Aspects of the EB virus

The Role of Herpes Viruses in Pulmonary Fibrosis

Pulmonary fibrosis (PF) is a serious lung disease which can result from known genetic or environmental exposures but is more commonly idiopathic (IPF). In familial PF (FPF), the majority of identified causal genes play key roles in the maintenance of telomeres, the protective end structures of chromosomes. Recent evidence suggests that short telomeres may also be implicated causally in a significant proportion of idiopathic cases. The possible involvement of herpes viruses in PF disease incidence and progression has been examined for many years, with some studies showing strong, statistically significant associations and others reporting no involvement. Evidence is thus polarized and remains inconclusive. Here we review the reported involvement of herpes viruses in PF in both animals and humans and present a summary of the evidence to date. We also present several possible mechanisms of action of the different herpes viruses in PF pathogenesis, including potential contributions to telomere attrition and cellular senescence. Evidence for antiviral treatment in PF is very limited but suggests a potential benefit. Further work is required to definitely answer the question of whether herpes viruses impact PF disease onset and progression and to enable the possible use of targeted antiviral treatments to improve clinical outcomes.

New aspects in clinicopathologic and oncogene studies of 23 pulmonary lymphoepithelioma-like carcinomas

Lymphoepithelioma-like carcinoma, an uncommon epithelial tumor, has been described as being closely associated with Epstein-Barr virus (EBV) infection in many organs, especially the nasopharynx. We experienced 23 cases of lymphoepithelioma-like carcinoma arising in the lung from 2498 lung cancer patients in the Cancer Registry of our hospital. Seven patients were male and 16 were female. All patients were Chinese. Their ages ranged from 42 to 80 years. Six patients were smokers and 17 were nonsmokers. The tumor sizes ranged from 1.2 to 11.0 cm. All tumors showed the typical syncytial growth pattern of undifferentiated epithelial cells with a significant CD8+ T-lymphocyte reaction. EBV serology revealed prior infection in all 15 serum-available patients, all of whom were also found by in situ hybridization to have the virus genome. In addition, the higher the EBV serology titer, the larger the tumor size and the higher the staging would be. EBV viral capsid antigen IgG level remained elevated despite response to therapy. Nearly all cases had bcl-2 oncoprotein expression, but the detection rate of latent membrane protein-1, p53, and c-erb B-2 expression was extremely low. The encouraging chemotherapy response for advanced stage disease is also discussed.

Complete characterization of the gene coding for the Epstein-Barr virus major membrane antigen gp 220/340 and selective expression of a secreted form of gp 220

The gene which encodes the Epstein-Barr gp 220/340 was inserted into a eukaryotic expression vector. A cDNA clone corresponding to the mature mRNA coding for gp 220 was isolated from an Epstein-Barr virus cDNA library and inserted in the same expression vector, enabling us to identify the precise location of the intron within the gp 220/340 coding sequence. The recombinant plasmids direct the expression of membrane proteins detected by immunofluorescence experiments using an anti-gp 220/340 monoclonal antibody in transfected human cells. The region of the gp 220/340 gene encoding the domain for membrane anchorage was removed from the two recombinant plasmids and the sequence containing the intron produced secreted forms of both truncated gp 220 and gp 340 whereas only the former was obtained with the intronless sequence.

Association of the Epstein-Barr virus with lymphoepithelioma of the thymus

A 30-year-old woman with the histologic diagnosis of lymphoepithelioma of the thymus is reported on. Investigation of Epstein-Barr serology showed evidence of infection, and Southern blot analysis showed the presence of the viral genome in the tumor specimen. The patient achieved complete remission after treatment with combination chemotherapy, autologous bone marrow transplant, and radiotherapy. These findings suggest that lymphoepithelioma of the thymus may have a viral pathogenesis similar to that of nasopharyngeal carcinoma.

Immortalization of monkey epithelial cells by specific fragments of Epstein-Barr virus DNA

Epstein-Barr virus (EBV) is unique among the DNA tumour viruses by virtue of its association with two human malignancies, Burkitt's lymphoma and nasopharyngeal carcinoma (NPC), the former a tumour of B lymphocytes and the latter encompassing low-differentiated epithelial cells of the nasopharynx. A viral gene product has not been definitively linked to these malignant diseases, although an EBV nuclear antigen(s) (EBNA) seems to be ubiquitous in EBV-infected cells; indeed, the detection of EBNA by immunofluorescence is often taken as an indication of the presence of the viral genome. As part of a study to investigate which part of the EBV genome is responsible for transformation and whether the same mechanism of cellular transformation is involved in the case of B lymphocytes and epithelial cells, we have tried to establish whether a detectable cellular alteration(s) can be induced in primate epithelial cells by the presence of a specific region of the EBV genome. We report here that it can--the result is immortalization of the cells.

Elevated levels of collagenase and prostaglandin E2 from synovium associated with erosion of cartilage and bone in a patient with chronic Lyme arthritis

A patient with chronic Lyme arthritis and roentgenographic evidence of bony erosion underwent a synovectomy; proliferative synovium (pannus), containing aggregates of small lymphocytes, was found adherent to eroded cartilage and bone. During 8 days in tissue culture, the synovial cells produced large amounts of collagenase and prostaglandin E2, but only low levels of both neutral and acid proteinases. Sixty-seven percent of the lymphocytes from the synovium were T cells; 19% were B cells. Attempts to identify agent/antigen in the synovial cells were unsuccessful. Thus, the synovium of this patient, whose disease appears to be tick-transmitted, resembles that of rheumatoid arthritis. This finding further supports the hypothesis that many possible agents, including infectious ones, trigger a common pathway in synovium, which leads to joint destruction.

Venereal factors in human cervical cancer: evidence from marital clusters

All Caucasian women in a large Eastern city who developed pathologically confirmed cervical cancer between 1950 and 1969 are being prospectively followed in an epidemiological test of the venereal hypothesis of cervical carcinogenesis. We are attempting to identify all men who were married to these probands at any time prior to the date of their cancer diagnosis. The ultimate objective is the identification of all the other wives of the proband husbands in order that their risk of cervical cancer be assessed. A random sample of control wives similar to the other wives in age, race, date and place of marriage as well as prior marital status is also being followed. To date, a total of 1,087 other wives and 659 control wives has been fully traced. Cervical cancer or carcinoma in situ was detected in 29 (2.7%) of the other wives and in seven (1.1%) of the control wives. A total of 14.0% of the other wives had either cervical cancer or a cervical cytological specimen which was other than normal. The corresponding statistic for the control wives was 8.0%. These differences in the prevalence of cervical cancer and of non-normal cervical cytology are statistically significant. In the course of this investigation so far, we have identified 29 "marital clusters" of cervical cancer in which two women married to the same man have all developed cervical neoplasms. The observed number of 29 clusters may be compared with an expected number of 11.6. This investigation, as yet incomplete, offers confirmatory evidence of the possible role of venereal factors in the pathogenesis of human cervical neoplasia. While the genital herpesvirus is the likeliest candidate, other venereal elements might also be involved.

Coeliac disease, gluten-free diet, and malignancy

Two hundred and two patients with coeliac disease or idiopathic steatorrhoea previously reported from this unit have been reviewed after a further 10 years of follow-up. Of 20 more deaths, 10 were due to malignancy. A separate study was made of all patients with histologically confirmed coeliac disease seen to the end of 1972 and followed up to the end of 1974. Twenty-one of the 43 deaths in this series were due to malignant tumours, of which 13 were reticulum cell sarcomas. There was no evidence that patients showing sub-optimal clinical response to gluten withdrawal or persisting falt jejunal biopsies were more prone to die of cancer. A gluten-free diet did not appear to be effective in preventing malignant complications, but a longer follow-up of patients will be necessary to provide a final answer to this question.

Malignant lymphoma resembling Burkitt's tumour in rhesus monkeys: (light- and electron microscopic studies)

Spontaneous tumours of the haematopoetic system have been only rarely observed in nonhuman primates. We had the opportunity to carry out light and electron microscopic investigations of three lymphomas in immature rhesus monkeys from our colony. All animals had tumours of both retroperitoneum and lymph nodes. The relatively uniform lymphoblastic or lymphoreticular tumour cells as well as the massive occurence of the so-called "starry sky macrophages" were histologically characteristic. Histochemically, the marked pyroninophilia of these tumour cells was evident. The electron nicroscopy revealed the tumour cells as lymphoblasts of about 8 mu diameter with the following features: round or oval, occasionally deeply indented cell nuclei with relatively clear interchromatinic substance; mostly well developed nucleoli; sparsely, rough endoplasmatic reticulum; large numbers of free ribosomes and polyribosomes; a few large, bizzarre mitochondria, often situated at one pole; lipid vacuoles in some cells. These histological, cytological and electron microscopic characteristics correspond to those of the human Burkitt's Lymphoma. This tumour is classified as an undifferentiated malignant lymphoma. Tumours of this type are of particular interest on comparative and epidemiological reasons in light of the existence of morphologically similar experimental, virus induced lymphomas in monkeys.

Phosphorylation of 5-bromodeoxycytidine in cells infected with herpes simplex virus

5-Bromodeoxycytidine is phosphorylated to 5-bromodeoxycytidine 5'-monophosphate in extracts of cells infected with herpes simplex virus but not in extracts of uninfected cells. The conversion of 5-bromodeoxycytidine to nucleotides and its utilization for DNA synthesis in uninfected cells occurs by deamination of 5-bromodeoxycytidine to 5-bromodeoxyuridine followed by phosphorylation of 5-bromodeoxyuridine to 5-bromodeoxyuridine 5'-monophosphate. In contrast, in cells infected with herpes simplex virus, 5-bromodeoxycytidine is phosphorylated directly to 5-bromodeoxycytidine 5'-monophosphate, which can then be deaminated to 5-bromodeoxyuridine 5'-monophosphate and incorporated into DNA. These results indicate a difference in the substrate specificity of nucleoside kinases induced by herpes simplex virus and the enzymes present in uninfected cells. It is suggested that this difference in substrate specificity between virus-induced and host-cell enzymes may allow selective chemotherapy of herpes simplex infections with 5-bromo- or 5-iododeoxycytidine.

Epstein-Barr virus antibody in cases and contacts of infectious mononucleosis; a family study

Serological investigations were carried out on 147 patients with Paul-Bunnell positive infectious mononucleosis (IM) from the general population. All possessed antibody to the Epstein-Barr virus (EBV) and 63% showed serological evidence of recent infection. Contacts of 132 patients, 306 in all, were followed serologically; within 6 months of the index cases' illness twenty one contacts developed evidence of EBV infection or re-infection and of these five developed overt IM. The secondary attack rate of EBV infection among susceptible contacts was at least 19%; the corresponding figure for clinically apparent IM was 6%. EBV antibody prevalence among patients' siblings was significantly lower than among age-matched controls, suggesting that cases of IM come from families with a lower than normal previous experience of the virus. Of thirteen patients with persistently Paul-Bunnell negative ;glandular fever' four had serological evidence of recent EBV infection and two had probable cytomegalovirus mononucleosis. Recent EBV infection may have been associated with the illnesses of five of the remaining patients.