Abstract

Varicella zoster virus (VZV) causes varicella during acute infection and establishes latency in the sensory ganglia. Reactivation of VZV results in herpes zoster, a debilitating and painful disease. It is believed that VZV reactivates due to a decline in cell-mediated immunity; however, the roles that CD4 versus CD8 T cells play in the prevention of herpes zoster remain poorly understood. To address this question, we used a well-characterized model of VZV infection where rhesus macaques are intrabronchially infected with the homologous simian varicella virus (SVV). Latently infected rhesus macaques were thymectomized and depleted of either CD4 or CD8 T cells to induce selective senescence of each T cell subset. After T cell depletion, the animals were transferred to a new housing room to induce stress. SVV reactivation (viremia in the absence of rash) was detected in three out of six CD8-depleted and two out of six CD4-depleted animals suggesting that both CD4 and CD8 T cells play a critical role in preventing SVV reactivation. Viral loads in multiple ganglia were higher in reactivated animals compared to non-reactivated animals. In addition, reactivation results in sustained transcriptional changes in the ganglia that enriched to gene ontology and diseases terms associated with neuronal function and inflammation indicative of potential damage as a result of viral reactivation. These studies support the critical role of cellular immunity in preventing varicella virus reactivation and indicate that reactivation results in long-lasting remodeling of the ganglia transcriptome.

Highlights

  • Varicella zoster virus (VZV) is a human neurotropic alpha herpesvirus that causes varicella during primary infection

  • We previously showed that this model recapitulates the essential features of VZV infection in humans including varicella and establishment of latency in sensory ganglia (Messaoudi et al 2009)

  • The changes in frequency of naïve and memory T cells in the depleted animals prompted us to investigate the role of homeostatic proliferation

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Summary

Introduction

Varicella zoster virus (VZV) is a human neurotropic alpha herpesvirus that causes varicella (chicken pox) during primary infection. VZV establishes latency in the sensory ganglia where it can reactivate to cause herpes zoster (HZ, shingles). VZV has been shown to reactivate following stressful situations (Schmader et al 1990), such as during and after spaceflight (Cohrs et al 2008) and in medical students (Uchakin et al 2011). It is generally believed that VZV reactivation is due to the loss of VZV-specific cell-mediated immunity (Terada et al 1994), since antibody titers remain relatively stable with increasing age (Levin et al 2008; Oxman 2009; Weinberg et al 2009). VZV reactivation in hematopoietic stem cell transplants was associated with low CD4 T cell counts in the absence of significant changes in antibody titers

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