title: Does apolipoprotein E determine outcome of infection by varicella zoster virus and by Epstein Barr virus?
abstract: Over 90% of the population are infected with varicella zoster virus (VZV) but only some develop shingles - caused when the virus reactivates from latency, and only some shingles patients develop post-herpetic neuralgia (PHN), defined as pain continuing for more than about 4 months. Epstein Barr virus (EBV) similarly infects over 90% of the population; some of those infected during teenage or young adult years develop infectious mononucleosis (IM). The reason for these disparities between numbers infected and numbers affected by illness is unknown, but presumably reflects host factor(s). Our previous results showed that apolipoprotein E (APOE) genotype determines susceptibility to, or outcome of, infection in the case of several diseases of known infectious cause. Therefore, we investigated APOE genotypes of shingles, PHN, and IM patients. Our rationale for the previous studies and for investigating VZV was that these micro-organisms use for cell binding and entry the same sites in the cell surface as does the protein apoE, and that consequently, competition with apoE could affect the pathogen's extent of entry and hence extent of the damage caused. The APOE genotypes of shingles and PHN sufferers, and of IM sufferers were determined using restriction fragment length polymorphism. In females, epsilon4 homozygosity confers a risk of shingles and also of IM, and the APOE-epsilon4 allele is protective against PHN whereas APOE-epsilon3 allele is a risk. Our results showing that a host genetic factor influences the development of shingles and PHN in females have clinical significance: they could lead to identification of those (female) patients at greater risk of PHN, thus enabling these people to be targeted for treatment with the most effective drugs.
authors.affiliation: Faculty of Life Sciences, The University of Manchester, Manchester, UK.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Wozniak
authors.forename: Suzanne J
authors.initials: SJ
authors.lastname: Shipley
authors.forename: Curtis B
authors.initials: CB
authors.lastname: Dobson
authors.forename: Simon P
authors.initials: SP
authors.lastname: Parker
authors.forename: Fiona T
authors.initials: FT
authors.lastname: Scott
authors.forename: Mary
authors.initials: M
authors.lastname: Leedham-Green
authors.forename: Judy
authors.initials: J
authors.lastname: Breuer
authors.forename: Ruth F
authors.initials: RF
authors.lastname: Itzhaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001057:Apolipoproteins E / Q000235:genetics / Q000502:physiology*; D005260:Female; D005787:Gene Frequency; D006562:Herpes Zoster / Q000235:genetics*; D006801:Humans; D007244:Infectious Mononucleosis / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000235:genetics*
chemical_list: D001057:Apolipoproteins E