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Journal of Virology, December 2000, p. 11464-11471, Vol. 74, No. 24
0022-538X/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Analysis of Individual Human Trigeminal Ganglia for
Latent Herpes Simplex Virus Type 1 and Varicella-Zoster Virus Nucleic
Acids Using Real-Time PCR
Randall J.
Cohrs,1
Jessica
Randall,1
John
Smith,1
Donald H.
Gilden,1,2
Christine
Dabrowski,3
Harjeet
van
der Keyl,3 and
Ruth
Tal-Singer3,*
Departments of
Neurology1 and
Microbiology,2 University of Colorado
Health Sciences Center, Denver, Colorado 80262, and Department
of Molecular Virology and Host Defense, SmithKline Beecham
Pharmaceuticals, Collegeville, Pennsylvania 194263
Received 29 June 2000/Accepted 22 September 2000
 |
ABSTRACT |
Herpes simplex virus type 1 (HSV-1) and varicella-zoster virus
(VZV) establish latent infections in the peripheral nervous system
following primary infection. During latency both virus genomes exhibit
limited transcription, with the HSV-1 LATs and at least four VZV
transcripts consistently detected in latently infected human ganglia.
In this study we used real-time PCR quantitation to determine the viral
DNA copy number in individual trigeminal ganglia (TG) from 17 subjects.
The number of HSV-1 genomes was not significantly different between the
left and right TG from the same individual and varied per subject from
42.9 to 677.9 copies per 100 ng of DNA. The number of VZV genomes was
also not significantly different between left and right TG from the
same individual and varied per subject from 37.0 to 3,560.5 copies per
100 ng of DNA. HSV-1 LAT transcripts were consistently detected in
ganglia containing latent HSV-1 and varied in relative expression by
>500-fold. Of the three VZV transcripts analyzed, only transcripts mapping to gene 63 were consistently detected in latently infected ganglia and varied in relative expression by >2,000-fold. Thus, it
appears that, similar to LAT transcription in HSV-1 latently infected
ganglia, VZV gene 63 transcription is a hallmark of VZV latency.
 |
INTRODUCTION |
Herpes simplex virus type 1 (HSV-1)
and varicella-zoster virus (VZV) are neurotropic alphaherpesviruses
that are endemic in the human population. Under normal conditions, both
viruses are acquired early in life: HSV-1 often as an inapparent
asymptomatic infection of the mouth and lips (38) and VZV as
childhood chickenpox (1). Following primary infection, both
viruses establish latent infections in sensory ganglia. Reactivation of
latent HSV-1 typically results in localized epithelial eruptions (cold
sores) which shortly resolve with few, if any, consequences.
Reactivation of VZV involves the skin innervated by one to three
dermatomes lasting for weeks (shingles) and the excruciating pain can
persist long after skin lesions are cleared (reviewed in reference
18). In the normal population, the frequency of
HSV-1 reactivation wanes with age, while VZV reactivation occurs
usually once and is associated with the elderly (32). The
differences in the frequency and severity of HSV-1 and VZV reactivation
may be attributed to a number of factors that are yet to be elucidated.
Some possible explanations that have been proposed include the cell
type harboring latent virus, the virus burden during latency, and the
virus genes transcribed during latency, including interactions with
host factors (5, 6, 12, 18, 23, 30). The neuronal site of
HSV-1 latency has been firmly established in both human and animal
models (31). Lacking an animal model, the site of latent VZV
has been shown to be predominantly neuronal in human ganglia removed at
autopsy; however, nonneuronal satellite cells are also implicated as a reservoir of latent VZV (11, 15; and reviewed
in reference 19).
Latent virus DNA burden has been shown to be a major determinant in the
frequencies of HSV-1 and HSV-2 reactivation (17, 29). By
extension, latent VZV DNA copy number would be expected to be a factor
in the frequency of virus reactivation. Early studies using Southern
blot analysis of high-molecular-weight DNA extracted from human
trigeminal ganglia (TG) detected HSV-1 DNA in 9 of 20 individuals at a
virus DNA burden of 0.01 to 0.1 copy per ganglionic cell
(7). Taking into account the neuronal site of HSV-1 latency and a 1:100 frequency of neuronal cells to satellite cells in the human
TG (16), the present initial study detected 1 to 10 copies
of HSV-1 DNA per neuron. The quantity of HSV-1 DNA present during
latent infection in animal models has been determined. Latently
infected rabbits were found to contain, on average, 16.8 copies of
HSV-1 DNA per 100 cells (9), while latently infected mice
contained on average 50 copies of virus per 100 cell equivalents (10). At the single cell level, the HSV-1 DNA burden was
shown to range from 10 to 1,000 copies per individual latently infected mouse neuron (29). The amount of VZV DNA present in human
ganglia was determined to be 6 to 28 copies per 100,000 ganglionic cell equivalents (21). At the single-cell level, VZV DNA was
found at a rate of two to five copies per 100 neuronal cells
(15). Although it has been shown that both HSV-1 and VZV can
reside in the same human ganglia during latency (18, 21);
until recently, the simultaneous virus burden has not been determined.
Using the currently most sensitive and accurate method to determine
virus DNA copy number, real-time fluorescence PCR, Pevenstein et al. (27) detected approximately 2.9 × 103
copies of HSV-1 and 0.2 × 103 copies of VZV DNA per
105 human TG cells. When the satellite cell VZV DNA burden
was taken into account, these researchers concluded that similar
amounts of HSV-1 and VZV DNA were present per latently infected cell.
The lytic pattern of virus gene transcription differs substantially
from the latent program. A single HSV-1 transcriptional unit has
been consistently detected in human ganglia and in animal models. The
unstable 8.5-kb primary transcript maps to a region antisense with
respect to ICP0 and ICP4 from which stable introns of 2.0 and 1.5 kb
are spliced and accumulate in nuclei of latently infected neurons
(25, 33, 37, 39, 40). In the mouse model of HSV-1 latency,
low levels of acute immediate-early and early transcripts such as ICP4,
ICP27, and ICP6 have been detected (14, 35, 36), but the
presence of these lytic viral transcripts in latently infected human
ganglia has not been documented.
The transcriptional pattern of latent VZV is complex. Although the
HSV-1 and VZV genomes share a great deal of homology and most of the
open reading frames (ORFs) are colinear, VZV lacks a significant
portion of the long inverted repeat (IRL). Since the major
HSV-1 transcript detected in both human and animal models during
latency maps within the IRL (37), it would not
be surprising if the mechanism by which VZV maintains latency is
different from that of HSV-1. Supporting this assertion is the finding
that, unlike HSV-1, multiple VZV gene transcripts have been detected in
latently infected human ganglia (2-4, 22). However, due to
the low abundance of virus transcripts, previous analysis of latently
expressed VZV genes has required pooling ganglia from multiple
individuals. Inherent in these experiments is the chance of virus
reactivation within one or more ganglia confounding the results.
Since both HSV-1 and VZV can establish a latent or reactivated
infection within the same ganglia, we investigated individual trigeminal ganglia removed at autopsy from unselected individuals for
the footprints of both herpesviruses. Our real-time PCR data indicate
that VZV DNA is present in all ganglia tested; however, in contrast to
HSV-1, the VZV viral load is highly variable within this population.
Real-time reverse transcription-PCR (RT-PCR) of virus transcripts
associated with latency demonstrated that HSV-1 LAT and VZV gene 63 ranged in relative expression within individual ganglia from 500- to
2,000-fold, respectively. These observations are consistent with the
DNA copy number in our samples which may represent the variability in
viral load within the adult population.
 |
MATERIALS AND METHODS |
Tissue collection.
Both left and right trigeminal ganglia
were removed from the subjects who at autopsy did not show cutaneous
signs of recent herpesvirus infection. Table
1 shows the age, sex, cause of death, and
time between death and autopsy of the 17 individuals included in this
study. Using fresh instruments for each sample, we cleaned the nerve
roots and flash froze them in liquid nitrogen. All samples were stored
at
70°C.
Nucleic acid extraction.
Individual ganglia were powdered
under liquid nitrogen. Approximately 50 mg of the powdered tissue was
removed for DNA extraction (DNeasy Tissue Kit; Qiagen, Valencia,
Calif.). Total RNA was extracted from the remaining tissue (200 to 800 mg) (TRI Reagent; Molecular Research Center, Cincinnati, Ohio).
RT.
RNA was digested with RNase-free DNase I (Boehringer
Mannheim Biochemicals, Indianapolis, Ind.) for 45 min at 37°C,
followed by a 5-min incubation at 70°C. DNA (50 µl) was generated
from 4 µg of total RNA by using the Superscript Preamplification Kit (Life Technologies/Gibco-BRL, Grand Island, N.Y.), priming with oligo(dT) and random hexamers as described previously (35,
36).
Real-time PCR analysis (fluorescence-based simultaneous
amplification and product detection).
Reactions were performed in
50-µl volumes containing 2× TaqMan Universal PCR Master Mix
(Perkin-Elmer, Norwalk, Conn.) and appropriate amounts of cDNA (10%
for detection of viral transcripts, 2% for detection of cellular
transcripts) or 100 ng of DNA. Reactions also contained a 200 nM
concentration of TaqMan primers and a 200 nM concentration of TaqMan
probe. Primer pairs and probes described in Table
2 were designed using Primer Express
software (Perkin-Elmer) and analyzed in a 96-well optical plate. Probes were labeled at the 5' end with the fluorescent reporter dye Fam and at
the 3' end with fluorescent quencher dye Tamra (Synthegene, Houston,
Tex.) to allow direct detection of the PCR product. Real-time PCR
amplification and detection were performed using ABI 7700 Sequence
Detector (PE Biosystems). Relative copy numbers were calculated from a
standard curve generated in each individual assay using PCR standards.
Standard curves were highly reproducible. As a negative control, each
plate contained a minimum of three wells lacking template. Each sample
was analyzed in duplicate. The copy numbers for each individual gene
transcript were normalized to GAPDH (glyceraldehyde-3-phosphate
dehydrogenase) levels by dividing the copy number obtained from
standard curves to that obtained for GAPDH.
Real-time virus DNA PCR standards.
Purified HSV-1 (SC-16) or
VZV (strain Scott) viral DNA was serially diluted in 10 ng of human
genomic DNA (Clontech, Palo Alto, Calif.) per µl. The virus DNA was
diluted such that 2 µl of the sample contained 106,
105, 104, 103, 102,
101, or 100 of either HSV-1 or VZV DNA. For
quantitation of GAPDH, standard curves were generated using serial
dilutions of human genomic DNA. All samples in duplicate were subjected
to TaqMan PCR with each primer set to generate standard curves and to
evaluate relative primer sensitivity.
Standards for quantitative RT-PCR.
Polyadenylated VZV gene
21, 29, and 63 transcripts were individually synthesized, quantitated,
diluted, and reverse transcribed, and the cDNA yield was quantitated by
real-time PCR. To construct the plasmid templates for the in vitro
synthesis of polyadenylated VZV transcripts, restriction endonuclease
(RE) fragments containing each ORF were inserted into pAlter-1
(Promega, Madison, Wis.). Plasmid DNA was extracted, alkali-denatured,
and annealed to synthetic oligonucleotides containing unique RE sites
in apposition to the initiation and termination codons of the VZV ORF.
DNA was synthesized from the annealed oligonucleotide primers with T4
DNA polymerase, and the gaps were sealed with T4 DNA ligase. The newly
synthesized DNA was transformed into Es1301 mutS component
Escherichia coli and plasmids were screened for the inserted
RE sites by RE digestion and agarose gel electrophoresis. The plasmids
were then shuttled to the JM109 strain of E. coli for
extended propagation. The DNA sequence was obtained to verify the
fidelity of all constructs.
Each VZV ORF was directionally shuttled into pSP64 poly(A) (Promega)
between the SP6 promoter and the [A]
30 tract. Extracted
plasmid DNA was linearized downstream from the polyadenosine track,
and
SP6-dependent RNA transcripts were synthesized. After DNase
(Gibco-BRL)
digestion, transcripts were extracted by affinity
chromatography. Each
reaction yielded a single, discrete transcript
of the expected size
upon denaturing agarose gel electrophoresis.
The concentration of each
transcript, determined by measuring
the optical density at 260 nm, was
used to calculate the total
number of each transcript synthesized.
Since HSV-1 LAT is nonpolyadenylated
in vivo, pSP64 was not used as the
base plasmid for the in vitro
synthesis of HSV-1 LAT transcripts.
Instead, pLAT (the generous
gift of Roderick Smith, University of
Colorado Health Sciences
Center), which contains 1.2 kb of the major
HSV-1 LAT coding sequences,
was used to synthesize T3 transcripts.
Following linearization
of pLAT and in vitro T3-dependent
transcription, the RNA was digested
with DNase, extracted, resolved on
denaturing agarose gels, and
quantitated as described above. A stock
solution was prepared
which contained 10
7 copies per µl
of polyadenylated VZV gene 21, 29, and 63 transcripts
and
nonpolyadenylated HSV-1 LAT transcripts. Dilutions of from
10
6 to 10
1 copies of each transcript per 10 µl of nuclease-free water were
added to 500 ng of total RNA extracted
from control African green
monkey dorsal root ganglia as described
above. Each dilution of
ganglionic RNA containing known numbers of VZV
gene 21, 29, and
63 and HSV-1 LAT transcripts was reverse transcribed,
and the
cDNA was quantitated by real-time PCR. For each sample, a
reaction
lacking reverse transcriptase was prepared and similarly
quantitated.
 |
RESULTS |
HSV-1 and VZV DNA in human TG.
Samples from
individuals described in Table 1 were analyzed using real-time PCR
quantitation. Tables 3 and
4 present the amounts of HSV-1 and VZV
DNA in 100 ng of DNA extracted from individual human TG. Each
independent analysis contained no template DNA controls and, in all
cases, no PCR product was detected in samples lacking template. The
real-time PCR amplification of virus DNA standards was linear over a
range from 106 to 10 copies (r2 > 0.95).
The mean (average) and the standard error of the mean (SEM) for
replicate assays were compared by signed rank tests. Spearman
rank sum
test comparing the results from each set of primers showed
significant
correlation between all HSV-1 primers and between
all VZV primers:
HSV-1 ICP27 versus HSV-1 LAT,
P < 0.1 (
n = 15);
HSV-1 UL44 versus HSV-1 UL54,
P < 0.05 (
n = 8);
VZV 21 versus
VZV 63,
P < 0.0005 (
n = 34); VZV 21 versus VZV 29,
P < 0.1 (
n = 12); and VZV 29 versus VZV 63,
P < 0.05 (
n = 12). Similar
pairwise
analysis of the mean virus DNA copies showed no significant
differences
(Wilcoxon rank sum,
P > 0.2). Thus, the
results for HSV-1 UL44
and UL54 or LAT and ICP27 primer sets were
combined to yield the
mean HSV-1 DNA copy number per 100 ng of DNA for
each individual
ganglion. Similarly, the results for VZV gene 21 and
gene 63 or
for gene 29, gene 21, and gene 63 were combined to yield the
mean
VZV DNA copy number per 100 ng of DNA for each individual
ganglion.
Of the 17 individuals analyzed, HSV-1 DNA was detected in both TG from
11 subjects and not detected in either ganglion from
5 subjects (Table
3). HSV-1 DNA was present in the left TG of
subject 2 but was absent in
the right TG. VZV DNA was found in
both TG from all 17 individuals
(Table
4). Comparison of the
mean HSV-1 DNA copy number detected in the
left TG to that detected
in the right TG showed significant correlation
(Spearman rank
sum,
P < 0.025,
n = 12) and no
significant difference (Wilcoxon
rank sum,
P > 0.2).
Similar analysis showed the left and right
mean VZV DNA copy numbers to
be highly correlated (Spearman rank
sum,
P < 0.0005,
n = 17), with no significant differences (Wilcoxon
rank sum,
P > 0.2). Thus, for each subject, the virus DNA copy
numbers obtained from individual left and right TG were combined
to
yield the average HSV-1 and VZV DNA burdens in 100 ng of DNA
per
subject.
As quantitated in Table
3 and shown in Fig.
1, the average HSV-1 DNA copy number in
the 12 subjects which contained detectable
levels of the virus DNA
ranged from 42.9 to 677.9 (mean, 195.0;
SEM, 168). The average VZV DNA
copy number per 100 ng of TG DNA
of the 17 subjects (Table
4, Fig.
1)
ranged from 37.0 to 3560.5
(mean, 579.9; SEM, 847.8). In the instances
where both virus DNA
were present, comparison of the mean HSV-1 DNA
copy number to
the mean VZV DNA copy number within the same subject
showed no
significant correlation (Spearman rank sum,
P > 0.2,
n = 12) and
a modest difference in the means (Wilcoxon
rank sum, 0.2 >
P >
0.1,
n = 12).

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FIG. 1.
HSV-1 and VZV DNA burden in human TG. Total DNA was
extracted from left and right human TG and the virus DNA copy number
per 100 ng was determined by real-time PCR. Statistical analysis
allowed condensation of the results from individual ganglia to yield
virus DNA copy numbers in 100 ng per subject. Subject numbers refer to
the individuals described in Table 1; data quantitation is shown in
Tables 3 and 4. VZV DNA ( ) was found in the TG from all 17 subjects,
while HSV-1 DNA ( ) was found in 12 of the 17 subjects.
|
|
Quantitative RT PCR.
Polyadenylated VZV gene 21, 29, and 63 transcripts, along with nonpolyadenylated HSV-1 LAT transcripts, were
in vitro synthesized. After DNase treatment, each transcript produced a
discrete band at the appropriate size on denaturing agarose gels. After
removal of unincorporated ribonucleotides and quantitation by
determining the optical density at 260 nm, the number of transcripts
synthesized was calculated. Figure 2
shows the real-time PCR quantitation of cDNA synthesized from dilutions
of 106 to 10
1 copies of each transcript.
Using VZV gene 29-specific primers and probes to generate standard
curves, DNA quantitation was linear over a 7-log range of standard,
purified VZV DNA (r2 > 0.99) and sensitive
to a limit of 10 DNA molecules (Fig. 2A). Similar results were obtained
using primers and probes specific for VZV genes 21 and 63 using VZV
DNA, as well as HSV-1 LAT using HSV DNA (not shown). Figure 2B shows
the RT-dependent cDNA yield as determined by real-time PCR from various
amounts of synthetic virus transcripts (input RNA as determined by
measuring the optical density). A linear relation is evident between
the number of template RNA molecules and the yield of cDNA for each
transcript assayed. Overall, the assay was approximately 10-fold more
sensitive for the polyadenylated VZV transcripts than for the
nonpolyadenylated HSV-1 LAT transcripts. VZV gene 21, 29, and 63 cDNAs
were detected when as few as one copy of each transcript was reverse
transcribed. HSV-1 LAT cDNA was detected when as few as 10 copies of
the synthetic LAT transcript was reverse transcribed. Interestingly,
when one transcript from each VZV gene was reverse transcribed,
approximately 100 copies of cDNA were detected. An amplification of
cDNA was also detected for the synthetic HSV-1 LAT transcripts in that when 10 copies of HSV-1 LAT RNA were reverse transcribed, 100 copies of
LAT-specific cDNA was detected. The same proportional increase in cDNA
yield was maintained with all four transcripts as the amount of
template RNA molecules increased.

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FIG. 2.
Sensitivity of real-time PCR. Dilutions from
106 to 10 1 copies of polyadenylated VZV gene
21, 29, and 63 transcripts and nonpolyadenylated HSV-1 LAT transcript
per 10 µl of nuclease-free water were added to 500 ng of total RNA
extracted from control African green monkey dorsal root ganglia. Each
dilution was reverse transcribed, and the cDNA was subjected to
real-time PCR using gene 29 reagents. (A) Standard curve generated
using VZV genomic DNA as described in Materials and Methods. ,
standards; , unknowns (cDNA samples shown in panel B). (B)
Calculated gene 21, gene 29, gene 63, and LAT copy numbers in cDNA
generated from synthetic RNA, relative to the standard curve shown in
panel A (gene 29) and the standard curves for gene 21, gene 63, and LAT
(not shown).
|
|
HSV-1 and VZV latent transcripts.
Table
5 shows the real-time PCR quantitation of
cDNA synthesized from RNA extracted from individual ganglia obtained
from 11 individuals (subjects 1 to 11, Table 1). Columns 3 and 4 represent copies of GAPDH molecules quantitated in the cDNA prepared
from 80 ng of total RNA (2% of the cDNA synthesized from 4 µg of
RNA) in replicate samples. The average number of GAPDH molecules
(column 5) ranges from 117 to 4,478.5. The standard error of replicate GAPDH quantitations for each TG (SEM, column 6) shows that within an
individual cDNA synthesis reaction, quantitation of the number of
molecules is accurately obtained using real-time PCR. Columns 7 to 10 list the average quantities of HSV-1 LAT and VZV gene 21, 29, and 63 transcripts normalized to the average number of cellular GAPDH
transcripts in two replicate samples obtained from the same cDNA
synthesis reaction. HSV-1 LAT transcripts were found in all TG
containing HSV-1 DNA but not in TG that did not contain HSV-1 DNA
(column 7). The average number of HSV-1 LAT transcripts per 400 ng of
total TG RNA (10% of 4 µg of total RNA) ranged from 19.9 to 645 (not
shown). Normalizing the number of HSV-1 LAT transcripts to that of
GAPDH showed that the amount of LAT transcripts ranged over 2 orders of
magnitude. In latently infected ganglia, there was no statistical
correlation between the number of HSV-1 DNA copies and LAT expression
(linear regression, r2 = 0.40).
Table
5 also shows the real-time PCR quantitation of VZV gene 21, 29, and 63 transcripts normalized to cellular GAPDH transcripts
in the same
cDNA preparations from which HSV-1 LAT transcripts
were quantitated.
Gene 21 transcripts were detected in five individual
TG (column 8) and
gene 29 transcripts were detected in 3 individual
TG (column 9). Gene
63 transcripts were the most prevalent, being
present in 19 of the 22 individual TG (column 10). Normalizing
the number of VZV transcripts to
that of GAPDH showed that the
abundance of gene 21 transcripts spanned
1,430-fold, gene 29 transcripts
ranged over 20-fold, and gene 63 transcripts ranged over 2,000-fold.
At a confidence level of >85%,
there was a statistical correlation
between the number of VZV DNA
copies and the amount of gene 63
expression (linear regression,
r2 = 0.13).
 |
DISCUSSION |
Latent infection and virus recrudescence are central
themes among the neurotropic alphaherpesviruses. This study represents the first in which both HSV-1 and VZV DNA copy numbers and the numbers
of latently associated HSV-1 and VZV transcripts were quantitated in
the same individual human ganglia removed at autopsy.
Latent herpesvirus DNA burdens.
In this study of 17 individuals, HSV-1 DNA was detected in both TG of 11 individuals, in
only a single TG from one individual, and in no TG samples from 5 individuals (overall, 70.6% positive). In contrast, VZV DNA was found
in both TG from all individuals. These findings are in accordance with
the previous detection of HSV-1 DNA in TG from 72.7% and VZV DNA in TG
from 90.9% of 11 individuals using conventional PCR (21).
Liedtke et al. (18) found HSV-1 DNA in 100% and VZV DNA in
67% of TG from 39 individuals 50 to 80 years old using nested PCR
analysis. Recently, Pevenstein et al. (27) reported a higher
number of individuals latently infected with VZV (79 to 87%) than
those with HSV-1 (53%) following analysis of a single TG obtained from
15 subjects. Using real-time PCR, they detected a mean of 2,902 ± 1,082 copies of HSV-1 DNA and 258 ± 38 copies of VZV DNA per
105 ganglionic cells. In the present study we used
real-time PCR to detect HSV-1 and VZV DNA in both TG from 17 individuals. Statistical analysis allowed the condensations of data
obtained from individual primer pairs and individual TG to yield an
average virus DNA burden per 100 ng of DNA per subject. Assuming 15.6 pg of DNA per TG cell (27) to linearly transform our data,
the number of HSV-1 DNA copies per 105 ganglionic cells
ranged from 669 to 10,575 (mean, 3,042; SEM, 3,274; n = 12). Similarly, the number of VZV DNA copies per 105
cells ranged from 577 to 55,543 (mean, 9,046; SEM, 13,225; n = 17).
The numbers of HSV-1 copies detected in this study compare well with
the previous results of Pevenstein et al. (
27). However,
we
detected on average 35-fold more copies of VZV DNA per 10
5
ganglionic cells. The large range of VZV DNA burden within the
individual subjects may in part explain the higher mean VZV DNA
detected in our study. The median VZV DNA copy number per
10
5 ganglionic cells is 357. The mean VZV DNA copy number
per 10
5 ganglionic cells of the eight individuals below the
median is
112 (SEM, 57) and for the eight individuals above the median
is
1,075 (SEM, 965). The 10-fold difference in the mean VZV DNA copy
number for individual samples above and below the median could
be due
to limited virus reactivation. However, the time separating
death and
autopsy was not correlated with the VZV DNA copy number
in the TG. The
average time between death and autopsy (tissue
removal and flash
freezing in liquid nitrogen) for the eight subjects
whose mean VZV DNA
copy number was below the median was 18.3 h
(SEM, 6.7 h).
Similarly, 17.8 h (SEM, 5.0 h) is the average time
between
death and autopsy for the eight subjects whose mean VZV
DNA copy number
was above the population median. While the immediate
cause of death,
underlying illness, or resuscitative procedures
may contribute to VZV
reactivation, the sample size precludes
statistical association.
Further, the narrow range of HSV-1 DNA
copies per subject compared to
that of VZV suggests that if VZV
reactivation had occurred, the
initiation event did not induce
HSV-1 reactivation. An alternative
explanation for the wide range
in the VZV DNA copy number per subject
stems from the biology
of the virus. While HSV-1 latency is established
by retrograde
transport of the virus from the periphery, both
retrograde transport
and hematogenous infection of the ganglion during
primary viremia
may be involved in the establishment of VZV latency.
Primary VZV
infection is generally spread over more dermatomes than is
primary
HSV-1 infection and, therefore, one would expect more
ganglionic
cells latently infected with VZV than HSV-1. Also, the
severity
of primary VZV varies within the population; thus, one may
also
expect a variation in latent VZV
burden.
Latent HSV-1 and VZV gene transcription.
The function of the
HSV-1 LAT transcript is being debated (24, 28); however, the
basic consensus is that TG latently infected with wild-type virus
express LAT. Consistent with this assertion, we detected LAT
transcripts in all TG samples shown to contain HSV-1 DNA. For
comparison between individual TG and among subjects, the LAT copy
number was normalized to the number of GAPDH transcripts within the
same RT reaction. The relative expression of HSV-1 LAT varied by
>520-fold, with no association between the number of latent HSV-1 DNA
copies and LAT expression.
Polyadenylated transcripts mapping to VZV genes 21, 29, and 63 have
been detected in RNA extracted from latently infected
human TG. VZV
gene 62 transcripts have been detected by Northern
blot analysis of
poly(A) selected human TG RNA (
22). We have
also detected
VZV gene 62 transcripts in a cDNA library constructed
from poly(A)
selected human TG RNA (
2). However when the 3'
terminus of
the gene 62 transcripts were cloned and sequenced,
no polyadenosine
tract was detected. Thus, although circumstantial
evidence exists that
VZV gene 62 is a polyadenylated transcript
in latently infected human
ganglia, no sequence evidence has been
obtained. Therefore, in
this initial study, we concentrated our
quantitation efforts on the
three VZV transcripts that have been
shown to be polyadenylated in
latently infected human
TG.
With the exception of gene 21 transcripts, VZV transcripts have been
detected in samples obtained from pooled ganglia (
3).
The
present study is the first to quantitate multiple VZV genes
in
individual TG. The expression of VZV gene 21, 29, and 63 transcripts
relative to cellular GAPDH transcripts allows the comparison of
the
abundance of these transcripts between left and right TG of
the same
individual along with the relative abundance between
the TG of
different subjects. Our results indicate that, of the
three transcripts
analyzed, gene 63 is closely associated with
latent VZV infection, as
all but two individual TG expressed detectable
levels of gene 63 transcripts. Further, at a confidence level
of 85%, gene 63 expression is related to the amount of VZV DNA
detected within
the individual TG (linear regression,
r2 = 0.13). From 11 subjects we tested, gene 21 and 29 transcripts
were detected in 5 and 3 of the 22 latently infected TG, respectively.
In only one ganglion (i.e., the right ganglion, subject 2) were
all
three VZV transcripts
detected.
Despite extensive investigation by numerous laboratories, the function
of latently expressed herpesvirus transcripts has not
been conclusively
determined. Indeed, the lack of an animal model
for VZV latency and
hence the requirement to analyze human autopsy
tissue has always raised
concerns in interpreting the data. Further
confounding the analysis has
been the pooling of tissue from numerous
individuals. Here we have
shown that VZV gene 63 is consistently
detected in individual latently
infected human TG. VZV gene 63
encodes a 30.5-kDa nuclear-located
phosphoprotein detected in
latently infected TG neuronal cells and in
dermal nerves of herpes
zoster biopsies (
20,
26,
34).
Although the protein encoded
by gene 63 is classified as immediate
early, its lack of transcription
transactivation suggests that this
protein plays a subordinate
role in modulating VZV gene expression
(
13). Whether gene 63
is critically involved in latency or
whether gene 63 transcription
is initiated in response to neuronal
death awaits further
experimentation.
 |
ACKNOWLEDGMENTS |
We are grateful to Dexiang Gao and Gary Zerbe for aid in
the statistical analysis, Prabakaran Kesavan and Elizabeth Jonak for
technical assistance, and Connie Hunter for preparing the manuscript.
This work was supported in part by Public Health Service grants AG
06127 and NS 32623 from the National Institutes of Health.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: SmithKline
Beecham Pharmaceuticals, 1250 South Collegeville Rd., UP1455,
Collegeville, PA 19426. Phone: (610) 917-6869. Fax: (610) 917-4171. E-mail: Ruth_Tal-singer-1{at}sbphrd.com.
 |
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