Herpes simplex virus type 1 in brain and apolipoprotein E type 4 allele: a dangerous liaison for Alzheimer's disease.
R.F. Itzhaki, S. J. Shipley, C.B. Dobson, M.A. Wozniak
University of Manchester, Faculty of Life Sciences, North Campus, Moffat Building, Sackville Street, Manchester M60 1QD, UK.
Infectious agents have been proposed as factors in several chronic
diseases, especially the age-associated ones, heart disease and
Alzheimer's disease (AD). We have implicated herpes simplex virus type
1 (HSV1) in the aetiology of AD. We discovered, using solution PCR,
that HSV1 DNA resides latently in brain of a high proportion of elderly
people, and that in brain of carriers of the type 4 allele of the
apolipoprotein E gene it confers a strong risk of AD (Itzhaki et al.,
1997). HSV1-APOE interaction in AD is strongly supported by our
finding that APOE determines disease severity in disorders caused by
diverse pathogens (see Dobson et al., 2003). Further evidence for HSV1
in brain - and its replication - is afforded by our finding intrathecal
antibodies to HSV1 (these are long-lived) in many elderly people
(Wozniak et al., 2005). Very recently, we have shown by yet another
method - in situ PCR - that HSV1 DNA resides in AD brain, in neurons
and glial cells. Also, we have found that HSV1 infection of cultured
neural cells increases greatly the amount of beta-amyloid 42 within
cells; this peptide is the main component of the characteristic amyloid
plaques of AD brain and its formation - whether harmful or protective -
may be a major factor in the early stages of AD.
We suggest that stress or peripheral infection causes cytokine entry
into brain and the consequent inflammation reactivates latent HSV1; the
activated virus augments the inflammation (cf. enhanced inflammation in
mice with pre-clinical prion disease - Combrinck et al., 2002), and
brain damage perhaps via production of beta-amyloid 42, especially in
APOE-e4 carriers - leading eventually to AD. Research by others has
shown a link between amyloid precursor protein or amyloid and HSV1, and
epidemiological studies suggest that infection and stress cause
cognitive decline. Our results implicating HSV1 in brain indicate that
AD may be treatable with antiviral agents, and perhaps in future
preventable by vaccination against HSV1.
Key words:
Alzheimer's disease, herpes simplex virus type 1, apolipoprotein E, amyloid, inflammation
Problems or questions regarding this site should be directed to
the organiser