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Andersen O, Ernberg I, Hedström AK. Treatment Options for Epstein-Barr Virus-Related Disorders of the Central Nervous System. Infect Drug Resist 2023; 16:4599-4620. [PMID: 37465179 PMCID: PMC10351589 DOI: 10.2147/idr.s375624] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
Epstein-Barr virus (EBV), a causative agent for several types of lymphomas and mucosal cancers, is a human lymphotropic herpesvirus with the capacity to establish lifelong latent infection. More than 90% of the human population worldwide is infected. The primary infection is usually asymptomatic in childhood, whereas infectious mononucleosis (IM) is common when the infection occurs in adolescence. Primary EBV infection, with or without IM, or reactivation of latent infection in immunocompromised individuals have been associated with a wide range of neurologic conditions, such as encephalitis, meningitis, acute disseminated encephalomyelitis, and cerebellitis. EBV is also involved in malignant lymphomas in the brain. An increasing number of reports on EBV-related disorders of the central nervous system (CNS) including the convincing association with multiple sclerosis (MS) have put in focus EBV-related conditions beyond its established link to malignancies. In this review, we present the clinical manifestations of EBV-related CNS-disorders, put them in the context of known EBV biology and focus on available treatment options and future therapeutic approaches.
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Affiliation(s)
- Oluf Andersen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingemar Ernberg
- Department of Microbiology, Tumor and Cell Biology, Biomedicum Q8C, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Anna Karin Hedström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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2
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Clinicopathological risk factors for a poor prognosis of primary central nervous system lymphoma in elderly patients in the Tohoku and Niigata area: a multicenter, retrospective, cohort study of the Tohoku Brain Tumor Study Group. Brain Tumor Pathol 2022; 39:139-150. [PMID: 35312904 DOI: 10.1007/s10014-022-00427-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/09/2022] [Indexed: 11/02/2022]
Abstract
Clinicopathological risk factors for a poor prognosis were investigated in elderly patients with malignant lymphoma of the central nervous system. A total of 82 pathologically confirmed, CD20-positive, diffuse large B-cell lymphoma patients aged 71 years or older who underwent therapeutic intervention in the Tohoku and Niigata area in Japan were retrospectively reviewed. A univariate analysis was performed by the log-rank test using the Kaplan-Meier method. A Cox proportional hazards model was used for multivariate analysis of risk factors. Of the 82 patients, 39 were male and 43 were female, and their median age at onset was 75 years. At the end of the study, there were 34 relapse-free patients (41.5%), 48 relapse cases (58.5%), median progression-free survival was 18 months, and median overall survival (OS) was 26 months; there were 41 deaths and 41 survivors. Multivariate analysis of median OS showed that Karnofsky Performance Status less than 60% 3 months after treatment (p = 0.022, hazard ratio (HR) = 2.591) was the clinical risk factor, and double expressor lymphoma (p = 0.004, HR = 3.163), expression of programmed death-ligand 1 in tumor infiltrating lymphocytes or tumor-associated macrophages (p < 0.001, HR = 5.455), and Epstein-Barr virus infection (p = 0.031, HR = 5.304) were the pathological risk factors.
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Abdulla M, Alexsson A, Sundström C, Ladenvall C, Mansouri L, Lindskog C, Berglund M, Cavelier L, Enblad G, Hollander P, Amini RM. PD-L1 and IDO1 are potential targets for treatment in patients with primary diffuse large B-cell lymphoma of the CNS. Acta Oncol 2021; 60:531-538. [PMID: 33579170 DOI: 10.1080/0284186x.2021.1881161] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Programmed cell death 1 (PD-1) and its ligands PD-L1 and PD-L2, as well as Indoleamine 2,3-deoxygenase (IDO1) can be expressed both by tumor and microenvironmental cells and are crucial for tumor immune escape. We aimed to evaluate the role of PD-1, its ligands and IDO1 in a cohort of patients with primary diffuse large B-cell lymphoma of the CNS (PCNSL). MATERIAL AND METHODS Tissue microarrays (TMAs) were constructed in 45 PCNSL cases. RNA extraction from whole tissue sections and RNA sequencing were successfully performed in 33 cases. Immunohistochemical stainings for PD-1, PD-L1/paired box protein 5 (PAX-5), PD-L2/PAX-5 and IDO1, and Epstein-Barr virus encoding RNA (EBER) in situ hybridization were analyzed. RESULTS High proportions of PD-L1 and PD-L2 positive tumor cells were observed in 11% and 9% of cases, respectively. High proportions of PD-L1 and PD-L2 positive leukocytes were observed in 55% and 51% of cases, respectively. RNA sequencing revealed that gene expression of IDO1 was high in patients with high proportion of PD-L1 positive leukocytes (p = .01). Protein expression of IDO1 in leukocytes was detected in 14/45 cases, in 79% of these cases a high proportion of PD-L1 positive leukocytes was observed. Gene expression of IDO1 was high in EBER-positive cases (p = .0009) and protein expression of IDO1 was detected in five of six EBER-positive cases. CONCLUSION Our study shows a significant association between gene and protein expression of IDO1 and protein expression of PD-L1 in the tumor microenvironment of PCNSL, possibly of importance for prediction of response to immunotherapies.
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Affiliation(s)
- Maysaa Abdulla
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University and University Hospital, Uppsala, Sweden
| | - Andrei Alexsson
- Clinical Genomics Uppsala, Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Christer Sundström
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University and University Hospital, Uppsala, Sweden
| | - Claes Ladenvall
- Clinical Genomics Uppsala, Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Larry Mansouri
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Lindskog
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Mattias Berglund
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Lucia Cavelier
- Clinical Genomics Uppsala, Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Gunilla Enblad
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Peter Hollander
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University and University Hospital, Uppsala, Sweden
| | - Rose-Marie Amini
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University and University Hospital, Uppsala, Sweden
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The Association of Human Herpesviruses with Malignant Brain Tumor Pathology and Therapy: Two Sides of a Coin. Int J Mol Sci 2021; 22:ijms22052250. [PMID: 33668202 PMCID: PMC7956256 DOI: 10.3390/ijms22052250] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023] Open
Abstract
The role of certain viruses in malignant brain tumor development remains controversial. Experimental data demonstrate that human herpesviruses (HHVs), particularly cytomegalovirus (CMV), Epstein–Barr virus (EBV) and human herpes virus 6 (HHV-6), are implicated in brain tumor pathology, although their direct role has not yet been proven. CMV is present in most gliomas and medulloblastomas and is known to facilitate oncomodulation and/or immunomodulation, thus promoting cancer cell proliferation, invasion, apoptosis, angiogenesis, and immunosuppression. EBV and HHV-6 have also been detected in brain tumors and high-grade gliomas, showing high rates of expression and an inflammatory potential. On the other hand, due to the neurotropic nature of HHVs, novel studies have highlighted the engagement of such viruses in the development of new immunotherapeutic approaches in the context of oncolytic viral treatment and vaccine-based strategies against brain tumors. This review provides a comprehensive evaluation of recent scientific data concerning the emerging dual role of HHVs in malignant brain pathology, either as potential causative agents or as immunotherapeutic tools in the fight against these devastating diseases.
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Hajtovic S, Liu C, Diefenbach CM, Placantonakis DG. Epstein-Barr Virus-Positive Primary Central Nervous System Lymphoma in a 40-Year-Old Immunocompetent Patient. Cureus 2021; 13:e12754. [PMID: 33614348 PMCID: PMC7886623 DOI: 10.7759/cureus.12754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Epstein-Barr virus-positive (EBV+) primary central nervous system lymphoma (PCNSL) is a clinical entity rarely reported in young immunocompetent patients. Here, we present the case of a 40-year-old female with no history of immunosuppression or immunodeficiency, who presented with a ring-enhancing lesion in the right basal ganglia. The tumor generated significant vasogenic edema and mass effect, causing midline shift, symptoms of increased intracranial pressure, and rapidly progressive neurologic dysfunction. She underwent gross total resection of the tumor through a tubular retractor. Her tumor was of the diffuse large B cell lymphoma (DLBCL) subtype of PCNSL and was positive for EBV. No immunodeficiency or extracranial disease was identified. After adjuvant therapy with high-dose methotrexate, rituximab, and temozolomide, she remains disease-free two years after initial presentation. EBV+ PCNSL, although rare in young immunocompetent adults, poses unique clinical challenges and may require surgical intervention in the acute setting in some cases.
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Affiliation(s)
- Sabastian Hajtovic
- Neurosurgery, City University of New York (CUNY) School of Medicine, New York, USA
| | - Cynthia Liu
- Pathology, New York University (NYU) Grossman School of Medicine, New York, USA
| | - Catherine M Diefenbach
- Laura and Isaac Perlmutter Cancer Center, New York University (NYU) Grossman School of Medicine, New York, USA
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Alvarez R, Hall MD, Feinstein L, Gonzalez-Arias S, Odia Y. EBV-positive primary CNS lymphoma restricted to the conus medullaris in an immunocompetent host. Neurol Clin Pract 2019; 9:456-458. [DOI: 10.1212/cpj.0000000000000621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/15/2019] [Indexed: 11/15/2022]
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7
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Sugita Y, Furuta T, Ohshima K, Komaki S, Miyoshi J, Morioka M, Abe H, Nozawa T, Fujii Y, Takahashi H, Kakita A. The perivascular microenvironment in Epstein-Barr virus positive primary central nervous system lymphoma: The role of programmed cell death 1 and programmed cell death ligand 1. Neuropathology 2017; 38:125-134. [DOI: 10.1111/neup.12435] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/15/2017] [Accepted: 09/17/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Yasuo Sugita
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Takuya Furuta
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Koichi Ohshima
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Satoru Komaki
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
- Department of Neurosurgery; Kurume University School of Medicine; Kurume Japan
| | - Junko Miyoshi
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
- Department of Neurosurgery; Kurume University School of Medicine; Kurume Japan
| | - Motohiro Morioka
- Department of Neurosurgery; Kurume University School of Medicine; Kurume Japan
| | - Hideyuki Abe
- Department of Surgical Pathology; Kurume University School of Medicine; Kurume Japan
| | - Takanori Nozawa
- Department of Neurosurgery; Brain Research Institute, Niigata University; Niigata Japan
- Department of Pathology; Brain Research Institute, Niigata University; Niigata Japan
| | - Yukihiko Fujii
- Department of Neurosurgery; Brain Research Institute, Niigata University; Niigata Japan
| | - Hitoshi Takahashi
- Department of Pathology; Brain Research Institute, Niigata University; Niigata Japan
| | - Akiyoshi Kakita
- Department of Pathology; Brain Research Institute, Niigata University; Niigata Japan
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8
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Sugita Y, Muta H, Ohshima K, Morioka M, Tsukamoto Y, Takahashi H, Kakita A. Primary central nervous system lymphomas and related diseases: Pathological characteristics and discussion of the differential diagnosis. Neuropathology 2015; 36:313-24. [PMID: 26607855 DOI: 10.1111/neup.12276] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 10/19/2015] [Accepted: 10/20/2015] [Indexed: 01/15/2023]
Abstract
Although primary diffuse large B-cell lymphomas of the CNS are designated as primary CNS lymphomas according to the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissue in 2008, a variety of other lymphomas (Burkitt lymphomas, EBV-positive diffuse large B-cell lymphoma of the elderly) and related diseases (lymphomatoid granulomatosis) that are also found in the CNS have been spotlighted in recent years. The histopathology of primary CNS Burkitt lymphomas mimics that of primary diffuse large B-cell lymphomas of the CNS after steroid administration. Therefore, for correct diagnosis of the involved lymphoma, comprehensive fluorescent in situ hybridization analysis for c-MYC and BCL2 is recommended in all primary CNS lymphoma cases with aggressive clinical course, multifocal involvement of the CNS, and a high proliferation index. The pathological characteristics of primary CNS EBV-positive diffuse large B-cell lymphoma of the elderly have similarities with those of the latency phenotype III, EBV lymphoproliferative disorders that arise in the setting of immunodeficiency. These age-related lymphomas usually occur in elderly immunocompetent patients, and the incidence of this disease was estimated to range from 4.0% to 13.6% of all primary CNS lymphomas. Shorter overall survival has been reported for patients with this disease. Lymphomatoid granulomatosis (LYG) is a systemic, EBV-driven, angiocentric and angiodestructive lymphoproliferative disorder. Primary LYG that shows distinct clinicopathological features compared with systemic LYG was recently reported. Finally, this review focuses on the relationship between primary CNS lymphomas and demyelinating diseases, and the concomitant use of intraoperative cytology and frozen sections that are helpful in rapid intraoperative diagnosis.
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Affiliation(s)
- Yasuo Sugita
- Departments of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Hiroko Muta
- Departments of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Departments of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Motohiro Morioka
- Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Tsukamoto
- Department of Pathology, Brain Institute, Niigata University, Niigita, Japan
| | - Hitoshi Takahashi
- Department of Pathology, Brain Institute, Niigata University, Niigita, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Institute, Niigata University, Niigita, Japan
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9
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Neves M, Marinho-Dias J, Ribeiro J, Esteves M, Maltez E, Baldaque I, Breda E, Monteiro E, Medeiros R, Sousa H. Characterization of Epstein-Barr virus strains and LMP1-deletion variants in Portugal. J Med Virol 2015; 87:1382-8. [PMID: 25879824 DOI: 10.1002/jmv.24190] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2015] [Indexed: 11/08/2022]
Abstract
Variations in the genome sequence of Epstein-Barr Virus (EBV) are thought to lead to differential interaction with host cells, immune evasion, and transformation. The discussion regarding EBV strains as having a geographic or disease-association has been increasing and the majority of studies are performed in Asiatic populations. We developed a case-control study with 139 individuals, including 96 subjects with different malignancies and 43 healthy individuals, from the North region of Portugal. We have used PCR protocols for the characterization of EBV strains (type A or B) based on EBNA3C genome variation and for the LMP1 30bp-deletion variants (wt-LMP1 or del-LMP1). Our study showed that type A is the most prevalent in our population (100% of healthy controls, 96.9% of aHSCT patients, 90.8% of HNSCC patients, and 94.9% of NPC patients) and that type B was significantly associated with NPC (P = 0.019; RR = 8.90). Regarding the LMP1 30bp-deletion, we found a similar distribution of both wt- and del-LMP1 variants in controls and dispare results in cases: del-LMP1 was more frequent in aHSCT and HNSCC patients (64.7% and 63.2%, respectively) and wt-LMP1 in NPC patients (100%). In fact, the study reveals that wt-LPM1 was significantly associated with NPC (P < 0.001; RR = 18.4). Hence, our study showed that EBV type B and wt-LMP1 variant seem to be associated with NPC in our population, with a clear disease-association for wt-LMP1. These results contribute for the knowledge of EBV genetic diversity among Caucasian populations.
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Affiliation(s)
- Marco Neves
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Department of Biology, University of Aveiro, Campus de Santiago, Aveiro, Portugal
| | - Joana Marinho-Dias
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal
| | - Joana Ribeiro
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Faculty of Medicine of University of Porto, Porto, Portugal
| | - Marlene Esteves
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal
| | - Elsa Maltez
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal
| | - Inês Baldaque
- Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal
| | - Eduardo Breda
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Otorhinolaryngology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal
| | - Eurico Monteiro
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Otorhinolaryngology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Abel Salazar Institute for the Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal.,Research Department, Portuguese League Against Cancer (Liga Portuguesa Contra o Cancro - Núcleo Regional do Norte), Porto, Portugal
| | - Hugo Sousa
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal.,Faculty of Medicine of University of Porto, Porto, Portugal
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Kameda K, Shono T, Takagishi S, Kono S, Aoki T, Ito Y, Kamimura T, Sugita Y, Ohshima K. Epstein-Barr virus-positive diffuse large B-cell primary central nervous system lymphoma associated with organized chronic subdural hematoma: A case report and review of the literature. Pathol Int 2015; 65:138-43. [DOI: 10.1111/pin.12242] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 11/20/2014] [Indexed: 11/30/2022]
Affiliation(s)
| | - Tadahisa Shono
- Department of Neurosurgery; Harasanshin Hospital; Fukuoka Japan
| | - Soh Takagishi
- Department of Neurosurgery; Harasanshin Hospital; Fukuoka Japan
| | - Shinji Kono
- Department of Pathology; Harasanshin Hospital; Fukuoka Japan
| | - Takatoshi Aoki
- Department of Hematology; Harasanshin Hospital; Fukuoka Japan
| | - Yoshikiyo Ito
- Department of Hematology; Harasanshin Hospital; Fukuoka Japan
| | | | - Yasuo Sugita
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Koichi Ohshima
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
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11
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Wohlford EM, Asito AS, Chelimo K, Sumba PO, Baresel PC, Oot RA, Moormann AM, Rochford R. Identification of a novel variant of LMP-1 of EBV in patients with endemic Burkitt lymphoma in western Kenya. Infect Agent Cancer 2013; 8:34. [PMID: 24016332 PMCID: PMC3847075 DOI: 10.1186/1750-9378-8-34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 05/09/2013] [Indexed: 12/24/2022] Open
Abstract
Background Epstein Barr virus (EBV) is a gammaherpesvirus that is associated with nasopharyngeal carcinoma (NPC) and endemic Burkitt lymphoma (eBL). EBV carries several latent genes that contribute to oncogenesis including the latent membrane protein 1 (LMP-1), a known oncogene and constitutively active CD40 homolog. Variation in the C terminal region of LMP-1 has been linked to NPC pathogenesis, but little is known regarding LMP-1 variation and eBL. Results In the present study, peripheral blood samples were obtained from 38 eBL patients and 22 healthy controls in western Kenya, where the disease is endemic. The LMP-1 C-terminal region from these samples was sequenced and analyzed. The frequency of a 30 base pair deletion of LMP-1 previously linked to NPC was not associated with eBL compared to healthy controls. However a novel LMP-1 variant was identified, called K for Kenya and for the G318K mutation that characterizes it. The K variant LMP-1 was found in 40.5% of eBL sequences and 25.0% of healthy controls. All K variant sequences contained mutations in both of the previously described minimal T cell epitopes in the C terminal end of LMP-1. These mutations occurred in the anchor residue at the C-terminal binding groove of both epitopes, a pocket necessary for MHC loading. Conclusions Overall, our results suggest that there is a novel K variant of LMP-1 in Kenya that may be associated with eBL. Further studies are necessary to determine the functional implications of the LMP-1 variant on early events in eBL genesis.
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Affiliation(s)
- Eric M Wohlford
- Center for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
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12
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Ruf S, Wagner HJ. Determining EBV load: current best practice and future requirements. Expert Rev Clin Immunol 2013; 9:139-51. [PMID: 23390945 DOI: 10.1586/eci.12.111] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
EBV, a gammaherpesvirus and the pathogenic agent for infectious mononucleosis, is also associated with a broad spectrum of lymphoid and epithelial malignancies in immunocompetent and immunosuppressed individuals. EBV-DNA-load measurement by PCR has been shown to be a potential tool for the diagnosis of these diseases, a prognostic factor of their outcome and a successful method to monitor immunosuppressed patients. Since the end of 2011, there is an international WHO standard reference for EBV quantification available; however, many questions still remain; for instance about the optimal amplified region of the EBV genome, or the best-used specimen for EBV detection. Additionally, the optimal specimen and amplified region may vary in different malignancies. In this article, the authors review the different methods to measure EBV load, focus on the best-used specimen for the different EBV-associated malignancies and discuss future requirements and opportunities for EBV-load measurement.
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Affiliation(s)
- Stephanie Ruf
- Department of Pediatric Hematology and Oncology, University Hospital of Giessen, Germany
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13
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Lee HY, Kim HS, Park JW, Baek HJ, Kim SJ, Choi CG. Atypical imaging features of Epstein-Barr virus-positive primary central nervous system lymphomas in patients without AIDS. AJNR Am J Neuroradiol 2013; 34:1562-7. [PMID: 23413244 DOI: 10.3174/ajnr.a3429] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Recent clinical experience with EBV-positive PCNSL in patients without acquired immune deficiency syndrome showed that they tended to have atypical features seen on conventional MR imaging. The purpose of our study was to evaluate the MR imaging features of EBV-positive PCNSL in patients without AIDS and to compare these imaging findings with those of EBV-negative PCNSL. MATERIALS AND METHODS MR images were obtained in 55 consecutive patients with pathologically proved EBV-positive (n = 10) or EBV-negative (n = 45) PCNSL. We statistically analyzed the differences between the patient groups regarding the occurrence of tumor necrosis or hemorrhage and ADC, rCBVmax, rCBVr, and the Cho/NAA ratio in the tumor area. RESULTS Tumor necrosis and hemorrhage were observed in 9 (90%) and 7 (70%), respectively, of the patients with EBV-positive PCNSL; necrosis was observed in 8 (18%), and hemorrhage, in 3 (7%) patients with EBV-negative PCNSL (P < .0001 each). The necrotic core was hyperintense relative to contralateral white matter, as seen on DWI in 4 patients with EBV-positive PCNSL, though the ADC between the 2 patient groups did not differ significantly. rCBVmax, rCBVr, and the Cho/NAA ratios did not differ significantly between the 2 groups. The sensitivity and specificity of necrosis and hemorrhage for differentiating the 2 groups were 89.2% and 81.7% and 78.5% and 94.1%, respectively. CONCLUSIONS Our initial clinical experience with a small number of patients suggests that EBV-positive PCNSL in patients without AIDS tends to present with atypical MR imaging features.
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Affiliation(s)
- H Y Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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14
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Bibliography. Lymphoma. Current world literature. Curr Opin Oncol 2011; 23:537-41. [PMID: 21836468 DOI: 10.1097/cco.0b013e32834b18ec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Sugita Y, Niino D, Ohshima K, Toda K, Baba H, Ito M. Left cerebellar hemispheric tumor in an 80-year-old man. Neuropathology 2011; 31:556-9. [PMID: 21615519 DOI: 10.1111/j.1440-1789.2011.01228.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Yasuo Sugita
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan.
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Utsuki S, Oka H, Miyajima Y, Kijima C, Yasui Y, Fujii K. Epstein–Barr virus (EBV)-associated primary central nervous system lymphoma: is incidence of EBV expression associated with median survival time? Brain Tumor Pathol 2011; 28:145-9. [DOI: 10.1007/s10014-011-0020-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Accepted: 01/12/2011] [Indexed: 11/28/2022]
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van Krieken JH. New developments in the pathology of malignant lymphoma: a review of the literature published from April 2010–July 2010. J Hematop 2010. [DOI: 10.1007/s12308-010-0069-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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