title: The participation of varicella zoster virus in relapses of multiple sclerosis.
abstract: OBJECTIVE
  Recent studies have documented the apparent participation of varicella zoster virus (VZV) in the etiopathogenesis of multiple sclerosis (MS). The present study aimed to corroborate the possible presence of VZV during exacerbations of MS.
  
  
  METHODS
  Fifty-three patients with definite MS were included; of them, 31 were studied during the first week of a clinical relapse, whereas 16 were studied during remission; 6 patients with progressive MS were also studied. Genes from 5 herpes viruses: varicella zoster, herpes simplex 1 and 2, Epstein-Barr and herpes 6 were studied by polymerase chain reaction in cerebrospinal fluid and in peripheral blood mononuclear cells (PBMC). As controls 21 patients with inflammatory or functional neurological disorders were included.
  
  
  RESULTS
  DNA from varicella zoster virus was found in the CSF from all MS patients studied during relapse (100%) and in the PBMC from 28 of them (90%). However, VZV DNA was found in the CSF only in 5 MS patients studied during remission (31%) and in the PBMC from 3 of them (19%). VZV DNA was also found, but in lower amounts, in the CSF (83%) and PBMC (33%) from patients with progressive MS. In contrast, VZV was not found either in CSF or in PBMC from controls. Results from the other herpes viruses tested were similar in MS patients and in controls.
  
  
  CONCLUSIONS
  Our results corroborate the conspicuous, but ephemeral presence of VZV during relapses of MS and support the idea of VZV involvement in the etiopathogenesis of MS. Recent epidemiological and molecular studies as well as reports of severe VZV infections triggered by specifically induced immunosuppression during therapy of MS give additional support to this potential association.
authors.affiliation: Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico, Insurgentes Sur 3877, Mexico City 14269, Mexico. Electronic address: jsotelo@unam.mx.
authors.forename: Julio
authors.initials: J
authors.lastname: Sotelo
authors.affiliation: Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico, Insurgentes Sur 3877, Mexico City 14269, Mexico.
authors.forename: Graciela
authors.initials: G
authors.lastname: Ordoñez
authors.affiliation: Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico, Insurgentes Sur 3877, Mexico City 14269, Mexico.
authors.forename: Benjamín
authors.initials: B
authors.lastname: Pineda
authors.affiliation: Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico, Insurgentes Sur 3877, Mexico City 14269, Mexico.
authors.forename: José
authors.initials: J
authors.lastname: Flores
mesh_terms: D016022:Case-Control Studies; D004279:DNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid*; D018450:Disease Progression; D018259:Herpesvirus 1, Human / Q000235:genetics; D018258:Herpesvirus 2, Human / Q000235:genetics; D014645:Herpesvirus 3, Human / Q000235:genetics*; D004854:Herpesvirus 4, Human / Q000235:genetics; D015654:Herpesvirus 6, Human / Q000235:genetics; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000821:virology*; D020528:Multiple Sclerosis, Chronic Progressive / Q000097:blood / Q000134:cerebrospinal fluid / Q000821:virology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood / Q000134:cerebrospinal fluid / Q000821:virology*; D060888:Real-Time Polymerase Chain Reaction; D012008:Recurrence
chemical_list: D004279:DNA, Viral
keywords: Fingolimod; Multiple sclerosis; Natalizumab; Varicella zoster virus; Virus and multiple sclerosis