Advances in Salivary Diagnostics by Charles F. Streckfus

Author:Charles F. Streckfus
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

Herpes Viruses

Herpes viruses are the most common viral type found in human saliva [321–323]. There are eight known herpes viruses that infect humans: herpes simplex types 1 and 2, cytomegalovirus, Epstein-Barr virus, varicella zoster virus, herpes virus 6, herpes virus 7, and herpes virus 8 (Kaposi’s sarcoma) [324]. Herpes viral infections can lead to diseases of the periodontium and oral mucosa or may present asymptomatically but still with active viral shedding into saliva [322, 324]. Herpes viruses exist in either the lytic (active) or latent (dormant) phase [324] and persist as a permanent infection of the host. The change from dormant to active replication in healthy adults can happen spontaneously or more likely is caused by environmental changes (e.g., physical or emotional stress) [325–332]. Those suffering from systemic diseases (e.g., HIV, cancer) or immunosuppression (e.g., elderly) often display a reactivation of herpes viruses that may exacerbate or create new symptoms.

Thorough work looking at astronauts has shown that in space otherwise healthy adults shift into a state of immuno-dampening [326, 333]. Viruses that are normally kept in check by the body’s immune system start to flourish and result in oral shedding. Epstein-Barr virus and varicella zoster are found in enormous quantities while the astronauts are in space for several weeks after returning to earth [326, 328, 329]. A similar herpes zoster viral shedding is also seen in some pregnant women [334]. Cold sores caused by herpes simplex 1 virus tend to come back during times of stress [334, 335]. This allows the normally latent virus to take hold and cause an active disease again. Aging adults often fail to control reactivation of Epstein-Barr virus, cytomegalovirus, and/or varicella zoster viruses [336]. The latter virus results in the development of painful shingles disease that can last for several weeks or months. All of the patients mentioned above exhibited some type of change or challenge to their immune system leading to increased viral load in their saliva. Yet, healthy adults can also continually shed various herpes viruses. These healthy adults are often asymptomatic and may easily spread the viruses [333, 335, 337].

Interesting research has shown that herpes virus infection is associated with periodontitis. A dual infection of both oral pathogenic bacteria and a herpes virus leads to immune signaling impairment, enhanced proinflammatory cytokine release, and more severe periodontitis [223, 313, 338, 339]. A distinct correlation has been found with Epstein-Barr and cytomegalovirus between both gingivitis and periodontitis. The prevalence of Epstein-Barr genome copies in dental patients was evaluated in separate studies and showed an average of 8 % in healthy individuals and 20 % in those suffering from gingivitis [149, 150, 323, 340–343] along with 46 % for chronic periodontitis and 58 % for aggressive periodontitis [149, 150, 340, 343–347]. Studies focused on cytomegalovirus showed similar results with a positive correlation between gingivitis/periodontitis and viral infection (average 8 % healthy, 33 % gingivitis, 52 % chronic periodontitis, and 42 % aggressive periodontitis) [149, 150, 221, 323, 341, 343, 344, 346, 348]. Periodontal lesions have been implicated as the main salivary source of the cytomegalovirus [341].

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