Herpes Simplex Virus 1 and 2 in Herpes Genitalis: A Polymerase Chain Reaction-Based Study from Kerala.

BACKGROUND: Herpes genitalis is an ulcerating sexually transmitted infection, the clinical importance of which lies in its ability to produce painful and recurrent disease in addition to its potential role as a cofactor in acquisition and transmission of human immunodeficiency virus. In recent years, there are increasing reports of genital herpes due to herpes simplex virus (HSV)-1 from various parts of the world. Molecular diagnostic methods such as polymerase chain reaction (PCR) have got both diagnostic and prognostic significance in genital herpes. AIMS: The present study was designed to identify the viral serotype in herpes genitalis patients in our locality, using PCR. MATERIALS AND METHODS: The specimens from forty herpes genitalis patients were subjected to nested PCR and results were evaluated. RESULTS: PCR was positive for HSV in 83% of cases, of which 58% were due to HSV-1. HSV-2 accounted for maximum number of recurrent herpes. LIMITATION: Higher sample size would have been more representative. CONCLUSION: A rising trend of type 1 HSV was observed in herpes genitalis in south India probably due to increasing practice of orogenital sex.

Dynamics of influenza seasonality at sub-regional levels in India and implications for vaccination timing.

BACKGROUND: Influenza surveillance is an important tool to identify emerging/reemerging strains, and defining seasonality. We describe the distinct patterns of circulating strains of the virus in different areas in India from 2009 to 2013. METHODS: Patients in ten cities presenting with influenza like illness in out-patient departments of dispensaries/hospitals and hospitalized patients with severe acute respiratory infections were enrolled. Nasopharangeal swabs were tested for influenza viruses by real-time RT-PCR, and subtyping; antigenic and genetic analysis were carried out using standard assays. RESULTS: Of the 44,127 ILI/SARI cases, 6,193 (14.0%) were positive for influenza virus. Peaks of influenza were observed during July-September coinciding with monsoon in cities Delhi and Lucknow (north), Pune (west), Allaphuza (southwest), Nagpur (central), Kolkata (east) and Dibrugarh (northeast), whereas Chennai and Vellore (southeast) revealed peaks in October-November, coinciding with the monsoon months in these cities. In Srinagar (Northern most city at 34°N latitude) influenza circulation peaked in January-March in winter months. The patterns of circulating strains varied over the years: whereas A/H1N1pdm09 and type B co-circulated in 2009 and 2010, H3N2 was the predominant circulating strain in 2011, followed by circulation of A/H1N1pdm09 and influenza B in 2012 and return of A/H3N2 in 2013. Antigenic analysis revealed that most circulating viruses were close to vaccine selected viral strains. CONCLUSIONS: Our data shows that India, though physically located in northern hemisphere, has distinct seasonality that might be related to latitude and environmental factors. While cities with temperate seasonality will benefit from vaccination in September-October, cities with peaks in the monsoon season in July-September will benefit from vaccination in April-May. Continued surveillance is critical to understand regional differences in influenza seasonality at regional and sub-regional level, especially in countries with large latitude span.

Neuro-invasion of Chandipura virus mediates pathogenesis in experimentally infected mice.

Neuro-tropism is a major feature in many viral infections. Chandipura virus produces neurological symptoms in naturally infected young children and experimentally infected suckling mice. This study was undertaken to find out the neuro-invasive behaviour of Chandipura virus in suckling mice. The suckling mice were infected with the virus via footpad injection. Different tissues were collected at 24-h intervals up to 96-h post infection and processed for virus quantification and histological study. Further confirming the virus predilection to nerves tissues, the adult mice were inoculated with the virus via different routes. The suckling mice experimental results revealed a progressive replication of virus in spinal cord and brain. The progressive-virus replication was not observed in the other tissues like kidney, spleen, liver etc. Histo-pathological lesions noticed in the spinal cord and brain tissues suggested the extensive damages in these tissues. In adult mice experiment, the virus replication observed only in the brain of the mice infected via intra-cerebral route. From this study, we conclude that nervous tissues are predilection sites for Chandipura virus replication in suckling and adult mice. In suckling mice, virus might transmit through nervous tissues for dissemination. In contrast, the adult mice the nervous terminal might not pick up the virus through footpad infection. The pathogenesis in mice might be due to the virus replication mediated damage in the central nervous system.

Chandipura virus infection in mice: the role of toll like receptor 4 in pathogenesis.

BACKGROUND: The susceptibility of mice and humans to Chandipura virus infection is age-dependent. Upon experimental infection, mice secrete significant amounts of proinflammatory cytokines. Similarly, children who recover from natural infection with the virus show significant amounts of TNF-α production, suggesting that innate immunity plays a major role in the response to Chandipura virus. Toll-like receptors (TLR) are key host molecules involved in innate immune responses in infections. Therefore, the aim of this study was to examine the role of TLR in the response to Chandipura virus infection. METHODS: The mouse monocyte-macrophage cell line, RAW 264.7, and C3H/HeJ mice were used as models. Micro array techniques were used to identify the type of TLR involved in the response to infection. The results were validated by examining TLR expression using flow cytometry and by measuring the levels of proinflammatory cytokines and nitric oxide (NO) in the culture supernatants using bead assays and the Griess method, respectively. The pathogenic role of Toll-like receptor 4 (TLR4) was studied in a TLR4 mutant strain of mice -C3H/HeJ and the results compared with those from wild-type mice- C3H/CaJ. The pathogenic effects of NO were studied by treating experimentally infected mice with the NO inhibitor, aminoguanidine (AG). RESULTS: The micro array results showed that TLR4 was regulated after Chandipura virus infection. At high multiplicities of infection (10 MOI), RAW cells up- regulated cell surface expression of TLR4 and secreted significant amounts of TNF-α, MCP-1, IL-10 and IL-12 and NO. The survival rate of C3H/HeJ mice was higher than those of wild-type C3H/CaJ mice. The survived C3H/HeJ mice secreted significant quantity of MCP-1 and IFN-γ cytokines and cleared virus from brain. Similarly, the survival rate of AG-treated mice was higher than those of the untreated controls. CONCLUSIONS: Chandipura virus regulates TLR4, which leads to the secretion of proinflammatory cytokines and NO by infected RAW cells. Difference in survival rate in TLR4 mutant mice and nitric oxide inhibitor treated mice, confirmed the role of these molecules in disease pathogenesis. The result is significant in clinical management and designing antiviral intervention for Chandipura virus infection.

Immune regulation in Chandipura virus infection: characterization of CD4+ T regulatory cells from infected mice.

BACKGROUND: Chandipura virus produces acute infection in mice. During infection drastic reduction of CD4+, CD8+ and CD19 + cell was noticed. Depletion of lymphocytes also noticed in spleen. The reduction may be due to the regulatory mechanism of immune system to prevent the bystander host tissue injury. There are several mechanisms like generation of regulatory cells, activation induced cell death (ACID) etc were indicated to control the activation and maintain cellular homeostasis. Role of regulatory cells in homeostasis has been described in several viral diseases. This study was undertaken to characterize CD4+T regulatory cells from the infected mice. METHOD: In this study we purified the CD4+ T cells from Chandipura virus infected susceptible Balb/c mice. CD4+ T regulatory cells were identified by expression of cell surface markers CD25, CD127 and CTLA-4 and intracellular markers Foxp3, IL-10 and TGF-beta. Antigen specificity and ability to suppress the proliferation of other lymphocytes were studied in vitro by purified CD4+CD25+T regulatory cells from infected mice. The proliferation was calculated by proliferation module of Flow Jo software. Expression of death receptors on regulatory cells were studied by flowcytometer. RESULTS: The CD4+ T cells isolated from infected mice expressed characteristic markers of regulatory phenotype at all post infective hours tested. The CD4+ T regulatory cells were proliferated when stimulated with Chandipura virus antigen. The regulatory cells did not suppress the proliferation of splenocytes stimulated with anti CD3 antibody when co cultured with them. Interesting observation was, while purification of CD4+ T cells by negative selection, the population of cells negative for CD4 also co purified along with CD4+ T cell. Flow cytometry analysis and light microscopy revealed that CD4 negative cells were of different size and shape (atypical) compared to the normal lymphocytes. Greater percentage of these atypical lymphocytes expressed Fas Ligand and Programmed Death1 (PD-1) receptor. CONCLUSION: From these results we concluded that virus specific CD4+T regulatory cells are generated during Chandipura virus infection in mice and these cells might control the activated lymphocytes during infection by different mechanism.