NEW YORK (Reuters Health) - Intradermal doxorubicin injection reduces latent herpes simplex virus reactivation in mice, researchers from Japan and the US report in the June issue of the Journal of Medical Virology.

Co-investigator Dr. Harry Openshaw told Reuters Health that for many years, his colleague Dr. Tsuyoshi Sekizawa "has been interested in devising ways to eliminate sensory neurons which harbor latent herpes simplex virus, thereby preventing recurrent herpetic skin lesions."

A potential approach "is to inject into the skin, at the site of frequent herpetic recurrences, cytotoxic drugs which may be taken up by the corresponding nerve terminals and carried by the normal mechanism of flow in the nerve axon to the nerve cell body of sensory ganglia. This corresponding nerve cell body is then destroyed--a process that has been termed 'suicide transport'."

In studies in latently infected mice, Dr. Openshaw of the City of Hope National Medical Center, Duarte, California, and colleagues used intradermal injection of the cancer chemotherapeutic drug doxorubicin to achieve this aim.

Doxorubicin alone did not eliminate reactivation. However, when hypertonic saline was injected into the site 24 hours prior to doxorubicin injection, there was a 55% reduction of virus-positive ganglionic explant cultures.

"Preinjection of saline at the same skin site was necessary," Dr. Openshaw suggested, "probably to enhance uptake of doxorubicin by nerve terminals."

Because of doxorubicin's toxicity, he concluded, "injection into the skin of people for herpes should not be done outside of carefully-designed investigational studies." Nevertheless, the investigators conclude, these experiments "support the concept of anti-HSV treatment via retrograde axoplasmic transport."

J Med Virol 2003; 70:263-266.

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