Varicella-zoster virus DNA in the oesophageal myenteric plexus in achalasia.
In a search for past or present infection with herpes viruses, serum antibody titres to herpes simplex type 1 virus, cytomegalovirus, and varicella-zoster virus were measured by complement fixation test in 58 patients with achalasia. Serum was also taken from 40 age and sex matched patients without oesophageal symptoms who formed a control group. All titres were low, and those for herpes simplex type 1 virus and cytomegalovirus did not differ in the achalasia patients and the controls. However, the incidence of varicella-zoster virus antibodies was significantly greater in the achalasia than in the control group (p < 0.05). Using oesophageal tissue containing myenteric plexus removed at the time of cardiomyotomy in nine patients with achalasia, in situ DNA hybridisation showed evidence of varicella-zoster virus in three, but all were negative for the other two viruses. No positive results were obtained for herpes simplex type 1 virus, cytomegalovirus, or varicella-zoster virus in oesophageal tissue from 20 patients undergoing oesophageal resection for diseases other than achalasia. The incidence of positivity for varicella-zoster virus was significantly increased in the achalasia group compared with the controls (p < 0.02). The findings indicate that varicella-zoster virus DNA may persist in the oesophageal myenteric plexus in some patients with achalasia and raise the possibility that this virus is of aetiological importance in achalasia.
Department of Surgery, University of Nottingham.
C S
CS
Robertson
B A
BA
Martin
M
M
Atkinson
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D003587:Cytomegalovirus / Q000302:isolation & purification; D004279:DNA, Viral / Q000032:analysis*; D004931:Esophageal Achalasia / Q000209:etiology / Q000235:genetics / Q000382:microbiology*; D005260:Female; D006562:Herpes Zoster / Q000150:complications; D014645:Herpesvirus 3, Human / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D009197:Myenteric Plexus / Q000382:microbiology*; D018139:Simplexvirus / Q000302:isolation & purification
D000914:Antibodies, Viral; D004279:DNA, Viral