JCV Virus Expression in Oropharynx and HIV

描述(申请人提供)：血清学研究表明，世界上80%以上的成年人口感染JC病毒，一种乳头状病毒。这种病毒的传播方式尚不清楚，急性感染尚未被确认为可识别疾病的原因。然而，JCV是进行性多灶性白质脑病(PML)的原因，PML是一种以前罕见的脑脱髓鞘疾病。面对艾滋病毒大流行，PML已变得普遍，影响了大约5%的艾滋病患者，通常在免疫抑制的晚期。JCV在最初感染后仍潜伏在网状内皮系统中。扁桃体组织中的病毒显示为口咽部或呼吸道传播方式。JCV也周期性地在外周血淋巴细胞(PBL)中表达。这些细胞与感染了PML的CNS神经胶质细胞共享病毒的调控区。虽然在大约5%的其他正常个体的PBL中可以发现JCV，但在大约50%的免疫抑制个体的PBL中，包括艾滋病患者和90%的艾滋病相关PML患者的PBL中都可以发现JCV。JCV在口咽液中的表达此前尚未确定。我们假设JCV是在口咽液中脱落的，并且它在这些液体中的存在将与它在PBL中的存在和免疫抑制的严重程度相关。这项研究的目的包括确定三个人群(正常对照组、HIV感染者和艾滋病相关PML患者)唾液和咽洗液中的JCV；确定口咽液和PBL中JCV的存在之间是否存在相关性；以及确定JCV从口咽部脱落是否与免疫抑制的程度相关。这项调查将增加JCV传播的口咽机制的可信度，并最终可能导致临床上对这种病原体所致的急性疾病的鉴定。

DESCRIPTION (provided by applicant): Serological studies indicate that more than 80% of the world's adult population is infected with JC virus, a papovavirus. The mode of transmission of this virus is unknown and acute infection has not been recognized as a cause of an identifiable illness. However, JCV is the cause of progressive multi focal leukoencephalopathy (PML), a formerly rare demyelinating disease of the brain. PML has become common in the face of the HIV pandemic affecting approximately 5% of all AIDS patients, usually during advanced stages of immunosuppression. JCV remains latent in the reticuloendothelial system following the initial infection. Demonstration of the virus in tonsillar tissue suggests an oropharyngeal or respiratory mode of transmission. JCV is also expressed periodically in peripheral blood lymphocytes (PBLs). These cells share regulatory regions for the virus with CNS glial cells infected in PML. While JCV can be identified in the PBLs of approximately 5% of otherwise normal individuals, it is demonstrable in the PBLs of approximately 50% of immunosuppressed individuals, including those with AIDS, and in 90% of persons with AIDS-associated PML. The expression of JCV in the oropharyngeal fluids has not been previously determined. We hypothesize that JCV is shed in oropharyngeal fluids and that its presence in these fluids will correlate with both its presence in PBLs and the severity of immunosuppression. The aims of this study include identifying JCV in saliva and throat washings in three populations (normal controls, HIV-infected persons, and persons with AIDS-associated PML); determining whether a correlation exists between JCV presence in oropharyngeal fluids and in PBLs; and determining whether JCV shedding from the oropharynx correlates with the degree of immunosuppression. This line of investigation would add credence to an oropharyngeal mechanism of JCV transmission and may ultimately lead to the clinical identification of an acute illness attributable to this pathogen.