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Animal models for Epstein-Barr virus (EBV) are restricted to some species of new-world monkeys which develop malignant lymphoid tumours or benign lymphoproliferative diseases after virus inoculation. Similar pathological features were induced in rabbits by the EBV-related herpesvirus of Macaca arctoides (HVMA). In this study 17 of 32 rabbits infected with varying amounts of HVMA produced from MAL-1 cells developed lymphoproliferative disorders. In 13 rabbits high-grade malignant lymphomas were detected, 4 rabbits revealed the histopathological feature of lymphoid hyperplasia. These lympho-proliferations were shown to be associated with HVMA by PCR and by the expression of EBV-like RNAs (EBER) in 14 and 10 cases, respectively. The homology in the polymerase gene region between DNA from EBV and HVMA, and from HVMA and the malignant tissue was found to be 94.8% and 100%, respectively. All the infected animals produced antibodies to antigens corresponding to early and late EBV proteins. By studying the HVMA expression in MAL-1 cells EBV-like proteins expressed in latency (EBNA1 and EBNA2) and in the lytic cycle (VCA, EA) were detected. Our findings suggested that HVMA caused a symptomatic infection in rabbits with pathological features that fit the conditions of an animal model suitable for testing antiviral drugs and vaccines against EBV. [ABSTRACT FROM AUTHOR]

Fatemeh Abedini,1 Hossein Hosseinkhani,2 Maznah Ismail,1,3 Abraham J Domb,4 Abdul Rahman Omar,1,5 Pei Pei Chong,1,2 Po-Da Hong,3 Dah-Shyong Yu,6 Ira-Yudovin Farber41Laboratory of Molecular Biomedicine, Institute of Bioscience, Universiti Putra Malaysia, Selangor, 2Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan, 3Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia, 4Institute of Drug Research, The Center for Nanoscience and Nanotechnology, School of Pharmacy-Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel, 5Faculty of Veterinary Medicine, Universiti Putra Malaysia, Selangor, Malaysia, 6Nanomedicine Research Center, National Defense Medical Center, Taipei, TaiwanPurpose: The failure of colorectal cancer treatments is partly due to overexpression of CXCR4 by tumor cells, which plays a critical role in cell metastasis. Moreover, serum alkaline phosphatase (ALP) levels are frequently elevated in patients with metastatic colorectal cancer. A polysaccharide, dextran, was chosen as the vector of siRNA. Spermine was conjugated to oxidized dextran by reductive amination process to obtain cationized dextran, so-called dextran-spermine, in order to prepare CXCR4-siRNAs/dextran-spermine nanoparticles. The fabricated nanoparticles were used in order to investigate whether downregulation of CXCR4 expression could affect serum ALP in mouse models of colorectal cancer.Methods: Colorectal cancer was established in BALB/C mice following injection of mouse colon carcinoma cells CT.26WT through the tail vein. CXCR4 siRNA for two sites of the target gene was administered following injection of naked siRNA or siRNA encapsulated into nanoparticles.Results: In vivo animal data revealed that CXCR4 silencing by dextran-spermine nanoparticles significantly downregulated CXCR4 expression compared with naked CXCR4 siRNA. Furthermore, there was correlation between CXCR4 expression and serum ALP.Conclusion: CXCR4 siRNA/dextran-spermine nanoparticles appear to be highly effective, and may be suitable for further in vivo applications. Further research evaluation will be needed to determine the effect of CXCR4 silencing on serum ALP levels, which may be a useful marker to predict liver metastasis in colorectal cancer.Keywords: nanoparticles, cationized dextran, colorectal cancer, serum ALP enzyme, CXCR4, siRNA

Hossein Hosseinkhani,1 Po-Da Hong,1 Dah-Shyong Yu,2 Yi-Ru Chen,3 Diana Ickowicz,4 Ira-Yudovin Farber,4 Abraham J Domb41Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology (TAIWANTECH), 2Nanomedicine Research Center, National Defense Medical Center, Taipei, Taiwan, 3Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan, 4Institute of Drug Research, The Center for Nanoscience and Nanotechnology, School of Pharmacy-Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, IsraelAbstract: This study aims to develop a three-dimensional in vitro culture system to genetically engineer mesenchymal stem cells (MSC) to express bone morphogenic protein-2. We employed nanofabrication technologies borrowed from the spinning industry, such as electrospinning, to mass-produce identical building blocks in a variety of shapes and sizes to fabricate electrospun nanofiber sheets comprised of composites of poly (glycolic acid) and collagen. Homogenous nanoparticles of cationic biodegradable natural polymer were formed by simple mixing of an aqueous solution of plasmid DNA encoded bone morphogenic protein-2 with the same volume of cationic polysaccharide, dextran-spermine. Rat bone marrow MSC were cultured on electrospun nanofiber sheets comprised of composites of poly (glycolic acid) and collagen prior to the incorporation of the nanoparticles into the nanofiber sheets. Bone morphogenic protein-2 was significantly detected in MSC cultured on nanofiber sheets incorporated with nanoparticles after 2 days compared with MSC cultured on nanofiber sheets incorporated with naked plasmid DNA. We conclude that the incorporation of nanoparticles into nanofiber sheets is a very promising strategy to genetically engineer MSC and can be used for further applications in regenerative medicine therapy.Keywords: 3D culture, nanoparticles, nanofibers, polycations, tissue engineering

Culturing respiratory epithelial cells at an air-liquid interface (ALI) represents an established method for studies on infection or toxicology by the generation of an in vivo-like respiratory tract epithelial cellular layer. Although primary respiratory cells from a variety of animals have been cultured, an in-depth characterization of canine tracheal ALI cultures is lacking despite the fact that canines are a highly relevant animal species susceptible to various respiratory agents, including zoonotic pathogens such as severe acute respiratory coronavirus 2 (SARS-CoV-2). In this study, canine primary tracheal epithelial cells were cultured under ALI conditions for four weeks, and their development was characterized during the entire culture period. Light and electron microscopy were performed to evaluate cell morphology in correlation with the immunohistological expression profile. The formation of tight junctions was confirmed using transepithelial electrical resistance (TEER) measurements and immunofluorescence staining for the junctional protein ZO-1. After 21 days of culture at the ALI, a columnar epithelium containing basal, ciliated and goblet cells was seen, resembling native canine tracheal samples. However, cilia formation, goblet cell distribution and epithelial thickness differed significantly from the native tissue. Despite this limitation, tracheal ALI cultures could be used to investigate the pathomorphological interactions of canine respiratory diseases and zoonotic agents.

The emergence of the coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inspired rapid research efforts targeting the host range, pathogenesis and transmission mechanisms, and the development of antiviral strategies. Genetically modified mice, rhesus macaques, ferrets, and Syrian golden hamsters have been frequently used in studies of pathogenesis and efficacy of antiviral compounds and vaccines. However, alternatives to in vivo experiments, such as immortalized cell lines, primary respiratory epithelial cells cultured at an air-liquid interface, stem/progenitor cell-derived organoids, or tissue explants, have also been used for isolation of SARS-CoV-2, investigation of cytopathic effects, and pathogen-host interactions. Moreover, initial proof-of-concept studies for testing therapeutic agents can be performed with these tools, showing that animal-sparing cell culture methods could significantly reduce the need for animal models in the future, following the 3R principles of replace, reduce, and refine. So far, only few studies using animal-derived primary cells or tissues have been conducted in SARS-CoV-2 research, although natural infection has been shown to occur in several animal species. Therefore, the need for in-depth investigations on possible interspecies transmission routes and differences in susceptibility to SARS-CoV-2 is urgent. This review gives an overview of studies employing alternative culture systems like primary cell cultures, tissue explants, or organoids for investigations of the pathophysiology and reverse zoonotic potential of SARS-CoV-2 in animals. In addition, future possibilities of SARS-CoV-2 research in animals, including previously neglected methods like the use of precision-cut lung slices, will be outlined.

Several animal species are susceptible to SARS-CoV-2 infection, as documented by case reports and serological and in vivo infection studies. However, the susceptibility of many animal species remains unknown. Furthermore, the expression patterns of SARS-CoV-2 entry factors, such as the receptor angiotensin-converting enzyme 2 (ACE2), as well as transmembrane protease serine subtype 2 (TMPRSS2) and cathepsin L (CTSL), cellular proteases involved in SARS-CoV-2 spike protein activation, are largely unexplored in most species. Here, we generated primary cell cultures from the respiratory tract of domestic and wildlife animals to assess their susceptibility to SARS-CoV-2 infection. Additionally, the presence of ACE2 , TMPRSS2 and CTSL within respiratory tract compartments was investigated in a range of animals, some with unknown susceptibility to SARS-CoV-2. Productive viral replication was observed in the nasal mucosa explants and precision-cut lung slices from dogs and hamsters, whereas culture models from ferrets and multiple ungulate species were non-permissive to infection. Overall, whereas TMPRSS2 and CTSL were equally expressed in the respiratory tract, the expression levels of ACE2 were more variable, suggesting that a restricted availability of ACE2 may contribute to reduced susceptibility. Summarized, the experimental infection of primary respiratory tract cell cultures, as well as an analysis of entry-factor distribution, enable screening for SARS-CoV-2 animal reservoirs.

Natural or experimental infection of domestic cats and virus transmission from humans to captive predatory cats suggest that felids are highly susceptible to SARS-CoV-2 infection. However, it is unclear which cells and compartments of the respiratory tract are infected. To address this question, primary cell cultures derived from the nose, trachea, and lungs of cat and lion were inoculated with SARS-CoV-2. Strong viral replication was observed for nasal mucosa explants and tracheal air-liquid interface cultures, whereas replication in lung slices was less efficient. Infection was mainly restricted to epithelial cells and did not cause major pathological changes. Detection of high ACE2 levels in the nose and trachea but not lung further suggests that susceptibility of feline tissues to SARS-CoV-2 correlates with ACE2 expression. Collectively, this study demonstrates that SARS-CoV-2 can efficiently replicate in the feline upper respiratory tract ex vivo and thus highlights the risk of SARS-CoV-2 spillover from humans to felids.

A new pair of Epstein-Barr virus ELISAs (Biotest Anti-EBV VCA IgG and VCA IgM ELISA) was evaluated for usefulness for routine diagnosis of acute EBV infections. The ELISAs are based on two viral capsid antigens (VCA), p23 (BLRF2, full-length) and p18 (BFRF3, carboxy-half), that are combined by autologous gene fusion. In total, 179 sera were tested in direct comparison with classical VCA immunofluorescence assays (IFA). With the help of clinical data and additional reference serology, i.e., heterophile antibodies, anti-EA IgG (IFA) and anti-EBNA-1 IgG (ELISA), the patients were divided into the following categories: seronegatives (46), acute primary infections (67), previous infections (39), suspected reactivations (20) and constellations with intermediate serological patterns (7). The VCA IgG and VCA IgM ELISAs showed overall agreement to IFA of 95.0% and 94.4%, respectively. The calculated analytical performance (sensitivity; specificity) of VCA IgG and VCA IgM was 94.0%; 97.8% and 97.1%; 96.5%, respectively. A certain delay in seroconversion of anti-p23-p18 IgG may account for a significant difference in sensitivity of the VCA IgG ELISA between primary (88.4%) and previous infections (100%). In summary, the new recombinant VCA ELISAs yielded good correlation to VCA IFA and in combination with EBNA-1 IgG allow rapid, sensitive, and specific diagnosis of infectious mononucleosis or EBV immune status in general.

This study was carried out to determine the prevalence of antibodies to herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) in selected German populations, such as blood donors, hospital patients, and human immunodeficiency virus (HIV)-seropositive individuals. Serum samples collected between 1996 and 1998 were tested by enzyme immunoassays using monoclonal antibody-selected native gG1 and gG2 as antigens and an immunoblot using type-specific recombinant glycoproteins. Equivocal results were resolved by an "in-house" Western blot assay. The prevalence of HSV-1 antibodies increased steadily with age and reached high levels of >/=88% among subjects 40 years of age or older. In the sample of patients and blood donors, the HSV-2 seroprevalence was 12.8% (95% CI = 11.9-13.8%). About 81% of the HSV-2 seropositive subjects were coinfected with HSV-1. When adjusted for age, there was no difference in the HSV-2 seroprevalence between hospital patients and blood donors. The HSV-2 seroprevalence was significantly higher among women (15%) than among men (10.5%), yielding a female : male odds ratio of 1.5 for hospital patients and of 1.67 for blood donors. Among the HIV-infected population, 91.1% were seropositive for HSV-1 and 47.9% for HSV-2. HIV-infected women have a significantly higher risk of HSV-2 infection than men (odds ratio [OR] = 3.22; 95% confidence ratio [CI] 1.99-5.20). In conclusion, although the rate of infections with HSV-2 is relatively low in the German population, attention should be given to the further development in adolescents, especially in view of a possible decrease of HSV-1 seroprevalence in childhood., (Copyright 2000 Wiley-Liss, Inc.)

The animal model of necrotic hepatitis caused by HSV-1 infection in juvenile mice was used to compare the efficacies of the oral antiherpes agents famciclovir (FCV), valaciclovir (VACV) and brivudin (BVDU). The experimental infection allows the measurement of viral replication in the liver by macroscopic lesions and the evaluation of mortality from encephalitis. Mice intravenously inoculated with a highly virulent clinical HSV-1 isolate were orally treated by gavage over a period of 3 days starting on day 2 post infection. The reference drug acyclovir (ACV) was administered subcutaneously. Necrotic hepatitis was significantly (p < 0.01) reduced by treatment with FCV, VACV and ACV at a dose of 50 mg/kg per day divided into 3 doses. No significant effect was achieved with BVDU at 200 mg/kg per day. Treatment with FCV at 50 mg/kg per day, ACV at 100 mg/kg per day, and VACV at 200 mg/kg per day significantly (p < 0.001) decreased mortality in mice. BVDU treatment at 200 mg/kg per day did not reduce mortality but significantly prolonged (p < 0.05) the survival time.

The efficacy of oral brivudin vs. intravenous acyclovir was compared in a randomized multicentered study under double-blind conditions using the double-dummy technique. Forty-eight patients with a herpes zoster rash less than 72 hours in duration were entered in the study. Brivudin was given as one 125-mg tablet every 6 hours. Acyclovir was infused over 1 hour at a dose of 10 mg/kg every 8 hours. Treatment was continued for 5 days. There was no significant difference between the treatment groups when analyzed in terms of new lesion formation, increase in the area of rash within the primary dermatome, cutaneous dissemination, and affection of mucous membranes or visceral organs. Both treatment regimes were also equally effective in the time to full crusting of lesions. Oral brivudin and intravenous acyclovir were well tolerated by most patients. There was no need to interrupt the treatment in any case. As effective as intravenous acyclovir in the treatment of herpes zoster, oral brivudin offers the potential for outpatient treatment of herpes zoster in immunocompromised patients.

A new Epstein-Barr virus (EBV) ELISA system (Biotest Anti-EBV recombinant) was evaluated for usefulness for routine diagnosis of EBV primary infection. The assay system is composed of three different microtest plates coated with three highly purified recombinant EBV antigens. The early antigens p138 (BALF2, truncated) and p54 (BMRF1, whole sequence) are used as a mixture for testing IgM (assay 1) and IgG (assay 2) antibodies. In addition, the EBNA-1 antigen p72 (BKRF1, carboxy-half) is used for detecting IgG antibodies (assay 3). Three panels of sera were examined in direct comparison with standard immunofluorescence (IF): Specimens of (i) 120 infectious mononucleosis (IM) patients, (ii) 60 patients with acute CMV infection, toxoplasmosis or rheumatic disease, respectively, and (iii) 185 healthy blood donors as a control group. 119 IM patients were clearly recognized as having acute primary infection (sensitivity 99.2% compared to VCA-IgM by IF). Three apparently false-positive results were obtained with patients of other diseases and none within the control group (specificity 98.8%). The data suggest that the recombinant ELISA can be used advantageously for standardized rapid diagnosis of acute EBV primary infection.

In 66 children having undergone bone marrow transplantation (BMT) the occurrence of infections was studied retrospectively. Bacterial infections were mostly found in the early period after transplantation before marrow engraftment. The analysis of positive blood cultures showed a dominance of gram-positive bacteria, especially of coagulase-negative staphylococci. Cytomegalovirus (CMV) infections were most important, because of its high rate and the risk of CMV associated interstitial pneumonia (IP), two patients suffered from. Infections from herpes simplex virus (HSV), varizella zoster virus (VZV) and Epstein Barr virus (EBV) had no influence on prognosis. In fungal infections the systemic aspergillosis was the most important complication. To increase the effectiveness and safety of therapy the serum levels of antibiotics and antifungal drugs should be determined.

The clinical pictures of 11 adults with cytomegalovirus-infection were analyzed. Characteristic symptom was fever of unknown origin lasting up to 50 days. Indications of an accompanying hepatitis were found in all patients and confirmed by increased serum levels of the transaminases which for al short time exceeded 5 mumols/s/l (AST) and 8 mumols/s/l (ALT) only in 2 patients. Mononucleosislike pictures, however, have not been seen. One patient developed neurological symptoms. The diagnosis was made by demonstrating IgM and IgG antibodies by way of the fluorescence antibody test. An antiviral therapy has not been introduced.

Tonsils of 50 patients with infectious mononucleosis were examined for the presence of Epstein-Barr virus nuclear antigens (EBNA) and in 11 cases for the presence of Epstein-Barr virus (EBV) nucleic acid sequences. In tonsillar tissue of 42 patients less than 1 to 40 per cent EBNA-positive cells could be demonstrated by anticomplement immunofluorescence. 10 out of 11 tonsils examined by in situ hybridization contained less than 1 to 50 per cent cells with EBV nucleic acid sequences. The histological examination indicated that cells labelled by in situ hybridisation are in the majority proliferating B-lymphocytes and to a small extent cells of tonsillar epithelium.

The conditions of in situ hybridization for demonstration of herpesvirus genomes in animal and human tissues were tested using the ORWO(R) K6 emulsion. It was possible to localize herpes simplex virus (HSV) genomes in infected mice organs (brain and liver) as well as Epstein-Barr virus (EBV) genomes in tonsils of patients with infectious mononucleosis and in tumour specimens of patients with nasopharyngeal carcinomas. Immunofluorescence (IF) revealed mostly corresponding results. The in situ hybridization is more favourable due to its higher specifity, but it is more time consuming and expensive. IF seems advantageous for screening of a great number of tissues.

IgG class antibodies to the early antigen complex (EA; D + R components) of the Epstein-Barr virus (EBV) were found by indirect immunofluorescence in titres greater than or equal to 1:10 in 196 (49.4%) out of 397 blood donors and titres greater than or equal to 1:20 in 84 (21.2%) of these subjects. Anti-EA titres of greater than or equal to 1:2560 were detected in 6 sera, anti-EA(D) only in 17 donors (4.3%). Additional EBV-specific antibody tests were performed in sera with anti-EA-IgG titres of greater than or equal to 1:20 (n = 84), including IgM class antibodies to virus capsid antigen (anti-VCA-IgM). Specific IgM revealed active EBV infection in 12 blood donors. There was no correlation between the presence of anti-VCA-IgM and the magnitude of anti-EA-IgG titres. Therefore, it seems to be impossible to define the threshold titre for EA antibodies indicating active EBV infection. For this purpose probably a titre increase should be demonstrated in paired sera.

Clinical isolates of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) induced focal necrotic hepatitis in ICR/Schö mice. The extent of the hepatitis could be considerably reduced by trisodium phosphonoformate (PFA) administered for 3 days in a daily dose of 400-600 mg/kg. The HSV hepatitis in mice could serve as a suitable model for testing antiherpetic drugs.

In the present study, the clinical course and the specific humoral immunological response to Epstein-Barr virus antigens have been investigated in patients affected with infectious mononucleosis after tonsillectomy in the acute phase of the disease, compared against conservatively treated patients. Clinical results confirm that tonsillectomy in the acute phase of infectious mononucleosis has a favourable effect on the course of the disease, and reduces the duration of the disease by about half of the usual time. Statistically significant differences - indicating a confined, delayed humoral immunological response or unresponsiveness to some extent - regarding the examined antigens after tonsillectomy in the acute phase of infectious mononucleosis, could be observed between the two groups of patients in respect of the production of antibodies against viral capsid and nuclear antigens of the Epstein-Barr virus and heterophilic antibodies. For this reason, tonsillectomy should be suggested only as therapy of infectious mononucleosis in anginous courses of the disease which appear life-threatening.

Tumor tissue specimens of 25 patients with various entities of Non-Hodgkin's lymphomas were examined for the presence of Epstein-Barr virus (EBV) nucleic acids and EBV nuclear antigens (EBNA) by in situ hybridization and anticomplement immunofluorescence. In tumor cells of five patients EBV nucleic acid and EBNA were demonstrated. The histopathologic examinations revealed in these cases one Burkitt's lymphoma, two centroblastic lymphomas and each one lymphoplasmocytic and lymphocytic lymphoma.

The antibody titres to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus (HSV) and varicella-zoster virus (VZV) were determined in 57 adult patients with Hodgkin's disease and a group of age- and sex-matched controls. In the group of patients, the geometric mean antibody titres to EBV capsid antigen, CMV early and late antigens, and also VZV, were significantly higher than in the healthy controls. Antibodies to early antigens of EBV and CMV were found more commonly in patients than in controls. The raised antibody titres to herpesviruses were taken to be the result of the disturbed cellular immunity in Hodgkin's disease.

33 children with acute lymphatic leukemia and 33 healthy controls were longitudinally studied for herpesvirus infections. Active herpes simplex-virus, varicella-zoster virus and cytomegalovirus (CMV) infections were more frequent in patients than in controls. CMV and Epstein-Barr virus infections were often inapparent or associated with infections of the upper respiratory tract. Analysis of serological datas revealed a coincidence of active CVM infection and lethal course of the leukemia. This may be a result of the immunodeficiency in leukemia patients caused by disease and therapy. An additional influence of the immunosuppressive effect of active CMV infections on the course of the disease is discussed.

In 34 patients without pre-existing infection of the urinary tract mostly a few days after insertion of an indwelling catheter a bacteriuria with 10(5) germs per ml urine developed. In 24 patients from the moment of the first proof of bacteriuria up to the removal of the catheter 1 to 10 days passed away. During this time in 6 patients a cylindruria, in no case, however, an antibody-coat of the bacteria could be established. In 10 patients who carried the catheter for a longer time, the excretion of antibody-coated germs in the urine began 11 to 18 days after the first proof of bacteriuria. A cylindruria was observed in 9 of these patients. Altogether the proof of cylinders in the early phase of the renal infection was more sensitive than that of antibody-coated bacteria in the urine. The probability of a provable participation of the kidneys in catheter-conditioned infections of the urinary tract consequently increases with increasing period of indwelling of the catheter.

Cytomegalovirus (CMV) infection is a frequent and clinically important infection following bone marrow transplantation. Candidates for this study were patients admitted for transplantation: 22 patients received bone marrow from a HLA-identical, MCR-nonreactive sibling, in 9 patients an autologous BMT was performed. The anti-CMV IgG (Cytotect) was administered at a dosage of 1 ml/kg on days -7, 13, 33, 53, 73 and 93 after BMT. 5 patients in the very beginning of our BMT program did not receive Cytotect. Patients were given random blood products from the bloodbank not tested for CMV positivity. Active CMV infection or seroconversion in our patients was defined as a rise in IgG titer against the late antigen of fourfold or more or an IgM increase. In the allogeneic BMT group the pretransplant serological status was in 6 cases negative in recipients and donor, in 7 patients positive in recipients and negative in donors, and in 4 patients positive in recipients and donors. Of the 6 patients seronegative in recipients and donors, 3 developed active infection and of the 7 patients pretransplant positive with seronegative donors 3 developed active infection and 4 latent infections during the period from 2 to 100 days following grafting. 1 patient out of the group transplanted in third partial remission of AML developed interstitial pneumonia and died on day +30.4 of the 4 cases with seropositivity of recipients and donors developed active CMV infection. Of 9 patients with autologous transplantation 6 patients were pretransplant seropositive. 3 of these 6 developed active infection and 2 latent infection 30 to 180 days after grafting.(ABSTRACT TRUNCATED AT 250 WORDS)

In 71 patients after kidney transplantation the cytomegalovirus-antibody state was recognized with the help of the indirect fluorescence antibody test in a period of 24 months. The first estimations were performed in 33 patients in the early phase up to the 3rd month and in 38 patients in the late phase up to the 100th months after transplantation. Of 13 patients who had been controlled already before operation only 3 patients were seronegative. After this twice a seroconversion with clinically manifest cytomegalovirus infection appeared, in one case an irreversible failure of the graft developed. In the late phase 4 patients remained seronegative. Of these patients also in one case the chronic rejection caused the entering into the dialysis programme. -- A positive cytomegalovirus-antibody state was found in the early phase in 30 of 33 patients and in the late phase in 34 of 38 patients. An active cytomegalovirus infection was present in the early phase in 11 of 30 and in the late phase in 11 of 34 patients. In the early phase the clinical symptoms fever, leukopenia and hepatitis were more frequent and more expressed than in the late phase. In 7 of the 11 patients in the early phase and in 8 of 11 patients with active cytomegalovirus infection in the late phase rejections occurred which in 2 of the 7 patients in the early phase and in 5 of the 8 patients in the late phase led to the loss of the graft. In inactive cytomegalovirus infection an irreversible course thrice appeared in 11 patients with rejections. Three typical instances are demonstrated: 1. The course of an active cytomegalovirus infection in the early phase with rejection and irreversible failure of the graft. 2. The reactivation of a latent cytomegalovirus infection by uncontrollable rejection processes. 3. The course of an active cytomegalovirus infection without clinical complications and with transition into an inactive stage in minimal immunosuppression. The treatment is performed with immunosuppression of a possibly low dosage, the avoidance of increases of prednisolone in cytomegalovirus-associated rejections, the intravenous application of human-gamma-globulin as well as the prevention or intensive treatment of superinfections. In these cases the close relations between rejection processes, immunosuppressive therapy, superinfections and cytomegalovirus infections should find the necessary consideration.

The etiological role played by human pathogenic herpes viruses for diseases of the central nervous system has been verified (Herpes simplex virus, varicella zoster virus) or is being discussed (cytomegalo virus, Epstein-Barr virus). In this study, the significance of herpes virus infections for surgically treated cerebral tumour patients is examined. In a total of 30 patients with various cerebral tumours, infectious virus from cerebral tumour tissue could be isolated in none of the cases. The mean geometric antibody titres against herpes virus in the patients did not differ from those of comparable healthy controls. In patients with cerebral tumours, however, acute herpes virus infections were serologically identified with a significantly greater frequency than in the control group. They are mainly an expression of endogenous re-infections with these viruses which inhabit latently the human organism. Possible causes of the observed asymptomatically proceeding herpes virus reactivations are discussed.

After infection with human cytomegalovirus, rabbit lung fibroblasts showed, during the four week period of the experiment, cytopathic changes and virus-specific antigens demonstrable by fluorescent antibody. Infectious virus could be recovered from the infected cells by co-cultivation with human lung fibroblasts.