Detection of Human Herpes Virus-6 in saliva of Patients with Bell's palsy

Mustafa Hameed Majeed; Abdul–Kareem Kadhim Alkhazraji

doi:10.32947/ajps.v21i1.801

Authors

Mustafa Hameed Majeed Resident of neurology al-Imamein Al-kadhimein Medical City
Abdul–Kareem Kadhim Alkhazraji Section of neuromedicine,department of medicine Al-Nahrain Medical College

DOI:

https://doi.org/10.32947/ajps.v21i1.801

Keywords:

Bell’s palsy, human herpes virus-6 virus, Real-time PCR

Abstract

Background: Bell’s palsy is unilateral peripheral paralysis of the seventh cranial nerve, several mechanisms have been proposed in the pathogenesis of this disease, among the viral infections specially herpes virus's family including roseola viruses that have been detected in patients' saliva.

Method: A case-control study conducted on Bell’s palsy patients at al-Imamein Al-kadhimein Medical City throughout the period from March 2019 to November 2019. Saliva samples were taken from 50 patients (18-55) years of age with early stages of Bell's palsy and from 50 apparently healthy and age and sex matched volunteers as control. Viral DNA was extracted from the saliva and then real time PCR for detection and quantification of HHV6 DNA in these patients

Results: Saliva samples taken from 28 patients in the Bell’s palsy patients (56%) tested positive for HHV6, as vs. to just 8 (16%) in the healthy group(control) (P= 0.028). There was increase amount of HHV6 load in patients compare to control group (p=0.001). Regarding the demographic values, an important difference in the detection rate for Human herpes virus-6 between male (64%) and females (35%) (P= 0.02). There was significant correlation between age and grading (p =0.01), as increase age correlate with high grading, also between viral load of HH6 and grading as increase viral load of the virus correlate with high grading (p = 0.001).

Conclusion: HHV-6 virus might have a potential role in the pathogenesis of Bell’s palsy.

References

- Peitersen E. Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. ActaOtolaryngol Suppl. 2002(549):4-30. DOI: https://doi.org/10.1080/000164802320401694

- Yanagihara, N. (1988).” Incidence of Bell’s palsy.”The Annals of otology, rhinology & laryngology. Supplement 137: 3-4. DOI: https://doi.org/10.1177/00034894880976S301

- Murakami, S., M. Mizobuchi, Y. Nakashiro, T. Doi, N. Hato, and N. Yanagihara. 1996. Bell palsy and herpes simplex virus: identification of viral DNA in endoneural fluid and muscle. Ann. Intern. Med. 124:27–30.

- Murakami, S., M. Mizobuchi, Y. Nakashiro, T. Doi, N. Hato, and N. Yanagihara. 1996. Bell palsy and herpes simplex virus: identification of viral DNA in endoneural fluid and muscle. Ann. Intern. Med. 124:27–30. DOI: https://doi.org/10.7326/0003-4819-124-1_Part_1-199601010-00005

- Pazin, G. J., M. Ho, P. J. Janetta. 1978. Reactivation of herpes simplex virus after decompression of the trigeminal nerve root. J. Infect. Dis. 138:405–409 DOI: https://doi.org/10.1093/infdis/138.3.405

- Kimberlin, D. W., and R. J. Whitley. 1998. Human herpesvirus-6: neurologic implications of a newly-described viral pathogen. J. Neurovirol. 4:474–485.

- Furuta, Y., S. Fukuda, E. Chida, T. Takasu, F. Ohtani, Y. Inuyama, and K. Nagashima. 1998. Reactivation of herpes simplex virus type 1 in patients with Bell palsy. J. Med. Virol. 54:62–66. DOI: https://doi.org/10.1002/(SICI)1096-9071(199803)54:3<162::AID-JMV3>3.0.CO;2-3

- Kimberlin, D. W., and R. J. Whitley. 1998. Human herpesvirus-6: neurologic implications of a newly-described viral pathogen. J. Neurovirol. 4:474–485. DOI: https://doi.org/10.3109/13550289809113492

- Hall, C. B. (1997). Human herpesviruses at sixes, sevens, and more. Ann Intern Med 127, 481–483. DOI: https://doi.org/10.7326/0003-4819-127-6-199709150-00010

- Lusso, P., Markham, P. D., Tschachler, E., di Marzo Veronese, F., Salahuddin, S. Z., Ablashi, D. V., Pahwa, S., Krohn, K. & Gallo, R. C. (1988). In vitro cellular tropism of human B-lymphotropic virus (human herpesvirus-6). J Exp Med 167, 1659–1670. DOI: https://doi.org/10.1084/jem.167.5.1659

- Schirmer, E. C., Wyatt, L. S., Yamanashi, K., Rodriguez, W. J. &Frenkel, N. (1991). Differentiation between two distinct classes of viruses now classified as human herpesvirus 6. ProcNatlAcadSci U S A 88, 5922–5926. DOI: https://doi.org/10.1073/pnas.88.13.5922

- Yamanishi K, Okuno T, Shiraki K, et al. Identification of human herpesvirus-6 as a causal agent for exanthemsubitum. Lancet 1988; 1: 1065–7 DOI: https://doi.org/10.1016/S0140-6736(88)91893-4

- Berneman, Z. N., Ablashi, D. V., Li, G., Eger-Fletcher, M., Reitz, M. S., Jr, Hung, C. L., Brus, I., Komaroff, A. L. & Gallo, R. C. (1992). Human herpesvirus 7 is a T-lymphotropic virus and is related to, but significantly different from, human herpesvirus 6 and human cytomegalovirus. ProcNatlAcadSci U S A 89, 10552–10556 DOI: https://doi.org/10.1073/pnas.89.21.10552

- Campadelli-Fiume G, Mirandola P, Menotti L. Human herpesvirus 6:an emerging pathogen. Emerg Infect Dis 1999; 5:353–66. DOI: https://doi.org/10.3201/eid0503.990306

- Braun DK, Dominguez G, Pellett PE. Human herpesvirus 6. ClinMicrobiol Rev 1997; 10:521–67. DOI: https://doi.org/10.1128/CMR.10.3.521

- Pitka¨ranta A, Piiparinen H, Mannonen L, Vesaluoma M, Vaheri A. 2000. Detection of human herpesvirus 6 and varicella-zoster virus in tear fluid of patients with Bell’s palsy by PCR. J ClinMicrobiol 38:2753–2755. DOI: https://doi.org/10.1128/JCM.38.7.2753-2755.2000

- Kanerva M, Ja¨a¨skela¨inen AJ, Suvela M, Piiparinen H, Vaheri A, Pitka¨ranta A. 2008. Human herpesvirus-6 and -7 DNA in cerebrospinal fluid of facial palsy patients.ActaOtolaryngol 128:460–464. DOI: https://doi.org/10.1080/00016480701774990

- Linder T, Bossart W, Bodmer D. 2005. Bell’s palsy and herpes simplex virus: Fact or mystery? OtolNeurotol 26:109–113. DOI: https://doi.org/10.1097/00129492-200501000-00020

- Pereira CM, Gasparetto PF, Correˆa ME, Costa FF, de Almeida OP, Barjas-Castro ML. 2004. Human herpesvirus 6 in oral fluids from healthy individuals. Arch Oral Biol 49:1043–1046. DOI: https://doi.org/10.1016/j.archoralbio.2004.06.002

- Joséphine M. Reynaud and BrankaHorvat.Human Herpesvirus 6 and Neuroinflammation. Hindawi Publishing Corporation ISRN Virology.2013:5-7. DOI: https://doi.org/10.5402/2013/834890

- Turriziani O, Falasca F, Maida P, et al. Early collection of saliva specimens from Bell’s palsy patients: quantitative analysis of HHV-6, HSV-1, and VZV. J Med Virol.2014; 86:1752–1758. DOI: https://doi.org/10.1002/jmv.23917

- Jacob Genizi, MD, Orit Golan-Shany, PhD,TanyaTarazov, MD, SarelPechter, MD, NuritAssaf, MD, Idan Segal, MD, Isaac Srugo, MD, and Ellen Bamberger, MD. Does Herpes 6 Infection Have a Role in Bell’s palsy Among Children and Adolescents? The Pediatric Infectious Disease Journal.2019.38 (5):482. DOI: https://doi.org/10.1097/INF.0000000000002278

- Rowhani-Rahbar A, Baxter R, Rasgon B, et al. Epidemiologic and clinical features of Bell’s palsy among children in Northern California. Neuroepidemiology. 2012; 38:252–258 DOI: https://doi.org/10.1159/000338303