viral origin,manifestations may include conjunctival ciliary congestion or mixed congestion,corneal subepithelial bulla,localized corneal edema,keratic precipitates(KP)characteristic to the edema area,puckered posterior elastic lamina,mild anterior chamber reaction,intraocular pressure(IOP)elevation in presence of inflammation in trabecular meshwork,and endothelial decompensation[3-4].Accurate diagnosis of viral corneal endotheliitis is challenging due to its complex presentation,leading to a high misdiagnosis rate.To the best of our knowledge,there was no previous report of viral corneal endotheliitis presenting with corneal endothelial defects in the English literature.
基金Supported by Zhejiang Provincial Medical and Health Science Technology Program,Health Commission of Zhejiang Province(No.2022PY074)Science and Technology Program of Wenzhou City(No.Y2020335).
文摘AIM:To explore whether unilateral herpes simplex keratitis(HSK)can cause morphological changes of bilateral meibomian glands(MGs)based on artificial intelligence(AI)analytical system.METHODS:In the retrospective study,29 patients with unilateral HSK and 29 participants matched in terms of age and sex were included as control group.Meibographic images of the upper eyelid using Keratograph 5M and assessed ocular surface parameters including tear meniscus height and tear break-up time.MG density and vagueness values were automatically analyzed and calculated using an AI analytical system.We compared the differences between the affected and the contralateral unaffected eyes in HSK patients,and the normal control eyes.We employed either the paired t-test or the Wilcoxon signed-rank test to compare significant difference between the affected and unaffected eyes in HSK patients or between the HSK group and control group.RESULTS:The MG density was 0.19±0.09 in the HSKaffected eye and 0.18±0.07 in contralateral unaffected eye,which had no significant difference(P=0.616).The MG density between the affected eye with HSK and the normal control group was statistically significant(P=0.028).There was a significant difference in MG density between the contralateral unaffected eye and the normal control group(P=0.012).However,no significant difference in vagueness value was observed between the eye with HSK and the control group or between HSK eye and contralateral eye.CONCLUSION:The MG density between the HSKaffected eye and the contralateral unaffected eye don’t significantly differ,whereas there is a significant decrease in the HSK group compared to that of the normal participants.Unilateral HSV keratitis may suffer from bilateral changes of MG morphology indicating bilateral dry eye.Therefore,the fellow eye of patients with unilateral HSK should be considered a potential case of MG dysfunction,necessitating early treatment for bilateral dry eye in the clinic.
文摘BACKGROUND Intestinal obstruction is a common occurrence in clinical practice.However,the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare.In the diagnostic and treatment process,clinicians consider it crucial to identify the primary causes of its occurrence to ensure effective treatment and avoiding misdiagnosis.CASE SUMMARY Herein,we present the case of a 40-year-old female patient with intestinal obstruction who underwent laparoscopic appendectomy and developed herpes zoster after surgery.Combining the patient's clinical manifestations and relevant laboratory tests,it was suggested that the varicella zoster virus reactivated during the latent period after abdominal surgery,causing herpes zoster.Subsequently,the herpes virus invaded the visceral nerve fibers,causing gastrointestinal dysfunction and loss of intestinal peristalsis,which eventually led to intestinal obstruction.The patient was successfully treated through conservative treatment and antiviral therapy and subsequently discharged from the hospital.CONCLUSION Pseudo-intestinal obstruction secondary to herpes zoster infection is difficult to distinguish from mechanical intestinal obstruction owing to various causes.In cases of inexplicable intestinal obstructions,considering the possibility of a viral infection is essential to minimize misdiagnosis and missed diagnoses。
文摘Allicin, an antioxidant, is known for providing garlic with its unique fragrance and taste, as well as for its antimicrobial properties. Black garlic, a fermented form of garlic, contains higher levels of antioxidants than fresh garlic. Antioxidants play a vital role in alleviating cellular stress during viral infections. Viral infections result in oxidative stress through the production of reactive oxidative species (ROS). A prolonged state of oxidative stress can result in cell death, DNA damage, and disease progression. In this study, black garlic extract (BGE) is evaluated for its ability to mitigate cytopathic effects and oxidative stress caused by herpes simplex virus-2 (HSV-2) infections in vitro. Antiviral assays were performed to determine the percent of viral inhibition resulting from treatment with the BGE. ROS-Glo<sup>TM</sup> H<sub>2</sub>O<sub>2</sub> assays were then completed to measure the post-infection ROS levels of BGE-treated virus and cells. The results thus far suggest that BGE may inhibit viral infection and decrease levels of oxidative stress.
