Prevalence and distribution of VZV in temporal arteries of patients with giant cell arteritis

Abstract

I read with interest the article by Gilden et al.,1 but found myself questioning the reported findings and conclusions. The immunohistochemistry describing the presence of varicella-zoster virus (VZV) protein in the majority of temporal artery biopsies of patients with giant cell arteritis (GCA) is intriguing. However, the findings of VZV antigen staining in the vessel wall, mostly in smooth muscle cells, was not addressed by the authors in other arteries or in other smooth muscle cells. In my experience, the VZV antibodies bind nonspecifically to smooth muscle and skeletal muscle cells, and therefore can be detected in similar frequencies in GCA cases, non-GCA temporal arteries, any other arteries, or even in endometrial leiomyoma. The detection of this staining pattern, similar to the one described,1 is seen without surrounding inflammatory response, supporting …