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Query: UMLS:C0022568 (
keratitis
)
5,133
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The history of herpetic
keratitis
is presented. The similarities and differences between dendritic
keratitis
and herpes labialis are enumerated, with the suggestion that the similarities (in onset, pathology, and clinical course) far outweigh the differences. The principal difference seems to be that the avascalarity of the cornea retards the immunologic responses. Important points in the history of herpetic
keratitis
include (1) the close association of herpetic disease with malaria around the turn of the century; (2) the relatively benign nature of the disease, in contrast to herpes zoster
keratitis
; (3) the unfavorable response of the disease to immunosuppressive measures and diseases; (4) the failure of chemotherapy to influence favorably the natural history of the disease; and (5) the increasing visual damage caused by the disease since 1952 when corticosteroids were introduced into ocular therapy. Mention is made of the increasing problem of
venereal herpes
, with resultant neonatal herpetic
keratitis
, retinitis, and encephalitis.
...
PMID:Historical observations on herpetic keratitis. 79 Jun 18
Acyclovir (aciclovir) is a nucleoside analogue antiviral drug related to cytarabine, idoxuridine, trifluridine and vidarabine. In common with these earlier antivirals, acyclovir is active against some members of the herpesvirus group of DNA viruses. The efficacy of topical acyclovir has been convincingly demonstrated in ocular herpetic
keratitis
, and in initial and primary initial
genital herpes
infection, but little or no clinical benefit was seen when non-primary initial genital infections were assessed separately. Acyclovir ointment demonstrated little benefit in recurrent
genital herpes
but topical acyclovir cream decreased the course of the infection by 1 to 2 days. Orally and intravenously administered acyclovir were beneficial in initial
genital herpes
infections, and oral therapy shortened the duration of recurrent infections by 1 to 2 days but did not ameliorate pain. In non-immunocompromised patients with recurrent herpes simplex labialis, generally little clinical benefit was seen with the use of topical acyclovir ointment even when therapy was initiated during the prodromal phase, while topical acyclovir cream effected small but significant improvements in the clinical but not the symptomological course of the disease. However, in immunocompromised patients, both intravenous and topical acyclovir shortened the clinical course of herpes simplex virus infections occurring mainly on the lips, oral mucosa and face, and prophylaxis with either oral or intravenous acyclovir suppressed the appearance of recurrent lesions from latent virus for the period of drug administration, but acyclovir did not eradicate latent herpesviruses. In non-immunocompromised patients, intravenous acyclovir was shown to decrease the acute pain of zoster, especially in the elderly, but postherpetic neuralgia was not ameliorated. When immunocompromised patients were studied, intravenous acyclovir inhibited the progression of zoster infections and shortened the healing time and duration of viral shedding in patients with cutaneous disseminated zoster. However, acute and post-herpetic pain were not significantly affected. Well designed controlled studies are underway to establish the efficacy of acyclovir in herpes simplex encephalitis and cytomegalovirus infections in immunocompromised patients, infections due to Epstein-Barr virus, and neonatal herpesvirus infections. Despite some aspects of the drug's use which require further clarification, acyclovir will make a major impact on the treatment of herpesviral infections. Barring unexpected findings with wider clinical use, it will become the agent of choice in several conditions.
...
PMID:Acyclovir. A review of its pharmacodynamic properties and therapeutic efficacy. 631 32
A novel multiplex nested polymerase chain reaction (PCR) assay was designed and evaluated for routine diagnosis of herpes simplex virus (HSV) infections in patients with either putative HSV infection of the central nervous system or suspected HSV keratitis. Single-tube amplification of HSV type 1 (HSV-1) or type 2 (HSV-2) DNA extracted from cerebrospinal fluid (CSF) or from keratectomy specimens was followed by differentiation of the virus type-specific PCR products either by agarose gel analysis or by DNA enzyme immunoassay. Among 417 CSF specimens obtained from 395 consecutive patients with clinically suspected HSV infection, 11 (2.6%) were positive for HSV-1 DNA and four (1.0%) probes were positive for HSV-2 DNA. None of the specimens was positive for both HSV-1 and HSV-2 DNA. The genome of HSV-2 was detected in a CSF sample obtained from a woman with meningoencephalitis and
genital herpes
. The presence of PCR inhibitors was detected in six of 111 (5.4%) reconstructed CSF samples. Inhibition could be removed following extraction with a commercial kit. HSV-1 DNA, but no HSV-2 DNA, was detected in corneal buttons obtained from patients with suspected herpetic
keratitis
. No contamination has been recorded during the 2-year routine use of this test, which has met the specific requirements of a diagnostic laboratory.
...
PMID:Suitability and clinical application of a multiplex nested PCR assay for the diagnosis of herpes simplex virus infections. 889 44
In this work are reported the results of the researches performed by the authors more than a decade ago, aimed at assessing the clinical benefit of the introduction of the drug "Zovirax" in the treatment of recurrent herpetic infections with genital or ocular location. The results of the treatment carried out on a restricted group of patients were positive both in cases of
genital herpes
and of herpetic
keratitis
. The clinical benefit consisted in the reduction of the mean duration of the disease, in the shortening of the period of the infective virus elimination from the lesion, as well as in the decrease of the intensity and duration of the clinical symptomatology as a whole. With respect to these clinical parameters, the observations of the authors performed on a low number of cases are consistent with the data obtained by other authors in the framework of more extensive studies. The renewed discussion of these clinical and laboratory observations carried out by the authors during the first years after the introduction in our country of this drug in the therapeutic arsenal of herpetic infections is aimed at establishing a landmark for the comparison with more recent results of similar studies, starting from the idea of the opportunity of assessing periodically the sensitivity of herpes simplex virus strains, circulating among the autochthonous population, to the inhibitory action of some antiviral drugs. In other words, the in vitro testing of the susceptibility of these strains to the chemotherapeutic agents in current use is predictive for the efficacy degree of these drugs in the treatment of some forms of herpetic infections. This evaluation represents at the same time, undoubtedly, a useful epidemiological surveillance means of the circulation of human herpes viruses among the population. We refer especially to the risk of appearance of pharmacoresistant mutants, a risk possible under the conditions of the increased access of patients to the antiviral chemotherapeutic medication, which implicitly augments the probability of a fortuitous administration of treatments insufficient as regards the dose or the duration. In this work there are also shown the results regarding some experimental aspects related to the immune control mechanisms of the herpetic infection, which may complement the chemotherapeutic action. Under the treatment with acycloguanosine the synthesis of herpetic antigens is kept at a level sufficient for the circulating antibody synthesis induction and the HSV infected cells treated with the drug are recognized and lysed by effectors of the cell-mediated immune response of the host. Hence, it may be asserted that, in some clinical cases of recurrent herpes with frequent episodes, it is useful to perform immunostimulating treatments, able to potentiate the cell-mediated immune mechanisms possibly involved in the limitation of the herpetic infection at the peripheral level and of its spreading in the central nervous system.
...
PMID:Assessment trials of the therapeutic efficacy of the drug "Zovirax" in some recurrent ocular and genital herpetic infections. 1089 24
Herpes simplex virus type 1 (HSV-1) is the etiological agent of herpetic
keratitis
. The epithelial form ("epithelial keratitis") is attributed mainly to destruction of the epithelium through active viral replication within the epithelium. The stromal form ("stromal keratitis") is associated with immune reactions within the stroma and is the common cause of human blindness. In the present study, 29 HSV-1 strains isolated from human ocular materials of herpetic
keratitis
were classified into 14 genotypes on the basis of DNA polymorphisms. Twenty-one of 29 (72%) strains from eyes examined in the present study were of genotypes that were shown previously to be present in strains from non-ocular lesions (including
genital herpes
). Five of nine (56%) strains from eyes related to stromal
keratitis
were of the F1 genotype, while four of twenty (20%) strains from eyes not related to stromal
keratitis
were of the F1 genotype. Thus, the proportion of F1 genotype was assumed to be larger in the group of strains related to stromal
keratitis
than in that not so related, suggesting an association of the F1 genotype with stromal
keratitis
. A connection of F1 genotype with recurrence was proposed previously; hence, F1 genotype seems to be associated to both stromal
keratitis
and the recurrence, thereby supporting the relationship between stromal
keratitis
and recurrence.
...
PMID:Genotyping of herpes simplex virus type 1 strains isolated from ocular materials of patients with herpetic keratitis. 1285 12
Herpes simplex viruses (HSV) are highly pervasive pathogens in the human host with a seroconversion rate upwards of 60% worldwide. HSV type 1 (HSV-1) is associated with the disease herpetic stromal
keratitis
, the leading cause of infectious corneal blindness in the industrialized world. Individuals suffering from
genital herpes
associated with HSV type 2 (HSV-2) are found to be two- to threefold more susceptible in acquiring human immunodeficiency virus (HIV). The morbidity associated with these infections is principally due to the inflammatory response, the development of lesions, and scarring. Chemokines have become an important aspect in understanding the host immune response to microbial pathogens due in part to the timing of expression. In this paper, we will explore the current understanding of chemokine production as it relates to the orchestration of the immune response to HSV infection.
...
PMID:Herpes simplex virus and the chemokines that mediate the inflammation. 1657 Aug 56
Herpes simplex virus type 1 (HSV-1) produces oral lesions, encephalitis,
keratitis
, and severe infections in the immunocompromised host. HSV-1 is almost as common as HSV-2 in causing first episodes of
genital herpes
, a disease that is associated with an increased risk of human immunodeficiency virus acquisition and transmission. No approved vaccines are currently available to protect against HSV-1 or HSV-2 infection. We developed a novel HSV vaccine strategy that uses a replication-competent strain of HSV-1, NS-gEnull, which has a defect in anterograde and retrograde directional spread and cell-to-cell spread. Following scratch inoculation on the mouse flank, NS-gEnull replicated at the site of inoculation without causing disease. Importantly, the vaccine strain was not isolated from dorsal root ganglia (DRG). We used the flank model to challenge vaccinated mice and demonstrated that NS-gEnull was highly protective against wild-type HSV-1. The challenge virus replicated to low titers at the site of inoculation; therefore, the vaccine strain did not provide sterilizing immunity. Nevertheless, challenge by HSV-1 or HSV-2 resulted in less-severe disease at the inoculation site, and vaccinated mice were totally protected against zosteriform disease and death. After HSV-1 challenge, latent virus was recovered by DRG explant cocultures from <10% of vaccinated mice compared with 100% of mock-vaccinated mice. The vaccine provided protection against disease and death after intravaginal challenge and markedly lowered the titers of the challenge virus in the vagina. Therefore, the HSV-1 gEnull strain is an excellent candidate for further vaccine development.
...
PMID:A replication-competent, neuronal spread-defective, live attenuated herpes simplex virus type 1 vaccine. 1856 43
Hypogammaglobulinemia develops in 3 to 6% of patients with thymoma and this association is commonly referred to as thymoma with immunodeficiency (formerly Good syndrome). Recurrent infections with encapsulated bacteria and opportunistic infections associated with disorders of both humoral and cell mediated immunity frequently occur in this rare primary, adult-onset immunodeficiency. We report a case of thymoma with immunodeficiency complicated by disseminated herpes simplex virus (HSV) infection and review five additional cases of HSV-related infections reported since 1966 in patients presenting with thymoma with immunodeficiency. Patients presented with epiglottitis,
keratitis
, recurrent
genital herpes
, ulcerative dermatitis, and acute hepatitis. Four of the six cases had a fatal outcome, two of which were directly attributable to HSV infection. Since the risk of invasive opportunistic infections is high and the presentation atypical, lymphocyte count and total serum immunoglobulin should be measured regularly in all patients presenting with thymoma with immunodeficiency.
...
PMID:Thymoma, immunodeficiency, and herpes simplex virus infections. 1926 57
Herpes simplex virus (HSV) is an ubiquitous agent responsible for a wide variety of human infections. In addition to epithelial infections such as gingivostomatitis, pharyngitis,
genital herpes
, whitlow, conjunctivitis, and
keratitis
, HSV is an important cause of central nervous system (CNS) infections and accounts for 2-19% of human encephalitis cases (1,2). The clinical spectrum of CNS diseases has been recently expanded; for example, most cases of benign recurrent aseptic meningitis (Mollaret meningitis) are caused by HSV (3), especially HSV-2 (4). Because specific antiviral therapy is available, the rapid, definitive laboratory diagnosis of HSV is important to support clinical findings. Moreover, in the setting of possible HSV encephalitis, patients are often managed as inpatients while awaiting test results.
...
PMID:A colorimetric microtiter plate polymerase chain reaction system that detects herpes simplex virus in cerebrospinal fluid and discriminates genotypes 1 and 2. 2137 Jan 53
Herpesviruses infect the majority of the human population and can cause significant morbidity and mortality. Herpes simplex virus (HSV) type 1 causes cold sores and herpes simplex
keratitis
, whereas HSV-2 is responsible for
genital herpes
. Human cytomegalovirus (HCMV) is the most common viral cause of congenital defects and is responsible for serious disease in immuno-compromised individuals. Epstein-Barr virus (EBV) is associated with infectious mononucleosis and a broad range of malignancies, including Burkitt's lymphoma, nasopharyngeal carcinoma, Hodgkin's disease, and post-transplant lymphomas. Herpesviruses persist in their host for life by establishing a latent infection that is interrupted by periodic reactivation events during which replication occurs. Current antiviral drug treatments target the clinical manifestations of this productive stage, but they are ineffective at eliminating these viruses from the infected host. Here, we set out to combat both productive and latent herpesvirus infections by exploiting the CRISPR/Cas9 system to target viral genetic elements important for virus fitness. We show effective abrogation of HCMV and HSV-1 replication by targeting gRNAs to essential viral genes. Simultaneous targeting of HSV-1 with multiple gRNAs completely abolished the production of infectious particles from human cells. Using the same approach, EBV can be almost completely cleared from latently infected EBV-transformed human tumor cells. Our studies indicate that the CRISPR/Cas9 system can be effectively targeted to herpesvirus genomes as a potent prophylactic and therapeutic anti-viral strategy that may be used to impair viral replication and clear latent virus infection.
...
PMID:CRISPR/Cas9-Mediated Genome Editing of Herpesviruses Limits Productive and Latent Infections. 2736 83
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