Histopathological Analysis of Adrenal Glands after Simian Varicella Virus Infection
Christy S. Niemeyer,
Teresa Mescher,
Rocio Griggs,
David J. Orlicky,
Gregory K. Wilkerson,
Andrew N. Bubak,
James E. Hassell,
Brittany Feia,
Ravi Mahalingam,
Vicki Traina-Dorge,
Maria A. Nagel
Affiliations
Christy S. Niemeyer
Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
Teresa Mescher
Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
Rocio Griggs
Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
David J. Orlicky
Department of Pathology, University of Colorado School of Medicine, Aurora, CO 80045, USA
Gregory K. Wilkerson
Department of Comparative Medicine, Keeling Center for Comparative Medicine and Research, University of Texas, MD Anderson Cancer Center, Bastrop, TX 78602, USA
Andrew N. Bubak
Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
James E. Hassell
Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
Brittany Feia
Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
Ravi Mahalingam
Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
Vicki Traina-Dorge
Microbiology Division, Tulane National Primate Research Center, Tulane University, Covington, LA 70433, USA
Maria A. Nagel
Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA
Latent varicella zoster virus (VZV) has been detected in human adrenal glands, raising the possibility of virus-induced adrenal damage and dysfunction during primary infection or reactivation. Rare cases of bilateral adrenal hemorrhage and insufficiency associated with VZV reactivation have been reported. Since there is no animal model for VZV infection of adrenal glands, we obtained adrenal glands from two non-human primates (NHPs) that spontaneously developed varicella from primary simian varicella virus (SVV) infection, the NHP VZV homolog. Histological and immunohistochemical analysis revealed SVV antigen and DNA in the adrenal medulla and cortex of both animals. Adrenal glands were observed to have Cowdry A inclusion bodies, cellular necrosis, multiple areas of hemorrhage, and varying amounts of polymorphonuclear cells. No specific association of SVV antigen with βIII-tubulin-positive nerve fibers was found. Overall, we found that SVV can productively infect NHP adrenal glands, and is associated with inflammation, hemorrhage, and cell death. These findings suggest that further studies are warranted to examine the contribution of VZV infection to human adrenal disease. This study also suggests that VZV infection may present itself as acute adrenal dysfunction with “long-hauler” symptoms of fatigue, weakness, myalgias/arthralgias, and hypotension.
