Pulmonary Fibrosis: Strongly Associated with a Herpes Virus

Gerard Nuovo MD Professor College of Medicine, The Ohio State University Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center Phylogeny Inc, Powell, OhioMedicalResearch.com Interview with:
Gerard Nuovo MD
Professor College of Medicine, The Ohio State University
Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center
Phylogeny Inc, Powell, Ohio

MedicalResearch.com: What are the main findings of the study?

Dr. Nuovo: The main finding of the study was that idiopathic pulmonary fibrosis was strongly associated with an infection by a herpesvirus.  The data that supported this main finding included:

  • 1) detection of the viral DNA by in situ hybridization in each case of idiopathic pulmonary fibrosis (IPF) and in none of the controls;
  • 2) the localization of the viral DNA to the nucleus of the cell that orchestrates IPF, the regenerating epithelial cell (herpes viruses localize to the nucleus of the target cell);
  • 3) the demonstration that the viral DNA co-localized with “pirated proteins” that the virus makes during productive infection (these were IL-17. cyclin D, dihydrofolate reductase, and thymidylate synthase); this combination of proteins are rarely if ever co-expressed in lung disease and  their co-expression per se was highly suggestive of a viral infection;
  • 4) the demonstration by RTPCR that the cyclin D RNA in IPF comes from the virus and not the human cells;
  • 5) the recognition that this family of herpesviruses (called gammaherpesvirus) causes IPF in other animals including horses, mice, and donkeys;
  • 6) the cloning of part of the gene of the virus from a clinical IPF sample that showed 100% homology to the published sequence of the likely viral pathogen – herpesvirus saimiri.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Nuovo: The unexpected part of the study was that the viral pirated proteins belong to a virus (herpesvirus saimiri) known to be able to infect humans but not known to be able to cause disease in humans.  Still, the virus is closely related to other herpesviruses well known to cause diseases in humans including EBV and Kaposi’s sarcoma associated virus.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Nuovo: As of now, there is no diagnostic test or effective therapy for IPF.  The message to clinicians is that we as physicians need to determine if testing for this virus may be an effective diagnostic test for IPF, especially early IPF when the disease may be curable.  The message for patients with the disease is that this data, though still in its early stages, offers hope that a diagnostic test and more importantly effective treatments may be on the near horizon.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Nuovo: Future research needs to examine clinical samples (eg blood) for the virus as well as examine whether medications that can hinder the growth of herpesvirus saimiri might reduce the symptoms and possibly cure the people with the disease.

Citation:

Folcik VA, et al “Idiopathic pulmonary fibrosis is strongly associated with productive infection by herpesvirus saimiri” Modern Pathology 2013.

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