title: Early collection of saliva specimens from Bell's palsy patients: quantitative analysis of HHV-6, HSV-1, and VZV.
abstract: Bell's palsy is the most common cause of facial paralysis. Although it has been associated with diabetes mellitus, hypertension, pregnancy, and preeclampsia, the etiology of Bell's palsy remains unknown. The reactivation of latent herpes simplex virus (HSV) or varicella-zoster virus (VZV) with subsequent inflammation and entrapment of the facial nerve in the narrow labyrinthine segment has been implicated as a cause of facial paralysis, but the active role of these viruses in Bell's palsy is still discussed. This study quantified HSV-1 DNA, VZV DNA, and HHV-6 DNA in 95 saliva samples collected from patients within 48 hr from the onset of paralysis. HSV-1, VZV, and HHV-6 were detected in 13%, 3%, and 61% of patients, respectively. The detection rate did not differ significantly between patients and a control group of healthy donors. Interestingly, however, the value of HHV-6 DNA copies was significantly higher than that detected in healthy donors. In addition, the mean value of HHV-6 DNA recorded in patients who had at least a one grade improvement of palsy at the first visit was significantly lower than that detected in patients who showed no change in facial palsy grade or an increase of at least one grade. These findings call into question the role of HSV-1 and VZV in the etiology of Bell's palsy, and suggest that HHV-6 may be involved in the development of the disease or that the underlying disease mechanism might predispose patients to HHV-6 reactivation.
authors.affiliation: Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
authors.forename: Ombretta
authors.initials: O
authors.lastname: Turriziani
authors.forename: Francesca
authors.initials: F
authors.lastname: Falasca
authors.forename: Paola
authors.initials: P
authors.lastname: Maida
authors.forename: Aurelia
authors.initials: A
authors.lastname: Gaeta
authors.forename: Corrado
authors.initials: C
authors.lastname: De Vito
authors.forename: Patrizia
authors.initials: P
authors.lastname: Mancini
authors.forename: Daniele
authors.initials: D
authors.lastname: De Seta
authors.forename: Edoardo
authors.initials: E
authors.lastname: Covelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Attanasio
authors.forename: Guido
authors.initials: G
authors.lastname: Antonelli
mesh_terms: D000328:Adult; D000368:Aged; D020330:Bell Palsy / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000821:virology*; D019562:Viral Load
chemical_list: D004279:DNA, Viral
keywords: Bell's palsy; HHV6; HSV1; VZV