Abstract

The increasing incidence of acyclovir (ACV) and multidrug-resistant strains in patients with corneal HSV-1 infections leading to Herpetic Stromal Keratitis (HSK) is a major health problem in industrialized countries and often results in blindness. To overcome this obstacle, we have previously developed an HSV-gB-specific monoclonal antibody (mAb 2c) that proved to be highly protective in immunodeficient NOD/SCID-mice towards genital infections. In the present study, we examined the effectivity of mAb 2c in preventing the immunopathological disease HSK in the HSK BALB/c mouse model. Therefore, mice were inoculated with HSV-1 strain KOS on the scarified cornea to induce HSK and subsequently either systemically or topically treated with mAb 2c. Systemic treatment was performed by intravenous administration of mAb 2c 24 h prior to infection (pre-exposure prophylaxis) or 24, 40, and 56 hours after infection (post-exposure immunotherapy). Topical treatment was performed by periodical inoculations (5 times per day) of antibody-containing eye drops as control, starting at 24 h post infection. Systemic antibody treatment markedly reduced viral loads at the site of infection and completely protected mice from developing HSK. The administration of the antiviral antibody prior or post infection was equally effective. Topical treatment had no improving effect on the severity of HSK. In conclusion, our data demonstrate that mAb 2c proved to be an excellent drug for the treatment of corneal HSV-infections and for prevention of HSK and blindness. Moreover, the humanized counterpart (mAb hu2c) was equally effective in protecting mice from HSV-induced HSK when compared to the parental mouse antibody. These results warrant the future development of this antibody as a novel approach for the treatment of corneal HSV-infections in humans.

Highlights

  • Ocular Herpes Simplex Virus type 1 (HSV-1) induced keratitis is one of the leading causes of infectious blindness in the industrialized world

  • We characterized the antiviral efficacy of the HSV-gB specific monoclonal antibody mAb 2c towards HSV-1 KOS and three acyclovir resistant clinical isolates obtained from patients with Herpetic Stromal Keratitis (HSK) [10]

  • MAb 2c completely neutralized equal viral loads of 100 TCID50 of the tested viruses at concentrations of 7.8 nM or 15.6 nM. This corresponds to the neutralization efficiency that mAb 2c exhibited to other drug sensitive HSV-1 strains and drug resistant isolates obtained from bone marrow transplants [11]

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Summary

Introduction

Ocular Herpes Simplex Virus type 1 (HSV-1) induced keratitis is one of the leading causes of infectious blindness in the industrialized world. After primary infection of the cornea the virus replicates in the corneal epithelium and migrates to the trigeminal ganglion by moving directly between adjacent epithelial cells, from epithelial cells to neurons, by intracellular axonal transport and by transfer across neuronal synapses for spread from first order to second-order neurons [4]. Frequent periodical reactivations of the latent virus and its transmission from the trigeminal ganglia to the periphery through the cell-to-cell spread may lead to recurrent infections of the cornea associated with severe T-cell mediated inflammatory lesions that may result in HSK [6] and blindness [7]. Systemic or topical treatment with acyclovir (ACV) is successfully used to suppress the viral replication in patients with recurrent herpes reactivation. It is essential to develop novel, well-tolerated treatment options for patients with recurrent acyclovir- or cross-resistant HSV-1 infections of the cornea

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