The Experimental Research Of Trigeminal Neuralgia Combined Trigeminal Nerve Root Zone Arachnoids' Adhesions With HSV-1 Virus Infection

Objective The cause of trigeminal neuralgia has not been cleared, trigeminal nerve root zone by vascular compression is only one of at least two abnormal factors. Virus infection, especially herpes simplex virus type I, it can get into the trigeminal ganglia and along with the trigeminal nerve retrograde that was because it has latent and neurotropic nature, especially after the initial infection, and can form latent infection in that place,When the body was suffered from stress, trauma, radiation, to take the medicine of immunosuppressive drugs and so on,the body's immune function decreased or immune disorder,the virus will be reactivated and form proliferative infection. So it has very important effect in the occurrence and development of trigeminal neuralgia. While interleukin-6(IL-6) is a molecular weight for 21-26KD, and be made from 184 amino acid residues, composed of glycoprotein, it can not only be mediated and regulate the body's immune response, but also participate in some viruses infectious diseases with recurrent control. Maybe IL-6 can arouse the HSV-1 virus reactivation during HSV-1 latent infections and amplification infections, so that IL-6 playing an important role during the infection. Therefore, we study the HSV-1 infection status in the arachnoids'tissue of the trigeminal neuralgia, and combined with IL-6 on HSV effects to further explored HSV-1 infection with trigeminal neuralgia relationship.Methods 79 cases of primary trigeminal neuralgia patients were implemented of microvascular decompression, Including 57 patients were founded trigeminal nerve root area exists arachnoids'adhesion in MVD interoperation, their arachnoids'tissue was taken for the Experimental group (including 7 cases were only arachnoids'tissue thickening and adhesions, there was no significant vascular compression or restricted vein oppression, there are 50 cases existing arachnoids'adhesion and arterial oppression). 22 cases were not founded significant arachnoids'tissue adhesion, and take its root zone arachnoids'tissue as Control group. And all of the patients were taken same blood before surgery. Firstly,Using the method of polymerase chain reaction to detecting the HSV-1 specific DNA fragments of the trigeminal nerve root area adhesive arachnoids'tissue and not significant adhesive arachnoids'tissue of the trigeminal neuralgia. Secondly, using the method of Western Blot technique to detecting the HSV-1 specific antigen, to determine the infection status, and re-classified it as latent infection group, reactive infection group and uninfected group, and then using ELISA technique to quantitative detecting the levels of IL-6 in the three groups'arachnoids tissue and the serum of the patients.Results 40 cases specimen are positive of HSV-1 DNA in the Experimental group, the ratio of positive result is 70.18%. 13 cases in Control group are positive of HSV-1 DNA; the ratio of positive result is 59.09%. There is no significant difference (p>0.05) between the two groups. And 28 cases specimen are positive of viral specific antigens in the Experimental group, the ratio of positive result is 49.12%. 5 cases in Control group are positive of viral specific antigens,the ratio of positive is 22.73%. There is a significant difference (p<0.05) between the two groups. According to the result of PCR and Western Blot, all of specimens can be segmented into three groups: the latent infection group 20 cases, the reactive infection group 33 cases, and the uninfected group 26 cases. The levels of IL-6 in the arachnoids tissue of HSV-1 reactive infection group is higher than the latent infection group, and also higher than the uninfected group, and there are significant difference (p<0.01), while the levels of IL-6 of serum are no significant difference (p>0.05).Conclusion1,The reactive infection of HSV-1 may induce or aggravate the trigeminal nerve root zone arachnoids'adhesion.2,IL-6 may be the important cytokine in the process of HSV-1 reactive infection.3,Arachnoids tissue may be another latent HSV-1 base.4,HSV-1 infection may be another important factor of arachnoids'adhesion besides the vascular compression in the trigeminal neuralgia.5,Maybe there are some relationship between HSV-1 infection and trigeminal neuralgia.