Letter to editor

There is an association between human adenovirus and uveitis, especially among the pathogenesis of uveitis, viral infection is an important contributing factor [1]. The occurrence of uveitis is related with many factors, including infection, autoimmune diseases, inflammatory spread of adjacent tissues, drug side effects, etc. Human adenovirus is a common virus that can cause a variety of diseases, including respiratory infections, conjunctivitis, gastrointestinal discomfort. After adenovirus infection, fever, cough, sore throat and other symptoms usually occur. During eye infection, it may show conjunctival congestion, tears and pain.

Infectious factors in uveitis include infections by viruses, bacteria, and pathogens such as fungi. Among them, adenovirus, as a common virus, may cause acute anterior uveitis when it infects the eye. In addition, adenovirus may also form uveitis by hematogenous dissemination to the eye, causing endogenous infection. The pathogenesis of uveitis is complex and involves multiple factors. Among the infectious factors, viral infection is an important contributing factor to [2,3]. As a common adenovirus virus, its infection may lead to the development of uveitis. In addition, adenovirus infection may also cause the body’s immune response, further aggravating the condition of uveitis.

We note that in the case of uveitis, although the herpes virus is widely recognized as the main infectious pathogen, the etiology of some cases is not yet clear. The two reported cases of uveitis associated with HAdV infection, this finding may provide new insight into our understanding of the etiology of uveitis. By sequencing some or all of the HAdV genome in a patient with Acquired Immunodeficiency Syndrome (AIDS) and another hematological malignancy, the new types of HAdV, infection and the unreported type of [4,5] for HAdV were identified. This report suggests that HAdV may be a cause of uveitis with retinal necrosis and also suggests us that some cases of uveitis classified as “idiopathic” in the past may in fact be caused by HAdV infection. This new understanding may have a major impact on the diagnosis and treatment strategy of uveitis.

Although previous studies have a clear understanding of the etiology of uevitis, we know that there are many unknown areas waiting to explore the etiology of uveitis, especially the relationship with HAdV. There may be other viral causes of retinitis, which requires our further study and exploration.

Declarations

Ethics approval: The study was approved by the ethics committee of Xiamen Pediatric Hospital affi liated with Fudan University, Xiamen, China (approval no: XEKLS [2022]38).

Funding: This work was sponsored by Fujian provincial health technology project (Joint Project of Xiamen Natural Science Foundation no. 3502Z20227410/3502Z20227301).

Consent to participate: N/A.

Date availability statement: Data are available upon reasonable request from corresponding author.

Author contributions: ZF, YL designed the study and drafted the manuscript; ZF, YL collected the data; ZF, YL performed literature searches and analyses; and ZF, YL critically reviewed and revised the manuscript. All the authors have read and approved the fi nal manuscript.

Conflicts of interest: The authors declare no confl ict of interest.

Acknowledgements: We wish to thank our colleagues at the Ophthalmology Depart ment, Xiamen Pediatric Hospital affi liated with Fudan University for their encouragement, support, and assistance during the course of this study.

References

1. Hankey DJ, Lightman SL, Baker D. Interphotoreceptor retinoidbinding protein peptide 2 induced uveitis in B10.R III mice: Characterization of diacase parameters and immunomodulation. Exp Eye Res. 2001; 72(3): 3412350.
2. Von Toerne C, Sieg C, Kaufmann U, et al. EffectorT cells drivingmonophasic vs. relapsing/remitting experimental autoimmune u-veitis show unique pathway signatures. Mol Immunol. 2010; 48(1-3): 272-280.
3. Hoves S, Krause SW, Herfarth H, et al. Elimination of activated but not resting primary humanCD4+and CD8+T cellsby Fasligand (FasL/CD95L)-expresing killer-dendritic cells. Immuno-biology. 2004; 208(5): 463-475.
4. Nakano S, Sugita S, Tomaru Y, et al. Establishment of Multiplex Solid-Phase Strip PCR Test for Detection of 24 Ocular Infectious Disease Pathogens. Invest O phthalmol Vis Sci. 2017; 58(3): 1553-9.
5. Nakano S, Tomaru Y, Kubota T, et al. Evaluation of a Multiplex Strip PCR Test for Infectious Uveitis: A Prospective Multicenter Study. Am J Ophthalmol. 2020; 213: 252-9.