Abstract
Human adenoviruses cause disease at multiple mucosal sites, including the respiratory, gastrointestinal, and genitourinary tracts, and are common agents of conjunctivitis. One site of infection that has received sparse attention is the cornea, a transparent tissue and the window of the eye. While most adenovirus infections are self-limited, corneal inflammation (keratitis) due to adenovirus can persist or recur for months to years after infection, leading to reduced vision, discomfort, and light sensitivity. Topical corticosteroids effectively suppress late adenovirus keratitis but are associated with vision-threatening side effects. In this short review, we summarize current knowledge on infection of the cornea by adenoviruses, including corneal epithelial cell receptors and determinants of corneal tropism. We briefly discuss mechanisms of stromal keratitis due to adenovirus infection, and review an emerging therapy to mitigate adenovirus corneal infections based on evolving knowledge of corneal epithelial receptor usage.
Highlights
The human adenovirus (HAdV) is a ubiquitous pathogen that has contributed much to current knowledge of molecular biology, leading to critical revelations about the cell cycle and RNA splicing, among other discoveries [1]
Infections with HAdV are a significant source of morbidity and mortality, world-wide and at all ages, through readily transmittable infections at mucosal sites [2]
Adenovirus-associated stromal keratitis leads to foreign body sensation and symptoms of glare, irregular astigmatism, and blurred vision [37], and can cause permanent corneal scarring [38]
Summary
The human adenovirus (HAdV) is a ubiquitous pathogen that has contributed much to current knowledge of molecular biology, leading to critical revelations about the cell cycle and RNA splicing, among other discoveries [1]. The major corneal pathogens, all within species D, are HAdV-D8, 37, 53, 54, 56, 64 (previously typed as 19a), 82, and 85 (the latter two recently emerged) [15,16,17,18,19,20,21,22,23,24,25]. In this brief review, we discuss mechanisms of infection of the corneal epithelium by HAdVs, the immunologic manifestations of corneal infection, and recent approaches to antiviral therapy
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