Abstract

Gammaherpesviruses (γHV) are implicated in the pathogenesis of pulmonary fibrosis in humans and murine models of lung fibrosis, however there is little direct experimental evidence that such viruses induce lung fibrosis in the natural host. The equine γHV EHV 5 is associated with equine multinodular pulmonary fibrosis (EMPF), a progressive fibrosing lung disease in its natural host, the horse. Experimental reproduction of EMPF has not been attempted to date. We hypothesized that inoculation of EHV 5 isolated from cases of EMPF into the lungs of clinically normal horses would induce lung fibrosis similar to EMPF. Neutralizing antibody titers were measured in the horses before and after inoculation with EHV 5. PCR and virus isolation was used to detect EHV 5 in antemortem blood and BAL samples, and in tissues collected postmortem. Nodular pulmonary fibrosis and induction of myofibroblasts occurred in EHV 5 inoculated horses. Mean lung collagen in EHV 5 inoculated horses (80 µg/mg) was significantly increased compared to control horses (26 µg/mg) (p < 0.5), as was interstitial collagen (32.6% ± 1.2% vs 23% ± 1.4%) (mean ± SEM; p < 0.001). Virus was difficult to detect in infected horses throughout the experiment, although EHV 5 antigen was detected in the lung by immunohistochemistry. We conclude that the γHV EHV 5 can induce lung fibrosis in the horse, and hypothesize that induction of fibrosis occurs while the virus is latent within the lung. This is the first example of a γHV inducing lung fibrosis in the natural host.

Highlights

  • Idiopathic pulmonary fibrosis (IPF) is a poorly understood respiratory disease of humans

  • Pre-inoculation evaluation of horses Equid Herpesvirus 5 (EHV 5) or EHV 2 detection of viral genome (DNA) was not detected within cells isolated from the bronchoalveolar lavage (BAL) fluid obtained from any horse prior to experimental exposure with virus

  • The suggested role that viral infections might play in IPF include: 1) as the primary initiating event; 2) as co-factors in a ‘multi-hit’ event in the lung to drive the fibrosis; and 3) in precipitating acute exacerbations of disease[5,9,11]

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Summary

Introduction

Idiopathic pulmonary fibrosis (IPF) is a poorly understood respiratory disease of humans. In the United States of America the prevalence of IPF ranges from 14 to 27.9 cases per 100,000 individuals per year, making it is one of the more prevalent interstitial lung diseases[1]. Confounding these many cases is the lack of efficacy of most therapeutics for the disease; this lack of therapeutic options is associated with a 5year mortality of between 50-70%[2]. Recent data showing that latent pulmonary MHV 68 infection in wild-type mice enhances lung fibrosis in animals challenged with bleomycin or fluorescein isothiocyanate, suggests that an active lytic infection is not requisite for lung fibrosis to ensue[10,11]

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