ERYTHEMA MULTIFORME LESIONS ARE ASSOCIATED WITH EXPRESSION OF A HERPES-SIMPLEX VIRUS (HSV) GENE AND QUALITATIVE ALTERATIONS IN THE HSV-SPECIFIC T-CELL RESPONSE

A common form of erythema multiforme, herpes-associated erythema multi forme (HAEM), occurs following infection with herpes simplex virus (HS V). Here we report that HSV gene expression and the qualitative nature of the virus-specific T-cell responses are related to HAEM lesion dev elopment. Skin from HAEM lesions and 1-3 months healed HAEM lesional s kin were positive for the viral DNA polymerase gene (Pol) by polymeras e chain reaction, However, gene expression as determined by immunohist ochemistry with Pol-specific antibody was seen only in HAEM lesions, s uggesting that lesion development is associated with Pol gene expressi on. Similar HSV-specific T-cell lymphoproliferative responses were see n in peripheral blood mononuclear cells (PBMCs) from patients with acu te or healed HAEM lesions or HSV lesions and from HSV-seropositive pat ients with unrelated inflammatory diseases. However, the T-cell recept or variable (V beta) chain repertoire of HSV-stimulated PBMCs obtained from HAEM lesions was altered; the prevalence of some families of var iable chain (namely V beta 16 and V beta 19) was reduced, whereas the prevalence of others was increased (namely V beta 2, and V beta 7), V beta 2 cells were found in HAEM lesional skin positive for Pol antigen , suggesting that these cells home to viral antigen-positive skin.