A Study of Monocyte Excretion of TNF- α and IL-6 and Monocyte Expression of HLA Class Ⅱ Antigen In Genital Herpes

Objective: To study the role of monocytes in the pathogenesis of genital herpes. Methods: TNF- α and IL-6 levels in 27 cases of genital herpes were detected by enzyme linked immunosorbant assay (ELISA). HLA class Ⅱ antigen expression on monocytes were detected by an alkaline phosphatase anti-alkaline phosphatase method. Results: Compared with normal controls, levels of TNF- a and IL - 6 secreted by monocytes responding to LPS mitogen in vitro were significantly decreased [(3.13 ± 0.44ng/ml) vs (4.68 ± 0.54ng/ml), P<0.05 and (3.32 ± 1.06ng/ml) vs (6.46 ± 1.94ng/ ml), P<0.05, respectively]. HLA class Ⅱ antigen expression on monocytes in the genital herpes group was also significantly decreased [HLA-DR (67.48% ± 1.51%) vs (81.03% ± 1.32%), P<0.01 and HLA-DQ (29.54% ± 1.15%) vs (37.63% ± 1.79%), P <0.01 respectively]. Conclusion: These findings suggest that the decreased monocyte function may contribute to the pathogenesis of genital herpes. Augmenting or inducing monocyte function may be important in the prevention, treatment, and reduction of genital herpes cases.

Long Dan Xie Gan Formula Granule Promotes Pro-Inflammatory Cytokine Expression in Female Guinea Pigs with Recurrent Genital Herpes

Objective To explore the effects of Long Dan Xie Gan formula granule(LDXGFG)on regulation of pro-inflammatory cytokines in female guinea pigs with recurrent genital herpes(herpes simplex virus 2,HSV-2).Methods Levels of pro-inflammatory cytokines in blood of HSV-2-infected guinea pigs,including IL-6,IL-8,IL-10,IL-12,IFN-α,IFN-β,IFN-γ,and TNF-α,were detected by ELISA;corresponding gene expression levels in tissues were detected by real-time PCR.Results IL-6,IL-10,IL-12,IFN-α,IFN-γand TNF-αdecreased significantly in both blood and diseased tissues after infection with recurrent genital herpes.Upon feeding LDXGFG to HSV-2-infected guinea pigs,IL-6,IL-10,IL-12,IFN-α,IFN-γand TNF-αdemonstrated significant increases,similar to the effects of acyclovir(ACV).LDXGFG promoted the expression of pro-inflammatory cytokines in blood and tissue,with a stronger effect than ACV.Moreover,LDXGFG demonstrated broader effects than ACV.Conclusion The present results suggest that LDXGFG can serve as an alternative,inexpensive,and long-term treatment for HSV-2 infection.

Efficacy and safety of oral Chinese herbal medicine combined with nucleoside antiviral drugs against recurrent genital herpes:a systematic review and meta-analysis

Background:To compare the efficacy and safety of Chinese herbal medicine combined with nucleoside antiviral drugs and nucleoside antiviral drugs alone in treating recurrent genital herpes.Methods:PubMed,Embase,Web of Science,Cochrane Library,Chinese Biomedical Literature Database,China National Knowledge Internet,VIP Database,and Wanfang Data were searched from inception to April 2021.Randomized controlled trials on the efficacy and safety of oral Chinese herbal medicine combined with nucleoside antiviral drugs for recurrent genital herpes were collected.All included trials were independently assessed by two reviewers with the Cochrane risk-of-bias tool,and a meta-analysis was conducted using Review Manager 5.4.Results:Compared with the use of nucleoside antiviral drugs alone,combination therapy with oral Chinese herbal medicine plus nucleoside antiviral drugs effectively reduced the herpes recurrence rate after the end of treatment(3 months:P=0.0002;6 months:P<0.00001;1 year:P<0.00001)and the number of recurrences each year(P<0.00001),improved the recurrent Genital Herpes Quality of Life Questionnaire score(P<0.00001),and regulated the levels of interferon-γ,interleukin-2,tumor necrosis factor-α,and T lymphocyte subsets in the peripheral blood,and the difference was statistically significant.Different subgroups reported mixed results with respect to the efficacy in the short term.The incidence of adverse reactions and the time of symptom disappearance between the two groups were not significantly different.Conclusion:Chinese herbal medicine combined with nucleoside antiviral drugs can effectively reduce the recurrence rate of recurrent genital herpes,improve the patient’s quality of life and enhance the body’s immunity.Considering the possible risk of publication bias,more high-quality randomized controlled trials are still needed to verify the conclusions of this article.

Detection of Intracellular Cytokine Production in Peripheral Blood CD_^+ T Cells of Patients with Recurrent Genital Herpes

Objective: To study the role of Th1/Th2 cytokines in thepathogenesis of recurrent genital herpes (RGH), and tobetter understand the relationship between them. Methods: A two-color immunofluorescent staining of cellsurface antigen and intracellular cytokines for flowcytometric analysis was used for CD_3, IL-2, IL-10, IL-12,IFN-γ and TNF-α in CD_3^+ T-lymphocytes in activatedperipheral blood mononuclear cells of patients with RGH. Results: Compared to controls, patients with RGHshowed fewer CD_3^+ T cells (P<0.05) and IL-2 producing andIFN-γ producing T cells (P<0.02 and P<0.001, respectively)after in vitro stimulation with PMA and ionomycin in thepresence of a protein transport inhibitor. More IL-10producing and IL-12 producing T cells were found inpatients with RGH (P<0.01). There was no significantdifference in the number of TNF-α producing cells betweenRGH patients and controls (P<0.05). Conclusion: RGH patients showed relatively more Th2cytokines. The imbalance between Th1 and Th2 cytokinesresults in inhibitory effects on a series of cell-immuneresponses, which may play an important role in thepathogenesis of RGH.

Tc1/Tc2 Imbalance in the Peripheral Blood of Patients with Recurrent Genital Herpes

In order to investigate the IFN-γ and IL-4 expression of CD8^＋T lymphoeytes in the peripheral blood from patients with recurrent genital herpes （RGH） at different clinical periods and their relationship with the pathogenesis of RGH, flow cytometry was used to detect the intracellular cytokines （IFN-γ and IL-4） of CD8^＋ T lymphocytes in the peripheral blood of 30 patients with RGH at acute period, 20 patients with RGH at recovery period and 15 healthy volunteers. The results showed that RGH patients at acute period had a lower percentage of Tcl subsets in peripheral blood than that of healthy controls （P〈0. 001）, especially a remarkable decreased percentage of Tc1 subsets （P〈0. 001） among those RGH patients with recurrent number more than 3 in the recent half a year. Tc1/Tc2 ratio in the RGH patients at acute period was significantly decreased as conapared with normal control group （P〈0.05）. The recurrent number of acute patients in the recent half a year was significantly correlated with the percentage of Tc1 subsets and the ratio of Tc1/Tc2 （P〈 0.05）. A decreased percentage of Tc1 subsets was found among the RGH patients with recurrent number more than 3 in the recent half a year at recovery period in comparison with healthy volunteers （P〈0.05）, and it was significantly correlated with the recurrent number in the recent half a year （P〈0.05）. It is concluded that there are Tc1/Tc2 imbalance and a low level of Tc1 subsets in RGH patients who are relapsing repeatedly in the near period. The low level of Tc1 subsets may be an important factor for the recurrence of RGH and the reactivation of latent herpesvirus infection.

Interleukin-2 and Interleukin-6 in Recurrent Genital Herpes Patients

Objective:To study the cellular immunity status of patientswith recurrent genital herpes. Methods: Serum levels of interlukin-2 and its solublereceptor and interlukin-6 were measured by ELISA in 34patients with recurrent genital herpes. Results: Serum levels of IL-2 and IL-6 were significantlydecreased in patients compared to healthy controls (P<0.01),and the level of sIL-2R was significantly increased in patientswith recurrent genital herpes (P<0.01). There were nosignificant differences in all variables amongst patientsregarding relapse stage and remission stage (P>0.05). Conclusion: There was a cellular immune deficiency inpatients with recurrent genital herpes.

Effect of Traditional Chinese Medicine Antiviral Capsules On Animal Model Genital Herpes and HSV-2 in Cell Culture

Objective: To study the effect of traditional Chinese medicine antiviral capsules in the treatment of genital herpes. Methods: Using female guinea pig genital herpes as the animal model, this study used oral administration of two formulations of antiviral capsules (AC) and observed the effect on vaginal HSV-2 titers and vulvar symptoms. Cell cultures were also used to examine the direct inactivation of HSV-2 by the antiviral capsules and the suppression of HSV-2 via three drug administration methods. Results: There was no significant difference of mean vaginal virus titers between the antiviral capsule groups and that of the positive acyclovir (ACV) control (P>0.05). Mean vulvarsymptom scores of the two antiviral capsule groups were also significantly lower than that of the saline negative control group on days 2, 3, 5, 7 and 8 (P<0.05) and similar to that of the ACV control (P>0.05). Cell culture showed the minimum inhibitory concentrations of antiviral capsules No. 1 and No. 2 were 0.390625 mg/ml and 1.5625 mg/ml, respectively. Conclusion: The traditional Chinese medicine antiviral capsules had suppressive effects on HSV-2 in both animal model GH and in vitro cell culture.

Human Herpes Virus Type 2 ( HSV2 ), Human Cytomegalovirus (HCMV) in the Male Genital Tract and Fertilization

The possibility of infection of the human male genital tract by human herpes virus type 2 (HSV2) or human cytomegalovirus (HCMV) is well established and their sexual transmission has been the object of many studies. Moreover, medically assisted procreation, which helps in numerous fertility problems, raises the question of new viral risks linked to the application of these new technologies. In this review, we shall consider current knowledge in terms of the presence of HSV 2 and HCMV in the different parts of the genital tract of immunocompetent or immunodepressed men. We shall also consider the possibility of viral transmission by the sexual act or by the various techniques used in medically assisted procreation. We shall describe studies in human beings and in animals.

Urethral Orifice Genital Herpes Caused by HSV-1 in a Female Patient: A Case Report

Introduction:Genital herpes is one of the most common sexually transmitted infections worldwide.Most genital herpes occur on the genitalia,perineum,buttocks,upper thighs,or perianal areas.However,there were reports of rare cases of genital herpes on urethral orifice.Case presentation:A 53-year-old woman presented with vagina pruritus at first,with subsequent burning sensation around urethra.Mycostatin and mycospor were administered for the treatment of the pruritus.Then levofloxacin was prescribed.Finally,the patient was given treatment with acyclovir.Different from other cases,the investigation showed herpes simplex virus type 1 DNA positive and herpes simplex virus type 2 DNA negative by PCR.The patient was therefore diagnosed with genital herpes.Discussion:Most genital herpes happen on the genitalia,perineum,buttocks,upper thighs,or perianal areas.Few cases have been reported that genital herpes occurred on urethral orifice till now.Conclusion:If there is no typical symptoms that patient present with herpes simplex virus type 1 or 2 positive,urethral orifice genital herpes should be considered.

生殖器疱疹的中西医发病机制及治疗进展

生殖器疱疹(genital herpes, GH)作为临床常见的性传播疾病,根据其临床表现可归属于中医“热疮”“阴疮”等范畴,具有易复发、难根治的特点,严重影响了患者的身心健康。现代医学治疗GH主要以抗病毒、调节免疫为主,临床上取得一定成效,但都未能达到根治目的并且存在不良反应。中医药治疗GH方法多样,以辨证施治为主,具有缓解临床症状、减轻不良反应等优势。同时临床上还采用中西医结合的方法治疗GH,中西医并重取长补短,发挥各自的优势。文章就GH的中西医发病机制与治疗研究进展进行综述,为相关研究提供参考。

李曰庆治疗生殖器疱疹药对浅析

生殖器疱疹是常见的性传播疾病之一,也是男科的常见病和多发病,由于缺乏特效药物,容易反复发作,治疗较为棘手。中医学将该病归属于“热疮”“阴疮”的范畴,认识较早,治疗方法丰富。李曰庆教授认为生殖器疱疹的病机当根据其发病特点分期而辨,发作期多实证,以湿热淫毒壅遏肌肤多见;潜伏期多虚实夹杂,正虚邪恋,以肾阳不足、气阴两虚为著。李曰庆教授对该病的辨治经验丰富,见解有独到之处,强调辨证与辨病相结合,中医与西医相结合,男女同诊,内外兼治,身心同调,疗效确切,现对其治疗思路及常用药对做一浅析,以供同道相互借鉴。

外周血CXCL10及其受体CXCR3在复发性生殖器疱疹病毒2型感染患者中表达及其与预后关系研究

目的探讨外周血CXC趋化因子配体10(CXCL10)及其CXC趋化因子受体3(CXCR3)在复发性生殖器疱疹病毒2型感染患者中的表达及其与预后的关系。方法选取2019年7月—2020年7月医院收治的102例复发性生殖器疱疹病毒2型感染患者,另选取同期来院体检的94例健康者,比较复发性生殖器疱疹病毒2型感染患者与健康体检者外周血CXCL10和CXCR3水平。根据临床分期,将102例复发性生殖器疱疹病毒2型感染患者分为发作期(44例)和稳定期(58例),比较发作期和稳定期患者外周血CXCL10和CXCR3水平。随访1年,统计患者复发情况,采用单因素分析影响复发性生殖器疱疹病毒2型感染患者频繁复发的因素,并对其因素进行Logistic回归分析,采用受试者工作特征曲线(ROC)分析外周血CXCL10和CXCR3水平预测复发性生殖器疱疹病毒2型感染患者频繁复发的价值。结果复发性生殖器疱疹病毒2型感染患者外周血CXCL10和CXCR3水平低于健康体检者(P<0.05);发作期患者外周血CXCL10和CXCR3水平低于稳定期患者(P<0.05);随访1年,102例复发性生殖器疱疹病毒2型感染患者中共有28例频繁复发,频繁复发患者性伙伴个数3个及以上构成比高于非频繁复发患者(P<0.05),频繁复发患者外周血干扰素-γ(IFN-γ)、CXCL10和CXCR3水平均低于非频繁复发患者(P<0.05);Logistic多因素回归分析显示性伙伴个数、CXCR3和CXCL10均是影响复发性生殖器疱疹病毒2型感染患者频繁复发的独立危险因素(P<0.05);ROC分析显示,外周血CXCL10和CXCR3预测复发性生殖器疱疹病毒2型感染患者频繁复发的最佳截断点分别为10.14 pg/mL和8.20 ng/mL,曲线下面积(AUC)分别为0.806和0.822,二者联合的特异度和AUC分别为91.89%和0.914。结论复发性生殖器疱疹病毒2型感染患者CXCL10和CXCR3水平均异常降低,二者均与患者频繁复发密切相关,可作为临床预测复发性生殖器疱疹病毒2型感染患者频繁复发的敏感指标。

27例女性生殖器疱疹患者临床及阴道微生物特点分析

目的 了解妇科门诊就诊的女性生殖器疱疹患者临床特点及下生殖道微生态状况,帮助更规范地治疗生殖器疱疹。方法 纳入首都医科大学附属北京妇产医院妇科门诊就诊的27例临床诊断为生殖器疱疹的女性,分析其临床资料及阴道分泌物微生态检查结果。结果 27例女性生殖器疱疹临床表现为不同程度的外阴瘙痒、疼痛、烧灼痛、刺痛等,妇科查体表现从典型的外生殖器疱疹样改变到隐匿的不规则小溃疡,1例表现为宫颈疱疹样改变。24例(88.89%)阴道微生态异常,其中菌群正常功能下降者8例,细菌性阴道病者2例,白假丝酵母菌病6例,菌群异常者7例,混合感染1例。患者阴道分泌物pH值普遍升高,pH值>4.5者共计22例,占比81.48%(22/27)。结论 女性生殖器疱疹患者临床表现多样,且常合并阴道微生态失调。临床上推荐对所有可疑生殖器疱疹的女性进行阴道微生态检查,并进行个体化针对性治疗。

Asymptomatic Herpes Simplex Virus Shedding in STI Patients

Objective: This study examined Herpes Simplex Virus (HSV) subclinical shedding in the genital tract of patients withgenital herpes (GH) or non-gonoccal urethritis (NGU). Method Swabs were collected after exposure to rash andgenital tract during GH relapse or remission on a weekly basisfor four to six weeks. NGU patients with negative chlamydiaand mycoplasma tests were also swabbed for a similarduration. All swabs underwent HSV DNA detection withquantitative PCR. Result: There was a significant difference in the rate ofasymptomatic HSV shedding in urinary tracts comparing GHand the control group and comparing NGU and the controlgroup (P<0.05). The rate of HSV shedding was 22%, 9.8%and 3.3% for GH, NGU and control groups respectively. Therate of HSV shedding was 21.7% (20/92) for patients withactive GH and 23% for those in remission. The HSV positiverate was significantly higher in the group with patients whohad more than six relapses within one year compared to thegroup of patients with less than six relapses.Conclusion: There is HSV subclinical shedding in theirgenital tract during active GH and remission. SubclinicalHSV shedding is more common in patients with more than sixGH relapses per year compared to GH patients with fewerrelapses. Approximately 9.9% of NGU patients with negativechlamydia mycoplasma testing was found to have subclinicalHSV infection.

Clinical Application of Multiplex PCR Assay for the Diagnosis of the Etiology of Genital Ulcer Disease Among Patients Attending STD Clinics in Guangzhou, China

Objectives: To develop a method of simultaneous PCR detection of Haemophilus ducreyi, Treponema pallidum, andHerpes Simplex Virus Types 1 and 2 from genital ulcersamong patients attending STD clinics in Guangzhou, China;and evaluate the clinical application of multiplex PCR (M-PCR) assay for diagnosing the etiology of genital ulcerdiseases (GUD). Methods: 244 patients with a genital ulcer were evaluated.Clinical etiology of GUD was based on physical appearanceand microbiologic evaluations that included darkfieldmicroscopy examination (D-F) and serology test for syphilis(STS). Swabs of each genital ulcer were tested for HSVantigen by enzyme immunoassay (EIA) and processed in anM-PCR assay for simultaneous detection of T pallidum, HSVand H ducreyi. Results: The standard strains of T pallidum, HSV and Hducreyi were amplified by M-PCR, producing amplifiedproducts of 260bp,432bp,170bp, respectively. The sensitivityof M-PCR is 10~2 pg DNA. M-PCR assay for T.pallidum, HSVand H ducreyi showed good agreement en compared with D-F detection for T pallidum, STS, H ducreyi culture and EIAfor HSV antigen (Kappa scores are 0.774,0.704,0.793,0.756,respectively). Conclusions: The M-PCR is a convenient, accurate andreliable assay for the detection of T pallidum, HSV and Hducreyi from genital ulcers, and can be used as a method ofdiagnosing the etiology of GUD.

2010—2019年陕西省生殖器疱疹流行病学分析

目的 了解陕西省生殖器疱疹流行病学特征,为制定控制对策提供依据。方法 用描述性流行病学方法对2010—2019年陕西省报告的生殖器疱疹病例资料进行“三间分布”分析。结果 2010—2019年,陕西省生殖器疱疹累计报告6 222例,报告发病率总体呈下降趋势,由2010年2.49/10万下降到2019年0.95/10万,年均下降10.15%。报告病例总数居全省前3位的地区是西安市(3 980例)、渭南市(529例)、咸阳市(357例),占全省病例总数的78.21%(4 866/6 222)。2010—2019年男性报告发病率均高于女性,男、女性别比3.43∶1。高发年龄段为20~49岁的性活跃人群,2011—2013年和2016年以25~29岁年龄组报告发病率最高;2014—2015年和2017—2019年以30~34岁年龄组发病率最高。2010—2019年,在所有类型医疗机构中,以综合医院报告病例数最多,其次为皮肤性病专科医院。结论 2011—2019年陕西省生殖器疱疹处于低流行态势,15~49岁人群是重点防治人群,防治对策包括积极发现和治疗病例、避免漏诊,对重点人群开展健康教育和行为干预等。

生殖器疱疹患者经重组人干扰素α-2b凝胶辅助治疗的效果及血清细胞因子水平分析

目的探讨生殖器疱疹患者经重组人干扰素α-2b凝胶辅助治疗的效果。方法选取2020年9月至2021年10月深圳市龙岗区人民医院收治的126例生殖器疱疹患者作为研究对象,依据随机数字表法分为对照组和观察组,各63例。对照组采用伐昔洛韦治疗,观察组在对照组基础上联合使用重组人干扰素α-2b凝胶治疗,均治疗4周。比较两组治疗效果及外周血细胞因子水平。结果治疗后,观察组临床总有效率高于对照组;观察组痊愈、停止、结痂、消失、皮损愈合、脱痂时间均短于对照组;治疗后6个月内,观察组复发率低于对照组;与治疗前比,治疗后两组血清白介素-2(IL-2)、外周血人白细胞分化抗原(CD)4^(+)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平、CD4^(+)/CD8^(+)、生活质量各项评分均升高,且观察组高于对照组;血清可溶性IL-2受体(sIL-2R)、白介素-4(IL-4)、外周血CD8^(+)水平则均降低,且观察组低于对照组(P<0.05)。结论重组人干扰素α-2b凝胶辅助治疗可有效稳定生殖器疱疹患者体内炎性因子水平,改善免疫功能,提高生活质量,降低其治疗后复发率。

169例女性生殖器疱疹患者的流行病学特征分析

目的分析女性生殖器疱疹的流行病学特点,为防控疾病、促进女性生殖健康提供依据。方法从中国疾病预防控制信息系统收集北京市海淀区2005—2022年女性生殖器疱疹的传染病报告卡,分析其流行病学特征。结果169例中,年龄18~78岁,中位数30岁,发病年龄集中在22~34岁(60.4%);职业类型中占比前5位的依次为家务及待业41例(24.3%)、不详33例(19.5%)、干部职员例24(14.2%)、商业服务16例(9.5%)、其他12例(7.1%);发病到诊断的间隔时间最短0 d,最长达2年以上。结论生殖器疱疹对女性生殖健康影响较大,应加强宣教生殖器疱疹的预防知识,并提高医院生殖器疱疹的报告水平。

儿童不典型生殖器疱疹1例

报告儿童不典型生殖器疱疹1例。患儿女,2岁。因外阴、双侧股内侧、肛周泛发米粒至绿豆大水疱,部分糜烂3 d就诊。皮肤科检查:双侧股内侧、外阴、肛周可见泛发米粒至绿豆大水疱,大部分水疱有脐凹,疱壁厚,疱液清,部分水疱破溃露出鲜红糜烂面。引流区淋巴结无明显肿大。取水疱液检测单纯疱疹病毒Ⅱ-DNA阳性,血清HSV-ⅡIgM阳性。诊断为生殖器疱疹。予抗病毒治疗1周后好转,随访1年未见复发。

原发性生殖器疱疹治疗后T淋巴细胞亚群变化对1年内频繁复发的影响

目的观察原发性生殖器疱疹(PGH)患者治疗后T淋巴细胞亚群水平变化,并分析治疗后T淋巴细胞亚群水平对1年内频繁复发的影响。方法选取2016年5月至2021年5月台州市第一人民医院诊治的177例PGH患者作为研究对象,并随访1年,治疗后接受T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))检查。根据随访期间频繁复发情况,分为频繁复发组(1年内复发≥6次)与非频繁复发组(1年内复发<6次)。比较两组基线资料及治疗后T淋巴细胞亚群水平;分析治疗后T淋巴细胞亚群水平对PGH患者1年内频繁复发的影响。结果随访1年期间,177例PGH患者中,频繁复发55例,频繁复发率为31.07%。频繁复发组合并糖尿病占比高于非频繁复发组,治疗后CD3^(+)、CD4^(+)低于非频繁复发组,CD8^(+)高于非频繁复发组(P<0.05)。Logistic回归分析结果显示,治疗后CD3^(+)、CD4^(+)高表达是PGH患者治疗后1年内频繁复发的保护因素(OR<1,P<0.05);CD8^(+)高表达是其危险因素(OR>1,P<0.05)。结论PGH患者治疗后1年内频繁复发可能受治疗后T淋巴细胞亚群水平的影响。