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Lurain KA, Ramaswami R, Krug LT, Whitby D, Ziegelbauer JM, Wang HW, Yarchoan R. HIV-associated cancers and lymphoproliferative disorders caused by Kaposi sarcoma herpesvirus and Epstein-Barr virus. Clin Microbiol Rev 2024:e0002223. [PMID: 38899877 DOI: 10.1128/cmr.00022-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
SUMMARYWithin weeks of the first report of acquired immunodeficiency syndrome (AIDS) in 1981, it was observed that these patients often had Kaposi sarcoma (KS), a hitherto rarely seen skin tumor in the USA. It soon became apparent that AIDS was also associated with an increased incidence of high-grade lymphomas caused by Epstein-Barr virus (EBV). The association of AIDS with KS remained a mystery for more than a decade until Kaposi sarcoma-associated herpesvirus (KSHV) was discovered and found to be the cause of KS. KSHV was subsequently found to cause several other diseases associated with AIDS and human immunodeficiency virus (HIV) infection. People living with HIV/AIDS continue to have an increased incidence of certain cancers, and many of these cancers are caused by EBV and/or KSHV. In this review, we discuss the epidemiology, virology, pathogenesis, clinical manifestations, and treatment of cancers caused by EBV and KSHV in persons living with HIV.
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Affiliation(s)
- Kathryn A Lurain
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Ramya Ramaswami
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Laurie T Krug
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Joseph M Ziegelbauer
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
| | - Hao-Wei Wang
- Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA
| | - Robert Yarchoan
- The HIV and AIDS Malignancy Branch, Center for Cancer Research, Bethesda, Maryland, USA
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Hong HG, Gouveia MH, Ogwang MD, Kerchan P, Reynolds SJ, Tenge CN, Were PA, Kuremu RT, Wekesa WN, Masalu N, Kawira E, Kinyera T, Wang X, Zhou J, Leal TP, Otim I, Legason ID, Nabalende H, Dhudha H, Mumia M, Baker FS, Okusolubo T, Ayers LW, Bhatia K, Goedert JJ, Woo J, Manning M, Cole N, Luo W, Hicks B, Chagaluka G, Johnston WT, Mutalima N, Borgstein E, Liomba GN, Kamiza S, Mkandawire N, Mitambo C, Molyneux EM, Newton R, Hutchinson A, Yeager M, Adeyemo AA, Thein SL, Rotimi CN, Chanock SJ, Prokunina-Olsson L, Mbulaiteye SM. Sickle cell allele HBB-rs334(T) is associated with decreased risk of childhood Burkitt lymphoma in East Africa. Am J Hematol 2024; 99:113-123. [PMID: 38009642 PMCID: PMC10872868 DOI: 10.1002/ajh.27149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/30/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
Burkitt lymphoma (BL) is an aggressive B-cell lymphoma that significantly contributes to childhood cancer burden in sub-Saharan Africa. Plasmodium falciparum, which causes malaria, is geographically associated with BL, but the evidence remains insufficient for causal inference. Inference could be strengthened by demonstrating that mendelian genes known to protect against malaria-such as the sickle cell trait variant, HBB-rs334(T)-also protect against BL. We investigated this hypothesis among 800 BL cases and 3845 controls in four East African countries using genome-scan data to detect polymorphisms in 22 genes known to affect malaria risk. We fit generalized linear mixed models to estimate odds ratios (OR) and 95% confidence intervals (95% CI), controlling for age, sex, country, and ancestry. The ORs of the loci with BL and P. falciparum infection among controls were correlated (Spearman's ρ = 0.37, p = .039). HBB-rs334(T) was associated with lower P. falciparum infection risk among controls (OR = 0.752, 95% CI 0.628-0.9; p = .00189) and BL risk (OR = 0.687, 95% CI 0.533-0.885; p = .0037). ABO-rs8176703(T) was associated with decreased risk of BL (OR = 0.591, 95% CI 0.379-0.992; p = .00271), but not of P. falciparum infection. Our results increase support for the etiological correlation between P. falciparum and BL risk.
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Affiliation(s)
- Hyokyoung G. Hong
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Mateus H. Gouveia
- Center for Research on Genomics & Global Health, NHGRI, National Institutes of Health, Bethesda, MD, USA
| | - Martin D. Ogwang
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu, Uganda
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Patrick Kerchan
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Kuluva Hospital, Arua, Uganda
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Pamela A. Were
- EMBLEM Study, Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Robert T. Kuremu
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
| | - Walter N. Wekesa
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
| | | | - Esther Kawira
- EMBLEM Study, Shirati Health, Education, and Development Foundation, Shirati, Tanzania
| | - Tobias Kinyera
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu, Uganda
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Xunde Wang
- Sickle Cell Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USAs
| | - Jiefu Zhou
- Department of Statistics and Probability, Michigan State University, MI, USA
| | - Thiago Peixoto Leal
- Lerner Research Institute, Genomic Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Isaac Otim
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu, Uganda
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Ismail D. Legason
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Kuluva Hospital, Arua, Uganda
| | - Hadijah Nabalende
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu, Uganda
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Herry Dhudha
- EMBLEM Study, Bugando Medical Center, Mwanza, Tanzania
| | - Mediatrix Mumia
- EMBLEM Study, Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Francine S. Baker
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Temiloluwa Okusolubo
- Sickle Cell Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USAs
| | - Leona W. Ayers
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Kishor Bhatia
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - James J Goedert
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Joshua Woo
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Michelle Manning
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Nathan Cole
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Wen Luo
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Belynda Hicks
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - George Chagaluka
- Departments of Pediatrics and Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
| | - W Thomas Johnston
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Nora Mutalima
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Eric Borgstein
- Departments of Pediatrics and Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
| | - George N. Liomba
- Departments of Pediatrics and Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Steve Kamiza
- Departments of Pediatrics and Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Nyengo Mkandawire
- Departments of Pediatrics and Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
| | | | - Elizabeth M. Molyneux
- Departments of Pediatrics and Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Robert Newton
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Amy Hutchinson
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Meredith Yeager
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Adebowale A. Adeyemo
- Center for Research on Genomics & Global Health, NHGRI, National Institutes of Health, Bethesda, MD, USA
| | - Swee Lay Thein
- Sickle Cell Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USAs
| | - Charles N. Rotimi
- Center for Research on Genomics & Global Health, NHGRI, National Institutes of Health, Bethesda, MD, USA
| | - Stephen J. Chanock
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Ludmila Prokunina-Olsson
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
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Singh A, Obiorah IE. Aggressive non-Hodgkin lymphoma in the pediatric and young adult population; diagnostic and molecular pearls of wisdom. Semin Diagn Pathol 2023; 40:392-400. [PMID: 37400280 DOI: 10.1053/j.semdp.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
Mature non-Hodgkin lymphomas (NHLs) of the pediatric and young adults(PYA), including Burkitt lymphoma (BL), diffuse large B cell lymphoma (DLBCL), high-grade B cell lymphoma (HGBCL), primary mediastinal large B cell lymphoma (PMBL) and anaplastic large cell lymphoma (ALCL), generally have excellent prognosis compared to the adult population. BL, DLBCL and HGBCL are usually of germinal center (GCB) origin in the PYA population. PMBL neither belongs to the GCB nor the activated B cell subtype and is associated with a poorer outcome than BL or DLBCL of comparable stage. Anaplastic large cell lymphoma is the most frequent peripheral T cell lymphoma occurring in the PYA and accounts for 10-15% of childhood NHL. Most pediatric ALCL, unlike in the adult, demonstrate expression of anaplastic lymphoma kinase (ALK). In recent years, the understanding of the biology and molecular features of these aggressive lymphomas has increased tremendously. This has led to reclassification of newer PYA entities including Burkitt-like lymphoma with 11q aberration. In this review, we will discuss the current progress discovered in frequently encountered aggressive NHLs in the PYA, highlighting the clinical, pathologic and molecular features that aid in the diagnosis of these aggressive lymphomas. We will be updating the new concepts and terminologies used in the new classification systems.
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Affiliation(s)
- Amrit Singh
- Department of Pathology , University of Virginia Health, Charlottesville, VA, 22903, United States
| | - Ifeyinwa E Obiorah
- Department of Pathology , University of Virginia Health, Charlottesville, VA, 22903, United States.
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4
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Al-Khreisat MJ, Ismail NH, Tabnjh A, Hussain FA, Mohamed Yusoff AA, Johan MF, Islam MA. Worldwide Prevalence of Epstein-Barr Virus in Patients with Burkitt Lymphoma: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2023; 13:2068. [PMID: 37370963 DOI: 10.3390/diagnostics13122068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/28/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Burkitt lymphoma (BL) is a form of B-cell malignancy that progresses aggressively and is most often seen in children. While Epstein-Barr virus (EBV) is a double-stranded DNA virus that has been linked to a variety of cancers, it can transform B lymphocytes into immortalized cells, as shown in BL. Therefore, the estimated prevalence of EBV in a population may assist in the prediction of whether this population has a high risk of increased BL cases. This systematic review and meta-analysis aimed to estimate the prevalence of Epstein-Barr virus in patients with Burkitt lymphoma. Using the appropriate keywords, four electronic databases were searched. The quality of the included studies was assessed using the Joanna Briggs Institute's critical appraisal tool. The results were reported as percentages with a 95% confidence interval using a random-effects model (CI). PROSPERO was used to register the protocol (CRD42022372293), and 135 studies were included. The prevalence of Epstein-Barr virus in patients with Burkitt lymphoma was 57.5% (95% CI: 51.5 to 63.4, n = 4837). The sensitivity analyses demonstrated consistent results, and 65.2% of studies were of high quality. Egger's test revealed that there was a significant publication bias. EBV was found in a significantly high proportion of BL patients (more than 50% of BL patients). This study recommends EBV testing as an alternative for predictions and the assessment of the clinical disease status of BL.
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Affiliation(s)
- Mutaz Jamal Al-Khreisat
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Nor Hayati Ismail
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Abedelmalek Tabnjh
- Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Faezahtul Arbaeyah Hussain
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Abdul Aziz Mohamed Yusoff
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Muhammad Farid Johan
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Md Asiful Islam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
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5
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Herpesviruses, polyomaviruses, parvoviruses, papillomaviruses, and anelloviruses in vestibular schwannoma. J Neurovirol 2023; 29:226-231. [PMID: 36857017 DOI: 10.1007/s13365-023-01112-8] [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: 08/24/2022] [Revised: 12/14/2022] [Accepted: 01/02/2023] [Indexed: 03/02/2023]
Abstract
Etiology of vestibular schwannoma (VS) is unknown. Viruses can infect and reside in neural tissues for decades, and new viruses with unknown tumorigenic potential have been discovered. The presence of herpesvirus, polyomavirus, parvovirus, and anellovirus DNA was analyzed by quantitative PCR in 46 formalin-fixed paraffin-embedded VS samples. Five samples were analyzed by targeted next-generation sequencing. Viral DNA was detected altogether in 24/46 (52%) tumor samples, mostly representing anelloviruses (46%). Our findings show frequent persistence of anelloviruses, considered normal virome, in VS. None of the other viruses showed an extensive presence, thereby suggesting insignificant role in VS.
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López C, Burkhardt B, Chan JKC, Leoncini L, Mbulaiteye SM, Ogwang MD, Orem J, Rochford R, Roschewski M, Siebert R. Burkitt lymphoma. Nat Rev Dis Primers 2022; 8:78. [PMID: 36522349 DOI: 10.1038/s41572-022-00404-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 12/16/2022]
Abstract
Burkitt lymphoma (BL) is an aggressive form of B cell lymphoma that can affect children and adults. The study of BL led to the identification of the first recurrent chromosomal aberration in lymphoma, t(8;14)(q24;q32), and subsequent discovery of the central role of MYC and Epstein-Barr virus (EBV) in tumorigenesis. Most patients with BL are cured with chemotherapy but those with relapsed or refractory disease usually die of lymphoma. Historically, endemic BL, non-endemic sporadic BL and the immunodeficiency-associated BL have been recognized, but differentiation of these epidemiological variants is confounded by the frequency of EBV positivity. Subtyping into EBV+ and EBV- BL might better describe the biological heterogeneity of the disease. Phenotypically resembling germinal centre B cells, all types of BL are characterized by dysregulation of MYC due to enhancer activation via juxtaposition with one of the three immunoglobulin loci. Additional molecular changes commonly affect B cell receptor and sphingosine-1-phosphate signalling, proliferation, survival and SWI-SNF chromatin remodelling. BL is diagnosed on the basis of morphology and high expression of MYC. BL can be effectively treated in children and adolescents with short durations of high dose-intensity multiagent chemotherapy regimens. Adults are more susceptible to toxic effects but are effectively treated with chemotherapy, including modified versions of paediatric regimens. The outcomes in patients with BL are good in high-income countries with low mortality and few late effects, but in low-income and middle-income countries, BL is diagnosed late and is usually treated with less-effective regimens affecting the overall good outcomes in patients with this lymphoma.
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Affiliation(s)
- Cristina López
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Birgit Burkhardt
- Non-Hodgkin's Lymphoma Berlin-Frankfurt-Münster (NHL-BFM) Study Center and Paediatric Hematology, Oncology and BMT, University Hospital Muenster, Muenster, Germany
| | - John K C Chan
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Lorenzo Leoncini
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | | | | | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mark Roschewski
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Reiner Siebert
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany.
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7
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Herpesvirus ubiquitin deconjugases. Semin Cell Dev Biol 2022; 132:185-192. [PMID: 34776333 DOI: 10.1016/j.semcdb.2021.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/15/2022]
Abstract
The covalent attachment of ubiquitin and ubiquitin-like polypeptides to cellular and viral proteins regulates numerous processes that enable virus infection, viral genome replication, and the spread of viruses to new hosts. The importance of these protein modifications in the regulation of the life cycle of herpesviruses is underscored by the discovery that all known members of this virus family encode at least one protease that specifically recognizes and disassembles ubiquitin conjugates. The structural and functional characterization of the viral enzymes and the identification of their viral and cellular substrates is providing valuable insights into the biology of viral infection and increasing evidence suggests that the viral deconjugases may also play a role in malignant transformation.
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Muacevic A, Adler JR, Sayed S, Siyal T, Das T. An Acute Presentation of Epstein-Barr Virus (EBV) Infection in an Immunocompromised Gentleman. Cureus 2022; 14:e33036. [PMID: 36721558 PMCID: PMC9881071 DOI: 10.7759/cureus.33036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
Epstein-Barr virus (EBV) is a relevant cause of many clinical manifestations with a range of malignant and non-malignant presentations. This is particularly important to consider in immunosuppressed individuals. We present a case of a 36-year-old individual with ulcerative colitis who was in remission whilst taking mercaptopurine. The patient presented with weight loss, night sweats, and significant laboratory serum abnormalities on monitoring. Relevant investigations into his presentation ruled out a malignant feature, but his serology confirmed infection with EBV with the spread of infection to the liver and bone marrow. Overall, we identify a notable yet relevant clinical expression of EBV infection in the context of an immunosuppressed individual.
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Ward BJH, Schaal DL, Nkadi EH, Scott RS. EBV Association with Lymphomas and Carcinomas in the Oral Compartment. Viruses 2022; 14:v14122700. [PMID: 36560704 PMCID: PMC9783324 DOI: 10.3390/v14122700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Epstein-Barr virus (EBV) is an oncogenic human herpesvirus infecting approximately 90% of the world's population. The oral cavity serves a central role in the life cycle, transmission, and pathogenesis of EBV. Transmitted to a new host via saliva, EBV circulates between cellular compartments within oral lymphoid tissues. Epithelial cells primarily support productive viral replication, while B lymphocytes support viral latency and reactivation. EBV infections are typically asymptomatic and benign; however, the latent virus is associated with multiple lymphomas and carcinomas arising in the oral cavity. EBV association with cancer is complex as histologically similar cancers often test negative for the virus. However, the presence of EBV is associated with distinct features in certain cancers. The intrinsic ability of EBV to immortalize B-lymphocytes, via manipulation of survival and growth signaling, further implicates the virus as an oncogenic cofactor. A distinct mutational profile and burden have been observed in EBV-positive compared to EBV-negative tumors, suggesting that viral infection can drive alternative pathways that converge on oncogenesis. Taken together, EBV is also an important prognostic biomarker that can direct alternative therapeutic approaches. Here, we discuss the prevalence of EBV in oral malignancies and the EBV-dependent mechanisms associated with tumorigenesis.
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Affiliation(s)
- Mark Roschewski
- From the Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Louis M Staudt
- From the Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Wyndham H Wilson
- From the Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
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Farzanehpour M, Fard AM, Ghaleh HE. A brief overview of the Epstein Barr virus and its association with Burkitt's lymphoma. ROMANIAN JOURNAL OF MILITARY MEDICINE 2022. [DOI: 10.55453/rjmm.2022.125.3.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Epstein Barr virus (EBV) is known as an oncovirus and associates with several human malignancies such as Burkitt's lymphoma, other non-Hodgkin lymphomas, nasopharyngeal carcinoma, Hodgkin's disease, gastric adenocarcinoma, etc. in Burkitt's lymphoma, and the key event is the translocation of MYC gene, that increase of cell survival and aberrant expression of MYC gene. The biology of EBV and its function in the development of Burkitt's lymphoma are discussed in this review
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12
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Srichawla BS. Sporadic Burkitt Lymphoma of the Thoracic and Lumbar Spinal Canal in an Adult: Oncogenicity and a Literature Review. Cureus 2022; 14:e26860. [PMID: 35978743 PMCID: PMC9375639 DOI: 10.7759/cureus.26860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
Burkitt lymphoma (BL) is an aggressive form of lymphoma that occurs due to translocation of the c-myc proto-oncogene on chromosome 8. BL is characterized by three distinct groups: African/endemic variant, immunosuppressive variant, or sporadic variant. Most cases of the sporadic variant occur in patients less than 40 years of age with a median age of 30 at diagnosis and are primarily seen in Caucasians. An immunocompetent 69-year-old male presented with subacute onset weakness in the lower extremities. Magnetic resonance imaging (MRI) of the lumbar spine revealed a mass in the right paraspinal musculature with epidural extension, neural foraminal narrowing, and severe spinal canal stenosis in L2-L5. MRI of the thoracic spine revealed significant T5-T6 cord compression due to metastatic masses. Further diagnostic imaging revealed diffuse lymphadenopathy within the mediastinum and abdomen. Subsequently, the patient underwent a core needle biopsy of the left axillary lymph node, which revealed cluster of differentiation 20 and 10 (CD20 and CD10), c-myc, and B-cell lymphoma 6 (Bcl-6) positive lymphoid cells. A diagnosis of BL was made. The patient was treated with oral steroids and received one round of radiation therapy. The patient opted to forgo any antitumor treatment and was discharged to hospice. Primary lymphomas of the central nervous system (CNS) account for <5% of all CNS tumors. Approximately 5-10% of CNS lymphomas are recorded as BL, with the majority classified as high-grade B-cell lymphomas. Paraspinal involvement with BL is rare and not commonly seen in the sporadic variant.
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Manet E, Gruffat H. [Epstein-Barr virus: A key player in the development of multiple sclerosis]. Med Sci (Paris) 2022; 38:422-424. [PMID: 35608462 DOI: 10.1051/medsci/2022051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Evelyne Manet
- Centre international de recherche en infectiologie (CIRI), équipe Expression de l'ARN chez les virus et les eucaryotes, Inserm U1111, CNRS UMR5308, Université de Lyon, École normale supérieure de Lyon, Lyon, France
| | - Henri Gruffat
- Centre international de recherche en infectiologie (CIRI), équipe Expression de l'ARN chez les virus et les eucaryotes, Inserm U1111, CNRS UMR5308, Université de Lyon, École normale supérieure de Lyon, Lyon, France
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Liao HM, Liu H, Chin PJ, Li B, Hung GC, Tsai S, Otim I, Legason ID, Ogwang MD, Reynolds SJ, Kerchan P, Tenge CN, Were PA, Kuremu RT, Wekesa WN, Masalu N, Kawira E, Ayers LW, Pfeiffer RM, Bhatia K, Goedert JJ, Lo SC, Mbulaiteye SM. Epstein-Barr Virus in Burkitt Lymphoma in Africa Reveals a Limited Set of Whole Genome and LMP-1 Sequence Patterns: Analysis of Archival Datasets and Field Samples From Uganda, Tanzania, and Kenya. Front Oncol 2022; 12:812224. [PMID: 35340265 PMCID: PMC8948429 DOI: 10.3389/fonc.2022.812224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
Epstein-Barr virus (EBV) is associated with endemic Burkitt lymphoma (eBL), but the contribution of EBV variants is ill-defined. Studies of EBV whole genome sequences (WGS) have identified phylogroups that appear to be distinct for Asian versus non-Asian EBV, but samples from BL or Africa, where EBV was first discovered, are under-represented. We conducted a phylogenetic analysis of EBV WGS and LMP-1 sequences obtained primarily from BL patients in Africa and representative non-African EBV from other conditions or regions using data from GenBank, Sequence Read Archive, or Genomic Data Commons for the Burkitt Lymphoma Genome Sequencing Project (BLGSP) to generate data to support the use of a simpler biomarker of geographic or phenotypic associations. We also investigated LMP-1 patterns in 414 eBL cases and 414 geographically matched controls in the Epidemiology of Burkitt Lymphoma in East African children and minors (EMBLEM) study using LMP-1 PCR and Sanger sequencing. Phylogenetic analysis revealed distinct genetic patterns of African versus Asian EBV sequences. We identified 281 single nucleotide variations (SNVs) in LMP-1 promoter and coding region, which formed 12 unique patterns (A to L). Nine patterns (A, AB, C, D, F, I, J, K and L) predominated in African EBV, of which four were found in 92% of BL samples (A, AB, D, and H). Predominant patterns were B and G in Asia and H in Europe. EBV positivity in peripheral blood was detected in 95.6% of EMBLEM eBL cases versus 79.2% of the healthy controls (odds ratio [OR] =3.83; 95% confidence interval 2.06-7.14). LMP-1 was successfully sequenced in 66.7% of the EBV DNA positive cases but in 29.6% of the controls (ORs ranging 5-11 for different patterns). Four LMP-1 patterns (A, AB, D, and K) were detected in 63.1% of the cases versus 27.1% controls (ORs ranges: 5.58-11.4). Dual strain EBV infections were identified in WGS and PCR-Sanger data. In conclusion, EBV from Africa is phylogenetically separate from EBV in Asia. Genetic diversity in LMP-1 formed 12 patterns, which showed promising geographic and phenotypic associations. Presence of multiple strain infection should be considered in efforts to refine or improve EBV markers of ancestry or phenotype. Lay Summary Epstein-Barr virus (EBV) infection, a ubiquitous infection, contributes to the etiology of both Burkitt Lymphoma (BL) and nasopharyngeal carcinoma, yet their global distributions vary geographically with no overlap. Genomic variation in EBV is suspected to play a role in the geographical patterns of these EBV-associated cancers, but relatively few EBV samples from BL have been comprehensively studied. We sought to compare phylogenetic patterns of EBV genomes obtained from BL samples in Africa and from tumor and non-tumor samples from elsewhere. We concluded that EBV obtained from BL in Africa is genetically separate from EBV in Asia. Through comprehensive analysis of nucleotide variations in EBV's LMP-1 gene, we describe 12 LMP-1 patterns, two of which (B and G) were found mostly in Asia. Four LMP-1 patterns (A, AB, D, and F) accounted for 92% of EBVs sequenced from BL in Africa. Our results identified extensive diversity of EBV, but BL in Africa was associated with a limited number of variants identified, which were different from those identified in Asia. Further research is needed to optimize the use of PCR and sequencing to study LMP-1 diversity for classification of EBV variants and for use in epidemiologic studies to characterize geographic and/or phenotypic associations of EBV variants with EBV-associated malignancies, including eBL.
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Affiliation(s)
- Hsiao-Mei Liao
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Hebing Liu
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Pei-Ju Chin
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Bingjie Li
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Guo-Chiuan Hung
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Shien Tsai
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Isaac Otim
- EMBLEM Study, St. Mary's Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Ismail D Legason
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, Kuluva Hospital, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Martin D Ogwang
- EMBLEM Study, St. Mary's Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Patrick Kerchan
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, Kuluva Hospital, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Constance N Tenge
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya & Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Pamela A Were
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya & Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Robert T Kuremu
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya & Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Walter N Wekesa
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya & Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Nestory Masalu
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, Bugando Medical Center, Mwanza, Tanzania
| | - Esther Kawira
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda.,EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Leona W Ayers
- Department of Pathology, The Ohio State University, Columbus, OH, United States
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - James J Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Shyh-Ching Lo
- Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
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15
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Improved survival of Burkitt lymphoma/leukemia patients: observations from Poland, 1999-2020. Ann Hematol 2022; 101:1059-1065. [PMID: 35293608 DOI: 10.1007/s00277-022-04758-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/10/2022] [Indexed: 11/01/2022]
Abstract
The aim of this study was to estimate the survival of Polish Burkitt lymphoma/leukemia (BL) patients diagnosed between 1999 and 2017, considering multiple covariates and periods, to reflect changes in BL treatment. We identified all BL patients registered in the Polish National Cancer Registry in 1999-2017. Observed survival (OS) was evaluated deploying the life table method. Univariate and multivariate Cox proportional hazards regression models were fit to generate hazard ratios (HR) and the corresponding 95% confidence intervals (95% CI), describing the association between exposures (sex, age at the diagnosis, year of diagnosis, and region of residence) and time-to-event (death). Two-sided log-rank test was applied to assess the significance of exposures. Overall, 937 BL cases were included in the study (654 men and 283 women). Between the periods 1999-2005 and 2015-2017, the 3-year OS changed from 56.0% (95% CI 50.4 to 62.2%) to 73.8% (68.1 to 80.0%; P < 0.001), and the 5-year OS increased from 53.8% (48.2 to 60.0%) to 73.0% (67.1 to 79.3%; P < 0.001). The death HR was significantly higher in adolescents and young adults' (AYA) and adults' groups than in pediatric patients (HR = 3.00, 95% CI 2.05 to 4.39, P < 0.001, for AYA; and HR = 7.30, 5.14 to 10.3, P < 0.001, for adults). During the last two decades, the survival of Polish BL patients has been systematically improving. The death hazard ratio is most significantly associated with the patients' age at diagnosis and year of diagnosis, and not associated with sex or region of residence.
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16
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Human Cytomegalovirus Seropositivity and Viral DNA in Breast Tumors Are Associated with Poor Patient Prognosis. Cancers (Basel) 2022; 14:cancers14051148. [PMID: 35267456 PMCID: PMC8909033 DOI: 10.3390/cancers14051148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Human cytomegalovirus (HCMV) infects 40–70% of adult populations in developed countries and this is thought to be involved in breast cancer progression; however, reports of detection of the viral genome in breast tumors ranges from 0–100%. We optimized a method that is both sensitive and specific to detect HCMV DNA in tissues from Canadian breast cancer patients. Only ~42% of HCMV-seropositive patients expressed viral DNA in their breast tumors. Viral transcription was not detected in any HCMV-infected breast tumors, indicating a latent infection; however, HCMV seropositivity and the presence of latent infections in breast tumors were independently, and in combination, associated with increased metastasis. HCMV DNA-positive tumors were also associated with lower relapse-free survival. Therefore, HCMV infection status should be accounted for during the monitoring and treatment of breast cancer patients. Prevention or reducing the effects of HCMV infection could decrease morbidity and mortality from metastatic disease. Abstract Human cytomegalovirus (HCMV) infects 40–70% of adults in developed countries. Detection of HCMV DNA and/or proteins in breast tumors varies considerably, ranging from 0–100%. In this study, nested PCR to detect HCMV glycoprotein B (gB) DNA in breast tumors was shown to be sensitive and specific in contrast to the detection of DNA for immediate early genes. HCMV gB DNA was detected in 18.4% of 136 breast tumors while 62.8% of 94 breast cancer patients were seropositive for HCMV. mRNA for the HCMV immediate early gene was not detected in any sample, suggesting viral latency in breast tumors. HCMV seropositivity was positively correlated with age, body mass index and menopause. Patients who were HCMV seropositive or had HCMV DNA in their tumors were 5.61 (CI 1.77–15.67, p = 0.003) or 5.27 (CI 1.09–28.75, p = 0.039) times more likely to develop Stage IV metastatic tumors, respectively. Patients with HCMV DNA in tumors experienced reduced relapse-free survival (p = 0.042). Being both seropositive with HCMV DNA-positive tumors was associated with vascular involvement and metastasis. We conclude that determining the seropositivity for HCMV and detection of HCMV gB DNA in the breast tumors could identify breast cancer patients more likely to develop metastatic cancer and warrant special treatment.
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17
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Samayoa-Reyes G, Ogolla SO, Daud II, Jackson C, Sabourin KR, Dent A, Rochford R. Maternal HIV Infection as a Risk Factor for Primary Epstein-Barr Virus Infection in Kenyan Infants. Front Oncol 2022; 11:805145. [PMID: 35096607 PMCID: PMC8790250 DOI: 10.3389/fonc.2021.805145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Human immunodeficiency virus (HIV) infection is known to be associated with EBV shedding in saliva suggesting an increased risk of EBV transmission to infants born to mothers with HIV at an earlier age. In this study we investigated (i) whether maternal HIV status was a risk factor for EBV in blood at delivery or for shedding in saliva and breast milk of 6- and 10-weeks post-partum mothers, (ii) if there was a difference in EBV strains shed between HIV+ and HIV- mothers, and (iii) if maternal HIV status was a determinant of EBV viral load in their infants. Samples were collected as part of a prospective cohort study that followed HIV-positive (HIV+) and HIV-negative (HIV-) pregnant women in Western Kenya through delivery and post-partum period. EBV viral load in blood was found to be significantly higher in mothers with HIV (p-value = 0.04). Additionally, a statistically significant difference was observed between EBV viral load in saliva samples and HIV status where HIV+ mothers had a higher EBV viral load in saliva at 6-weeks post-partum compared to HIV- mothers (p-value < 0.01). The difference in EBV shedding in breast milk was not found to be statistically significant. Furthermore, no difference in frequency of EBV strain was attributable to HIV- or HIV+ mothers. Interestingly, we found that infants born to HIV+ mothers had a higher EBV viral load at the time of their first EBV detection in blood than infants born to HIV- mothers and this was independent of age at detection. Overall, our study suggests that HIV infected mothers shed more virus in saliva than HIV-negative mothers and infants born to HIV+ mothers were at risk for loss of control of primary EBV infection as evidenced by higher EBV viral load following primary infection.
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Affiliation(s)
- Gabriela Samayoa-Reyes
- Department of Immunology and Microbiology, University of Colorado, School of Medicine, Aurora, CO, United States
| | - Sidney O. Ogolla
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Ibrahim I. Daud
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Conner Jackson
- Department of Immunology and Microbiology, University of Colorado, School of Medicine, Aurora, CO, United States
| | - Katherine R. Sabourin
- Department of Immunology and Microbiology, University of Colorado, School of Medicine, Aurora, CO, United States
| | - Arlene Dent
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, United States
| | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado, School of Medicine, Aurora, CO, United States
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18
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Zanelli M, Sanguedolce F, Palicelli A, Zizzo M, Martino G, Caprera C, Fragliasso V, Soriano A, Gozzi F, Cimino L, Masia F, Moretti M, Foroni M, De Marco L, Pellegrini D, De Raeve H, Ricci S, Tamagnini I, Tafuni A, Cavazza A, Merli F, Pileri SA, Ascani S. EBV-Driven Lymphoproliferative Disorders and Lymphomas of the Gastrointestinal Tract: A Spectrum of Entities with a Common Denominator (Part 3). Cancers (Basel) 2021; 13:6021. [PMID: 34885131 PMCID: PMC8656853 DOI: 10.3390/cancers13236021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 12/28/2022] Open
Abstract
EBV is the first known oncogenic virus involved in the development of several tumors. The majority of the global population are infected with the virus early in life and the virus persists throughout life, in a latent stage, and usually within B lymphocytes. Despite the worldwide diffusion of EBV infection, EBV-associated diseases develop in only in a small subset of individuals often when conditions of immunosuppression disrupt the balance between the infection and host immune system. EBV-driven lymphoid proliferations are either of B-cell or T/NK-cell origin, and range from disorders with an indolent behavior to aggressive lymphomas. In this review, which is divided in three parts, we provide an update of EBV-associated lymphoid disorders developing in the gastrointestinal tract, often representing a challenging diagnostic and therapeutic issue. Our aim is to provide a practical diagnostic approach to clinicians and pathologists who face this complex spectrum of disorders in their daily practice. In this part of the review, the chronic active EBV infection of T-cell and NK-cell type, its systemic form; extranodal NK/T-cell lymphoma, nasal type and post-transplant lymphoproliferative disorders are discussed.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | | | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Giovanni Martino
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (D.P.); (S.A.)
| | - Cecilia Caprera
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (D.P.); (S.A.)
| | - Valentina Fragliasso
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Alessandra Soriano
- Gastroenterology Division, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.G.); (L.C.)
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.G.); (L.C.)
| | - Francesco Masia
- Dipartimento di Medicina, Università degli Studi di Perugia, 05100 Terni, Italy; (F.M.); (M.M.)
| | - Marina Moretti
- Dipartimento di Medicina, Università degli Studi di Perugia, 05100 Terni, Italy; (F.M.); (M.M.)
| | - Moira Foroni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Loredana De Marco
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - David Pellegrini
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (D.P.); (S.A.)
| | - Hendrik De Raeve
- Pathology, University Hospital Brussels, 1090 Brussels, Belgium;
- Pathology, O.L.V. Hospital Aalst, 9300 Aalst, Belgium
| | - Stefano Ricci
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Ione Tamagnini
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Alessandro Tafuni
- Pathology Unit, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy;
| | - Alberto Cavazza
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Stefano A. Pileri
- Haematopathology Division, European Institute of Oncology-IEO IRCCS Milan, 20141 Milan, Italy;
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (D.P.); (S.A.)
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Cai J, Zhang B, Li Y, Zhu W, Akihisa T, Li W, Kikuchi T, Liu W, Feng F, Zhang J. Prophylactic and Therapeutic EBV Vaccines: Major Scientific Obstacles, Historical Progress, and Future Direction. Vaccines (Basel) 2021; 9:vaccines9111290. [PMID: 34835222 PMCID: PMC8623587 DOI: 10.3390/vaccines9111290] [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] [Received: 09/01/2021] [Revised: 10/27/2021] [Accepted: 11/03/2021] [Indexed: 11/29/2022] Open
Abstract
The Epstein-Barr virus (EBV) infects more than 95% of adults worldwide and is associated with various malignant tumors and immune diseases, imparting a huge disease burden on the human population. Available EBV vaccines are imminent. Prophylactic vaccines can effectively prevent the spread of infection, whereas therapeutic vaccines mainly stimulate cell-mediated immunity and kill infected cells, thus curbing the development of malignant tumors. Nevertheless, there are still no approved EBV vaccines after decades of effort. The complexity of the EBV life cycle, the lack of appropriate animal models, and the limited reports on adjuvant selection and immune responses are gravely impeding progress in EBV vaccines. The soluble gp350 vaccine could reduce the incidence of infectious mononucleosis (IM), which seemed to offer hope, but could not prevent EBV infection. Continuous research and vaccine trials provide deep insights into the structural biology of viruses, the designs for immunogenicity, and the evolving vaccine platforms. Moreover, the new vaccine candidates are expected to achieve further success via combined immunization to elicit both a dual protection of B cells and epithelial cells, and sustainable immunization against infected cells at several phases of infection.
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Affiliation(s)
- Jing Cai
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 210009, China; (J.C.); (B.Z.); (Y.L.); (T.A.); (F.F.)
| | - Bodou Zhang
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 210009, China; (J.C.); (B.Z.); (Y.L.); (T.A.); (F.F.)
| | - Yuqi Li
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 210009, China; (J.C.); (B.Z.); (Y.L.); (T.A.); (F.F.)
| | - Wanfang Zhu
- School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China; (W.Z.); (W.L.)
| | - Toshihiro Akihisa
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 210009, China; (J.C.); (B.Z.); (Y.L.); (T.A.); (F.F.)
- Research Institute for Science and Technology, Tokyo University of Science, Chiba 278-8510, Japan
| | - Wei Li
- Faculty of Pharmaceutical Sciences, Toho University, Chiba 274-8510, Japan; (W.L.); (T.K.)
| | - Takashi Kikuchi
- Faculty of Pharmaceutical Sciences, Toho University, Chiba 274-8510, Japan; (W.L.); (T.K.)
| | - Wenyuan Liu
- School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China; (W.Z.); (W.L.)
| | - Feng Feng
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 210009, China; (J.C.); (B.Z.); (Y.L.); (T.A.); (F.F.)
- Jiangsu Food and Pharmaceutical Science College, Huaian 223003, China
| | - Jie Zhang
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 210009, China; (J.C.); (B.Z.); (Y.L.); (T.A.); (F.F.)
- Jiangsu Food and Pharmaceutical Science College, Huaian 223003, China
- Correspondence:
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20
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Dillon M, Lopez A, Lin E, Sales D, Perets R, Jain P. Progress on Ras/MAPK Signaling Research and Targeting in Blood and Solid Cancers. Cancers (Basel) 2021; 13:cancers13205059. [PMID: 34680208 PMCID: PMC8534156 DOI: 10.3390/cancers13205059] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary The Ras-Raf-MEK-ERK signaling pathway is responsible for regulating cell proliferation, differentiation, and survival. Overexpression and overactivation of members within the signaling cascade have been observed in many solid and blood cancers. Research often focuses on targeting the pathway to disrupt cancer initiation and progression. We aimed to provide an overview of the pathway’s physiologic role and regulation, interactions with other pathways involved in cancer development, and mutations that lead to malignancy. Several blood and solid cancers are analyzed to illustrate the impact of the pathway’s dysregulation, stemming from mutation or viral induction. Finally, we summarized different approaches to targeting the pathway and the associated novel treatments being researched or having recently achieved approval. Abstract The mitogen-activated protein kinase (MAPK) pathway, consisting of the Ras-Raf-MEK-ERK signaling cascade, regulates genes that control cellular development, differentiation, proliferation, and apoptosis. Within the cascade, multiple isoforms of Ras and Raf each display differences in functionality, efficiency, and, critically, oncogenic potential. According to the NCI, over 30% of all human cancers are driven by Ras genes. This dysfunctional signaling is implicated in a wide variety of leukemias and solid tumors, both with and without viral etiology. Due to the strong evidence of Ras-Raf involvement in tumorigenesis, many have attempted to target the cascade to treat these malignancies. Decades of unsuccessful experimentation had deemed Ras undruggable, but recently, the approval of Sotorasib as the first ever KRas inhibitor represents a monumental breakthrough. This advancement is not without novel challenges. As a G12C mutant-specific drug, it also represents the issue of drug target specificity within Ras pathway; not only do many drugs only affect single mutational profiles, with few pan-inhibitor exceptions, tumor genetic heterogeneity may give rise to drug-resistant profiles. Furthermore, significant challenges in targeting downstream Raf, especially the BRaf isoform, lie in the paradoxical activation of wild-type BRaf by BRaf mutant inhibitors. This literature review will delineate the mechanisms of Ras signaling in the MAPK pathway and its possible oncogenic mutations, illustrate how specific mutations affect the pathogenesis of specific cancers, and compare available and in-development treatments targeting the Ras pathway.
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21
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Lino CNR, Ghosh S. Epstein-Barr Virus in Inborn Immunodeficiency-More Than Infection. Cancers (Basel) 2021; 13:cancers13194752. [PMID: 34638238 PMCID: PMC8507541 DOI: 10.3390/cancers13194752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Epstein–Barr Virus (EBV) is a common virus that is readily controlled by a healthy immune system and rarely causes serious problems in infected people. However, patients with certain genetic defects of their immune system might have difficulties controlling EBV and often develop severe and life-threatening conditions, such as severe inflammation and malignancies. In this review, we provide a summary of inherited immune diseases that lead to a high susceptibility to EBV infection and discuss how this infection is associated with cancer development. Abstract Epstein–Barr Virus (EBV) is a ubiquitous virus affecting more than 90% of the world’s population. Upon infection, it establishes latency in B cells. It is a rather benign virus for immune-competent individuals, in whom infections usually go unnoticed. Nevertheless, EBV has been extensively associated with tumorigenesis. Patients suffering from certain inborn errors of immunity are at high risk of developing malignancies, while infection in the majority of immune-competent individuals does not seem to lead to immune dysregulation. Herein, we discuss how inborn mutations in TNFRSF9, CD27, CD70, CORO1A, CTPS1, ITK, MAGT1, RASGRP1, STK4, CARMIL2, SH2D1A, and XIAP affect the development, differentiation, and function of key factors involved in the immunity against EBV, leading to increased susceptibility to lymphoproliferative disease and lymphoma.
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Affiliation(s)
| | - Sujal Ghosh
- Correspondence: ; Tel.: +49-211-811-6224; Fax: +49-211-811-6191
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22
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Zanelli M, Sanguedolce F, Palicelli A, Zizzo M, Martino G, Caprera C, Fragliasso V, Soriano A, Valle L, Ricci S, Gozzi F, Cimino L, Cavazza A, Merli F, Pileri SA, Ascani S. EBV-Driven Lymphoproliferative Disorders and Lymphomas of the Gastrointestinal Tract: A Spectrum of Entities with a Common Denominator (Part 2). Cancers (Basel) 2021; 13:4527. [PMID: 34572754 PMCID: PMC8469260 DOI: 10.3390/cancers13184527] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/02/2021] [Accepted: 09/06/2021] [Indexed: 02/05/2023] Open
Abstract
Epstein-Barr virus (EBV) is a common pathogen infecting people primarily early in life. The virus has the ability to persist throughout a person's life, usually in B lymphocytes. Conditions of immunodeficiency as well as the introduction of immunosuppressive therapies and the advent of transplant technologies has brought immunodeficiency-associated lymphoproliferative disorders into view, which are often driven by EBV. The group of EBV-associated lymphoproliferative disorders includes different entities, with distinct biological features, ranging from indolent disorders, which may even spontaneously regress, to aggressive lymphomas requiring prompt and adequate treatment. These disorders are often diagnostically challenging due to their overlapping morphology and immunophenotype. Both nodal and extra-nodal sites, including the gastrointestinal tract, may be involved. This review, divided in three parts, summarizes the clinical, pathological, molecular features and treatment strategies of EBV-related lymphoproliferative disorders occurring in the gastrointestinal tract and critically analyzes the major issues in the differential diagnosis. In this part of the review, we discuss plasmablastic lymphoma, extra-cavitary primary effusion lymphoma and Burkitt lymphoma.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (S.R.); (A.C.)
| | | | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (S.R.); (A.C.)
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Giovanni Martino
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (S.A.)
| | - Cecilia Caprera
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (S.A.)
| | - Valentina Fragliasso
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Alessandra Soriano
- Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA;
- Gastroenterology Division, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Luca Valle
- Anatomic Pathology, Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa and Ospedale Policlinico San Martino, 16132 Genoa, Italy;
| | - Stefano Ricci
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (S.R.); (A.C.)
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.G.); (L.C.)
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.G.); (L.C.)
| | - Alberto Cavazza
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (S.R.); (A.C.)
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Stefano A. Pileri
- Haematopathology Division, European Institute of Oncology-IEO IRCCS Milan, 20141 Milan, Italy;
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (S.A.)
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23
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Ahsanuddin S, Cadwell JB, Sangal NR, Grube JG, Fang CH, Baredes S, Eloy JA. Survival Predictors of Head and Neck Burkitt's Lymphoma: An Analysis of the SEER Database. Otolaryngol Head Neck Surg 2021; 167:79-88. [PMID: 34491862 DOI: 10.1177/01945998211041533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze population-level data for Burkitt's lymphoma of the head and neck. STUDY DESIGN Retrospective study of a national cancer database. SETTING Academic medical center. METHODS The SEER database (Surveillance, Epidemiology, and End Results) identified all patients with primary Burkitt's lymphoma of the head and neck from 1975 to 2015. Demographic, clinicopathologic, and treatment characteristics were analyzed. Multivariable Cox regressions analyzed factors associated with survival while controlling for baseline differences. RESULTS A total of 920 patients with a mean (SD) age of 37.6 years (25.0) were identified. A majority of patients were White (82.8%) and male (72.3%). The most primary common sites included the lymph nodes (61.3%), pharynx (17.7%), and nasal cavity/paranasal sinuses (5.2%). The majority of patients received chemotherapy (90.5%), while fewer underwent surgery (42.1%) or radiotherapy (12.8%). Choice of treatment differed significantly among patients of different ages, year of diagnosis, primary site, nodal status, and Ann Arbor stage. Overall 10-year survival was 67.8%. On multivariable Cox regression, patients with older age (hazard ratio [HR], 1.05 per year; P < .001) and higher stage at presentation had increased risk of mortality (P < .001). Furthermore, cases diagnosed between 2006 and 2015 (HR, 0.35; P < .001) and 1996 and 2005 (HR, 0.53; P = .001) had lower mortality when compared with those diagnosed between 1975 and 1995. Treatment including surgery and chemotherapy tended to have the best survival (P < .001). CONCLUSION Burkitt's lymphoma of the head and neck diagnosed in more recent years has had improved survival. Factors significantly associated with survival include age, Ann Arbor stage, and treatment regimen. Treatment including surgery and chemotherapy was associated with the highest survival.
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Affiliation(s)
- Salma Ahsanuddin
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Joshua B Cadwell
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Neel R Sangal
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jordon G Grube
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Albany Medical Center, Albany, New York, USA
| | - Christina H Fang
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center-RWJBarnabas Health, Livingston, New Jersey, USA
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24
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Peprah S, Ogwang MD, Kerchan P, Reynolds SJ, Tenge CN, Were PA, Kuremu RT, Wekesa WN, Masalu N, Kawira E, Otim I, Legason ID, Ayers LW, Bhatia K, Goedert JJ, Pfeiffer RM, Mbulaiteye SM. Inverse association of falciparum positivity with endemic Burkitt lymphoma is robust in analyses adjusting for pre-enrollment malaria in the EMBLEM case-control study. Infect Agent Cancer 2021; 16:40. [PMID: 34099001 PMCID: PMC8186042 DOI: 10.1186/s13027-021-00377-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/07/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Falciparum and endemic Burkitt lymphoma (eBL) are co-endemic in Africa, but the malaria experience in eBL patients is unknown. A lower prevalence of falciparum has been reported in eBL patients, but those results are anecdotally attributed to pre-enrollment anti-malaria treatment. METHODS We studied 677 eBL patients and 2920 community controls aged 0-15 years enrolled in six regions in Uganda, Tanzania, and Kenya during 2010-2016. Falciparum was diagnosed using thick blood film microscopy (TFM) and antigen-capture rapid diagnostic tests (RDTs). Guardians of the children answered a 40-item structured questionnaire about their child's pre-enrollment lifetime malaria history and treatment, demographics, socioeconomics, animal exposures, fevers, and hospitalizations. We utilized exploratory factor analysis to reduce the 40 questionnaire variables into six factors, including Inpatient malaria and Outpatient malaria factors that were surrogates of pre-enrollment anti-malaria treatment. The six factors accounted for 83-90% of the variance in the questionnaire data. We calculated odds ratios and 95% confidence intervals (OR 95% CI) of association of eBL with falciparum positivity, defined as positive both on TFM or RDTs, or only RDTs (indicative of recent infection) or TFM (indicative of current falciparum infection) versus no infection, using multivariable logistic regression, controlling for group of age (0-2, 3-5, 6-8, 9-11 and 12-15 years), sex, and study site and the afore-mentioned pre-enrollment factors. RESULTS The prevalence of falciparum infection was 25.6% in the eBL cases and 45.7% in community controls (aOR = 0.43, 95% CI: 0.40, 0.47; P < 0.0001). The results were similar for recent falciparum infection (6.9% versus 13.5%, aOR = 0.44, 95% CI: 0.38, 0.50; P < 0.0001) and current falciparum infection (18.7% versus 32.1%, aOR = 0.47, 95% CI: 0.43, 0.51; P < 0.0001). These aORs for any, recent and current falciparum infection did not change when we adjusted for pre-enrollment factors (aORs = 0.46, =0.44, and = 0.51, respectively) were significantly lower in stratified analysis for any infection in children < 5 years (aOR = 0.46; 95% CI: 0.29, 0.75) or ≥ 10 years (aOR = 0.47; 95% CI: 0.32, 0.71). CONCLUSION Our study results reduce support for pre-enrollment antimalaria treatment as a sole explanation for the observed lower falciparum prevalence in eBL cases and open a space to consider alternative immunology-based hypotheses.
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Affiliation(s)
- Sally Peprah
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Infections and Immunoepidemiology Branch, 9609 Medical Center Dr, Rm. 6E-118, MSC 3330, Bethesda, MD, 20892, USA
| | - Martin D Ogwang
- EMBLEM Study, St. Mary's Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Patrick Kerchan
- EMBLEM Study, Kuluva Hospital, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Constance N Tenge
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
- Moi Teaching and Referral Hospital (MTRH), Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Pamela A Were
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
- Moi Teaching and Referral Hospital (MTRH), Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Robert T Kuremu
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
- Moi Teaching and Referral Hospital (MTRH), Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Walter N Wekesa
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
- Moi Teaching and Referral Hospital (MTRH), Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | | | - Esther Kawira
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Isaac Otim
- EMBLEM Study, St. Mary's Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Ismail D Legason
- EMBLEM Study, Kuluva Hospital, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Leona W Ayers
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Infections and Immunoepidemiology Branch, 9609 Medical Center Dr, Rm. 6E-118, MSC 3330, Bethesda, MD, 20892, USA
| | - James J Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Infections and Immunoepidemiology Branch, 9609 Medical Center Dr, Rm. 6E-118, MSC 3330, Bethesda, MD, 20892, USA
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Infections and Immunoepidemiology Branch, 9609 Medical Center Dr, Rm. 6E-118, MSC 3330, Bethesda, MD, 20892, USA
| | - Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Infections and Immunoepidemiology Branch, 9609 Medical Center Dr, Rm. 6E-118, MSC 3330, Bethesda, MD, 20892, USA.
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25
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Frappier L. Epstein-Barr virus: Current questions and challenges. Tumour Virus Res 2021; 12:200218. [PMID: 34052467 PMCID: PMC8173096 DOI: 10.1016/j.tvr.2021.200218] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/14/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023] Open
Abstract
Epstein-Barr virus (EBV) infects most people worldwide and persists for life due to complicated interplay between lytic infection and multiple types of latent infections. While usually asymptomatic, EBV is a causative agent in several types of cancer and has a strong association with multiple sclerosis. Exactly how EBV promotes these diseases and why they are rare consequences of infection are incompletely understood. Here I will discuss current ideas on disease induction by EBV, including the importance of lytic protein expression in the context of latent infection as well as the possible importance of specific EBV variants in disease induction.
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Affiliation(s)
- Lori Frappier
- Department of Molecular Genetics, University of Toronto, 661 University Ave, Suite 1600, Toronto, ON, M5G 1M1, Canada.
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26
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Volaric AK, Singh K, Gru AA. Rare EBV-associated B cell neoplasms of the gastrointestinal tract. Semin Diagn Pathol 2021; 38:38-45. [PMID: 33985830 DOI: 10.1053/j.semdp.2021.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/04/2021] [Accepted: 04/21/2021] [Indexed: 12/20/2022]
Abstract
EBV-driven B cell neoplasms can rarely present as an extranodal mass in the gastrointestinal tract and can be missed, even by experienced pathologists, because of this uncommon presentation. A selection of these neoplasms, namely EBV-positive diffuse large B cell lymphoma, not otherwise specified (DLBCL NOS), EBV-positive mucocutaneous ulcer (EBV MCU), extracavitary primary effusion lymphoma (EPEL), and EBV-positive Burkitt lymphoma, will be discussed in the present review. Besides the common thread of EBV positivity, these lymphoproliferative disorders arise in unique clinical settings that are often associated with immunodeficiency, immunosuppression or immunosenescence and can present as solitary masses albeit rarely, within the gastrointestinal tract.
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Affiliation(s)
- Ashley K Volaric
- Department of Pathology, Stanford Medicine, Stanford, CA, United States
| | - Kunwar Singh
- Department of Pathology, Stanford Medicine, Stanford, CA, United States
| | - Alejandro A Gru
- Department of Pathology, University of Virginia, Charlottesville, VA, United States.
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27
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Assessment of Mixed Plasmodium falciparum sera5 Infection in Endemic Burkitt Lymphoma: A Case-Control Study in Malawi. Cancers (Basel) 2021; 13:cancers13071692. [PMID: 33918470 PMCID: PMC8038222 DOI: 10.3390/cancers13071692] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Plasmodium falciparum(Pf) infection is a risk factor for endemic Burkitt lymphoma (eBL), the commonest childhood cancer in Africa, but the biomarkers of Pf infection that predict this risk are unknown. There is some evidence that the genetic complexity of Pf infection may be a risk factor. In 200 children with versus 140 without eBL in Malawi, this study compared variants of the malaria parasite, focusing on Pfsera5, a gene that codes for malaria protein that an infected person’s antibodies target to suppress the parasite. Multiple Pfsera5 variants, which arise when the parasite is not suppressed, were found in 41.7% of eBL children versus 24.3% of other local children, meaning that eBL risk was increased 2.4-fold with multiple Pfsera5 variants. No specific type of variant was related to eBL risk. Research to quantify malaria parasite variants and to clarify the host immune response needed to control variant infections may yield a test to predict eBL risk. Abstract Background: Endemic Burkitt lymphoma (eBL) is the most common childhood cancer in Africa and is linked to Plasmodium falciparum (Pf) malaria infection, one of the most common and deadly childhood infections in Africa; however, the role of Pf genetic diversity is unclear. A potential role of Pf genetic diversity in eBL has been suggested by a correlation of age-specific patterns of eBL with the complexity of Pf infection in Ghana, Uganda, and Tanzania, as well as a finding of significantly higher Pf genetic diversity, based on a sensitive molecular barcode assay, in eBL cases than matched controls in Malawi. We examined this hypothesis by measuring diversity in Pf-serine repeat antigen-5 (Pfsera5), an antigenic target of blood-stage immunity to malaria, among 200 eBL cases and 140 controls, all Pf polymerase chain reaction (PCR)-positive, in Malawi. Methods: We performed Pfsera5 PCR and sequencing (~3.3 kb over exons II–IV) to determine single or mixed PfSERA5 infection status. The patterns of Pfsera5 PCR positivity, mixed infection, sequence variants, and haplotypes among eBL cases, controls, and combined/pooled were analyzed using frequency tables. The association of mixed Pfsera5 infection with eBL was evaluated using logistic regression, controlling for age, sex, and previously measured Pf genetic diversity. Results: Pfsera5 PCR was positive in 108 eBL cases and 70 controls. Mixed PfSERA5 infection was detected in 41.7% of eBL cases versus 24.3% of controls; the odds ratio (OR) was 2.18, and the 95% confidence interval (CI) was 1.12–4.26, which remained significant in adjusted results (adjusted odds ratio [aOR] of 2.40, 95% CI of 1.11–5.17). A total of 29 nucleotide variations and 96 haplotypes were identified, but these were unrelated to eBL. Conclusions: Our results increase the evidence supporting the hypothesis that infection with mixed Pf infection is increased with eBL and suggest that measuring Pf genetic diversity may provide new insights into the role of Pf infection in eBL.
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28
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Cao Y, Xie L, Shi F, Tang M, Li Y, Hu J, Zhao L, Zhao L, Yu X, Luo X, Liao W, Bode AM. Targeting the signaling in Epstein-Barr virus-associated diseases: mechanism, regulation, and clinical study. Signal Transduct Target Ther 2021; 6:15. [PMID: 33436584 PMCID: PMC7801793 DOI: 10.1038/s41392-020-00376-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/30/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022] Open
Abstract
Epstein–Barr virus-associated diseases are important global health concerns. As a group I carcinogen, EBV accounts for 1.5% of human malignances, including both epithelial- and lymphatic-originated tumors. Moreover, EBV plays an etiological and pathogenic role in a number of non-neoplastic diseases, and is even involved in multiple autoimmune diseases (SADs). In this review, we summarize and discuss some recent exciting discoveries in EBV research area, which including DNA methylation alterations, metabolic reprogramming, the changes of mitochondria and ubiquitin-proteasome system (UPS), oxidative stress and EBV lytic reactivation, variations in non-coding RNA (ncRNA), radiochemotherapy and immunotherapy. Understanding and learning from this advancement will further confirm the far-reaching and future value of therapeutic strategies in EBV-associated diseases.
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Affiliation(s)
- Ya Cao
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China. .,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China. .,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China. .,Research Center for Technologies of Nucleic Acid-Based Diagnostics and Therapeutics Hunan Province, 410078, Changsha, China. .,Molecular Imaging Research Center of Central South University, 410008, Changsha, Hunan, China. .,National Joint Engineering Research Center for Genetic Diagnostics of Infectious Diseases and Cancer, 410078, Changsha, China. .,Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.
| | - Longlong Xie
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China.,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China
| | - Feng Shi
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China.,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China
| | - Min Tang
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China.,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China.,Molecular Imaging Research Center of Central South University, 410008, Changsha, Hunan, China
| | - Yueshuo Li
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China.,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China
| | - Jianmin Hu
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China.,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China
| | - Lin Zhao
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China.,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China
| | - Luqing Zhao
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China
| | - Xinfang Yu
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China.,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China
| | - Xiangjian Luo
- Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China.,Cancer Research Institute and School of Basic Medical Science, Xiangya School of Medicine, Central South University, 410078, Changsha, China.,Key Laboratory of Carcinogenesis, Chinese Ministry of Health, 410078, Changsha, China.,Molecular Imaging Research Center of Central South University, 410008, Changsha, Hunan, China
| | - Weihua Liao
- Department of Radiology, Xiangya Hospital, Central South University, 410078, Changsha, China
| | - Ann M Bode
- The Hormel Institute, University of Minnesota, Austin, MN, 55912, USA
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29
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Hutcheson RL, Chakravorty A, Sugden B. Burkitt Lymphomas Evolve to Escape Dependencies on Epstein-Barr Virus. Front Cell Infect Microbiol 2021; 10:606412. [PMID: 33505922 PMCID: PMC7829347 DOI: 10.3389/fcimb.2020.606412] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/27/2020] [Indexed: 01/25/2023] Open
Abstract
Epstein-Barr Virus (EBV) can transform B cells and contributes to the development of Burkitt lymphoma and other cancers. Through decades of study, we now recognize that many of the viral genes required to transform cells are not expressed in EBV-positive Burkitt lymphoma (BL) tumors, likely due to the immune pressure exerted on infected cells. This recognition has led to the hypothesis that the loss of expression of these viral genes must be compensated through some mechanisms. Recent progress in genome-wide mutational analysis of tumors provides a wealth of data about the cellular mutations found in EBV-positive BLs. Here, we review common cellular mutations found in these tumors and consider how they may compensate for the viral genes that are no longer expressed. Understanding these mutations and how they may substitute for EBV's genes and contribute to lymphomagenesis can serve as a launchpad for more mechanistic studies, which will help us navigate the sea of genomic data available today, and direct the discoveries necessary to improve the treatment of EBV-positive BLs.
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Epstein-Barr Virus: How Its Lytic Phase Contributes to Oncogenesis. Microorganisms 2020; 8:microorganisms8111824. [PMID: 33228078 PMCID: PMC7699388 DOI: 10.3390/microorganisms8111824] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022] Open
Abstract
Epstein–Barr Virus (EBV) contributes to the development of lymphoid and epithelial malignancies. While EBV’s latent phase is more commonly associated with EBV-associated malignancies, there is increasing evidence that EBV’s lytic phase plays a role in EBV-mediated oncogenesis. The lytic phase contributes to oncogenesis primarily in two ways: (1) the production of infectious particles to infect more cells, and (2) the regulation of cellular oncogenic pathways, both cell autonomously and non-cell autonomously. The production of infectious particles requires the completion of the lytic phase. However, the regulation of cellular oncogenic pathways can be mediated by an incomplete (abortive) lytic phase, in which early lytic gene products contribute substantially, whereas late lytic products are largely dispensable. In this review, we discuss the evidence of EBV’s lytic phase contributing to oncogenesis and the role it plays in tumor formation and progression, as well as summarize known mechanisms by which EBV lytic products regulate oncogenic pathways. Understanding the contribution of EBV’s lytic phase to oncogenesis will help design ways to target it to treat EBV-associated malignancies.
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31
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Omonisi AE, Liu B, Parkin DM. Population-Based Cancer Registration in Sub-Saharan Africa: Its Role in Research and Cancer Control. JCO Glob Oncol 2020; 6:1721-1728. [PMID: 33180635 PMCID: PMC7713579 DOI: 10.1200/go.20.00294] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Abidemi Emmanuel Omonisi
- Department of Anatomic Pathology, Ekiti State University, Ado-Ekiti, Nigeria
- Ekiti Cancer Registry, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Biying Liu
- African Cancer Registry Network, Oxford, United Kingdom
| | - Donald Maxwell Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- International Agency for Research on Cancer, Lyon, France
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Li Z, Zhang X, Dong L, Pang J, Xu M, Zhong Q, Zeng MS, Yu X. CryoEM structure of the tegumented capsid of Epstein-Barr virus. Cell Res 2020; 30:873-884. [PMID: 32620850 PMCID: PMC7608217 DOI: 10.1038/s41422-020-0363-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 06/16/2020] [Indexed: 12/13/2022] Open
Abstract
Epstein-Barr virus (EBV) is the primary cause of infectious mononucleosis and has been shown to be closely associated with various malignancies. Here, we present a complete atomic model of EBV, including the icosahedral capsid, the dodecameric portal and the capsid-associated tegument complex (CATC). Our in situ portal from the tegumented capsid adopts a closed conformation with its channel valve holding the terminal viral DNA and with its crown region firmly engaged by three layers of ring-like dsDNA, which, together with the penton flexibility, effectively alleviates the capsid inner pressure placed on the portal cap. In contrast, the CATCs, through binding to the flexible penton vertices in a stoichiometric manner, accurately increase the inner capsid pressure to facilitate the pressure-driven genome delivery. Together, our results provide important insights into the mechanism by which the EBV capsid, portal, packaged genome and the CATCs coordinately achieve a pressure balance to simultaneously benefit both viral genome retention and ejection.
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Affiliation(s)
- Zhihai Li
- Cryo-Electron Microscopy Research Center, The CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Xiao Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Lili Dong
- Cryo-Electron Microscopy Research Center, The CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Jingjing Pang
- Cryo-Electron Microscopy Research Center, The CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Miao Xu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Qian Zhong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Mu-Sheng Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Department of Experimental Research, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China.
| | - Xuekui Yu
- Cryo-Electron Microscopy Research Center, The CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China.
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Bakkalci D, Jia Y, Winter JR, Lewis JE, Taylor GS, Stagg HR. Risk factors for Epstein Barr virus-associated cancers: a systematic review, critical appraisal, and mapping of the epidemiological evidence. J Glob Health 2020; 10:010405. [PMID: 32257153 PMCID: PMC7125417 DOI: 10.7189/jogh.10.010405] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Epstein Barr Virus (EBV) infects 90%-95% of all adults globally and causes ~ 1% of all cancers. Differing proportions of Burkitt's lymphoma (BL), gastric carcinoma (GC), Hodgkin's lymphoma (HL) and nasopharyngeal carcinoma (NPC) are associated with EBV. We sought to systematically review the global epidemiological evidence for risk factors that (in addition to EBV) contribute to the development of the EBV-associated forms of these cancers, assess the quality of the evidence, and compare and contrast the cancers. METHODS MEDLINE, Embase and Web of Science were searched for studies of risk factors for EBV-associated BL, GC, HL and NPC without language or temporal restrictions. Studies were excluded if there was no cancer-free comparator group or where analyses of risk factors were inadequately documented. After screening and reference list searching, data were extracted into standardised spreadsheets and quality assessed. Due to heterogeneity, a narrative synthesis was undertaken. RESULTS 9916 hits were retrieved. 271 papers were retained: two BL, 24 HL, one GC and 244 NPC. The majority of studies were from China, North America and Western Europe. Risk factors were categorised as dietary, environmental/non-dietary, human genetic, and infection and clinical. Anti-EBV antibody load was associated with EBV-associated GC and BL. Although the evidence could be inconsistent, HLA-A alleles, smoking, infectious mononucleosis and potentially other infections were risk factors for EBV-associated HL. Rancid dairy products; anti-EBV antibody and EBV DNA load; history of chronic ear, nose and/or throat conditions; herbal medicine use; family history; and human genetics were risk factors for NPC. Fresh fruit and vegetable and tea consumption may be protective against NPC. CONCLUSIONS Many epidemiological studies of risk factors in addition to EBV for the EBV-associated forms of BL, GC, HL and NPC have been undertaken, but there is a dearth of evidence for GC and BL. Available evidence is of variable quality. The aetiology of EBV-associated cancers likely results from a complex intersection of genetic, clinical, environmental and dietary factors, which is difficult to assess with observational studies. Large, carefully designed, studies need to be strategically undertaken to harmonise and clarify the evidence. REGISTRATION PROSPERO CRD42017059806.
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Affiliation(s)
- Deniz Bakkalci
- Institute for Global Health, University College London, London, UK
- Joint first authors, listed alphabetically
| | - Yumeng Jia
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Joint first authors, listed alphabetically
| | - Joanne R Winter
- Institute for Global Health, University College London, London, UK
- Joint first authors, listed alphabetically
| | - Joanna Ea Lewis
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Graham S Taylor
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Joint senior authors
| | - Helen R Stagg
- Institute for Global Health, University College London, London, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Joint senior authors
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Melenotte C, Mezouar S, Mège JL, Gorvel JP, Kroemer G, Raoult D. Bacterial infection and non-Hodgkin's lymphoma. Crit Rev Microbiol 2020; 46:270-287. [PMID: 32412856 DOI: 10.1080/1040841x.2020.1760786] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
One quarter of all cancers are linked to infectious diseases. The link between viral infection and cancer has been widely studied, but few reports have focused on the carcinogenic role of bacterial infection. Nonetheless, Helicobacter pylori, Chlamydia psittaci, Coxiella burnetii, Borrelia burgdorferi and Campylobacter jejuni are bacteria that can be associated with non-Hodgkin's lymphoma (NHL), the most common haematologic malignancy. Here, we review the evidence in favour of a link between these bacterial infections and NHL. Sero-epidemiological observation makes it possible to identify a link between H. pylori, C. burnetii, B. burgdorferi infection and NHL. Helicobacter pylori, Chlamydia psittaci, Coxiella burnetii, Borrelia burgdorferi and Campylobacter jejuni could be identified in NHL tissue samples at the site of chronic inflammation, where B and T lymphocytes are attracted to participate in follicle formation. Lymphoma remissions have been observed under antimicrobial therapies supporting the carcinogenic contribution of bacteria. If the theory of causality is characterized by the lack of universal criteria for establishing a causal link between two diseases, infection and lymphoma, epidemiological, clinical, and histological evidences reported here, should lead clinicians to pay attention to these infectious agents, to detect early lymphoma transformation.
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Affiliation(s)
- Cléa Melenotte
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Soraya Mezouar
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Jean-Louis Mège
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | | | - Guido Kroemer
- Cell Biology and Metabolomics platforms, Villejuif, France.,INSERM, Paris, France.,Equipe 11 labellisée par la Ligue contre le Cancer, Centre de Recherche des Cordeliers, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Université Pierre et Marie Curie, Paris, France.,Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.,Karolinska Institute, Department of Women's and Children's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Didier Raoult
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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35
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Tenofovir prodrugs potently inhibit Epstein-Barr virus lytic DNA replication by targeting the viral DNA polymerase. Proc Natl Acad Sci U S A 2020; 117:12368-12374. [PMID: 32409608 DOI: 10.1073/pnas.2002392117] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Epstein-Barr virus (EBV) is a ubiquitous human γ-herpesvirus that establishes life-long infection and increases the risk for the development of several cancers and autoimmune diseases. The mechanisms by which chronic EBV infection leads to subsequent disease remain incompletely understood. Lytic reactivation plays a central role in the development of EBV-driven cancers and may contribute to other EBV-associated diseases. Thus, the clinical use of antivirals as suppressive therapy for EBV lytic reactivation may aid efforts aimed at disease prevention. Current antivirals for EBV have shown limited clinical utility due to low potency or high toxicity, leaving open the need for potent antivirals suitable for long-term prophylaxis. In the present study, we show that tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF), drugs with excellent safety profiles used clinically for HIV prevention, inhibit EBV lytic DNA replication, with respective IC50 values of 0.30 μM and 84 nM. In a cell-based assay, TAF was 35- and 24-fold and TDF was 10- and 7-fold more potent than acyclovir and penciclovir, respectively, and TAF was also twice as potent as ganciclovir. The active metabolite of tenofovir prodrugs, tenofovir-diphosphate, inhibited the incorporation of dATP into a primed DNA template by the EBV DNA polymerase in vitro. In contrast to acyclovir, treatment of cells during latency for 24 h with TAF still inhibited EBV lytic DNA replication at 72 h after drug was removed. Our results suggest that tenofovir prodrugs may be particularly effective as inhibitors of EBV lytic reactivation, and that clinical studies to address critical questions about disease prevention are warranted.
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Kirimunda S, Verboom M, Otim I, Ssennono M, Legason ID, Nabalende H, Ogwang MD, Kerchan P, Kinyera T, Mwebaza I, Joloba M, Ayers LW, Reynolds SJ, Bhatia K, Onabajo OO, Hallensleben M, Biggar RJ, Prokunina-Olsson L, Goedert JJ, Blasczyk R, Mbulaiteye SM. Variation in the Human Leukocyte Antigen system and risk for endemic Burkitt lymphoma in northern Uganda. Br J Haematol 2020; 189:489-499. [PMID: 32072624 PMCID: PMC7192769 DOI: 10.1111/bjh.16398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 11/04/2019] [Indexed: 12/17/2022]
Abstract
Endemic Burkitt lymphoma (eBL) is an aggressive childhood B-cell lymphoma associated with Plasmodium falciparum (Pf) malaria and Epstein-Barr virus (EBV) infections. Variation in the Human Leukocyte Antigen (HLA) system is suspected to play a role, but assessments using less accurate serology-based HLA typing techniques in small studies yielded conflicting results. We studied 200 eBL cases and 400 controls aged 0-15 years enrolled in northern Uganda and typed by accurate high-resolution HLA sequencing methods. HLA results were analyzed at one- or two-field resolution. Odds ratios and 95% confidence intervals (aOR, 95% CI) for eBL risk associated with common HLA alleles versus alleles that were rare (<1%) or differed by <2% between the cases and controls as the reference category, were estimated using multiple logistic regression adjusting for age, sex, microgeography, region, malaria positivity and treatment history, and genetic variants associated with eBL. Compared to the controls, eBL cases had a lower frequency of HLA-A*02 (aOR = 0·59, 95% CI 0·38-0·91), HLA-B*41 (aOR = 0·36, 95% CI 0·13-1·00), and HLA-B*58 alleles (aOR = 0·59, 95% CI 0·36-0·97). eBL cases had a lower frequency of HLA-DPB1 homozygosity (aOR = 0·57, 95% CI 0·40-0·82) but a higher frequency of HLA-DQA1 homozygosity (aOR = 2·19, 95% CI 1·42-3·37). Our results suggest that variation in HLA may be associated with eBL risk.
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Affiliation(s)
- Samuel Kirimunda
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Isaac Otim
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Mark Ssennono
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
- EMBLEM Study, Kuluva Hospital, Kuluva, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Ismail D. Legason
- EMBLEM Study, Kuluva Hospital, Kuluva, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Hadijah Nabalende
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Martin D. Ogwang
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Patrick Kerchan
- EMBLEM Study, Kuluva Hospital, Kuluva, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Tobias Kinyera
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Ivan Mwebaza
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses Joloba
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Leona W. Ayers
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Kishor Bhatia
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Olusegun O. Onabajo
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Robert J. Biggar
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ludmila Prokunina-Olsson
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James J. Goedert
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Sam M. Mbulaiteye
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Quintana MDP, Smith-Togobo C, Moormann A, Hviid L. Endemic Burkitt lymphoma - an aggressive childhood cancer linked to Plasmodium falciparum exposure, but not to exposure to other malaria parasites. APMIS 2020; 128:129-135. [PMID: 32133709 DOI: 10.1111/apm.13018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Abstract
Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma. The prevalence of BL is ten-fold higher in areas with stable transmission of Plasmodium falciparum malaria, where it is the most common childhood cancer, and is referred to as endemic BL (eBL). In addition to its association with exposure to P. falciparum infection, eBL is strongly associated with Epstein-Barr virus (EBV) infection (>90%). This is in contrast to BL as it occurs outside P. falciparum-endemic areas (sporadic BL), where only a minority of the tumours are EBV-positive. Although the striking geographical overlap in the distribution of eBL and P. falciparum was noted shortly after the first detailed description of eBL in 1958, the molecular details of the interaction between malaria and eBL remain unresolved. It is furthermore unexplained why exposure to P. falciparum appears to be essentially a prerequisite to the development of eBL, whereas other types of malaria parasites that infect humans have no impact. In this brief review, we summarize how malaria exposure may precipitate the malignant transformation of a B-cell clone that leads to eBL, and propose an explanation for why P. falciparum uniquely has this capacity.
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Affiliation(s)
- Maria Del Pilar Quintana
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Cecilia Smith-Togobo
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Biochemistry, Cell and Molecular Biology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Ann Moormann
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lars Hviid
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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Peprah S, Ogwang MD, Kerchan P, Reynolds SJ, Tenge CN, Were PA, Kuremu RT, Wekesa WN, Sumba PO, Masalu N, Kawira E, Magatti J, Kinyera T, Otim I, Legason ID, Nabalende H, Dhudha H, Ally H, Genga IO, Mumia M, Ayers LW, Pfeiffer RM, Biggar RJ, Bhatia K, Goedert JJ, Mbulaiteye SM. Risk factors for Burkitt lymphoma in East African children and minors: A case-control study in malaria-endemic regions in Uganda, Tanzania and Kenya. Int J Cancer 2020; 146:953-969. [PMID: 31054214 PMCID: PMC6829037 DOI: 10.1002/ijc.32390] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 12/25/2022]
Abstract
Endemic Burkitt lymphoma (eBL) is the most common childhood cancer in sub-Saharan African countries, however, few epidemiologic studies have been undertaken and none attempted enrolling cases from multiple countries. We therefore conducted a population-based case-control study of eBL in children aged 0-15 years old in six regions in Northern Uganda, Northern Tanzania and Western Kenya, enrolling 862 suspected cases and 2,934 population controls (response rates 98.5-100%), and processing ~40,000 vials of samples using standardized protocols. Risk factor questionnaires were administered, and malaria period prevalence was measured using rapid diagnostic tests (RDTs). A total of 80.9% of the recruited cases were diagnosed as eBL; 61.4% confirmed by histology. Associations with eBL risk were computed using logistic regression models adjusted for relevant confounders. Associations common in at least two countries were emphasized. eBL risk was decreased with higher maternal income and paternal education and elevated with history of inpatient malaria treatment >12 months before enrollment. Reporting malaria-attributed fever up to 6 months before enrollment and malaria-RDT positivity at enrollment were associated with decreased eBL risk. Conversely, reporting exposure to mass malaria suppression programs (e.g., indoor residual insecticide) was associated with elevated risk. HIV seropositivity was associated with elevated eBL risk, but the relative impact was small. The study shows that it is feasible to conduct networked, multisite population-based studies of eBL in Africa. eBL was inversely associated with socioeconomic status, positively associated with inpatient malaria treatment 12 months ago and with living in areas targeted for malaria suppression, which support a role of malaria in eBL.
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Affiliation(s)
- Sally Peprah
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Martin D. Ogwang
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Patrick Kerchan
- EMBLEM Study, Kuluva Hospital, Kuluva, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Pamela A. Were
- EMBLEM Study, Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Robert T. Kuremu
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
| | - Walter N Wekesa
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
| | | | | | - Esther Kawira
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Josiah Magatti
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Tobias Kinyera
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Isaac Otim
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Ismail D. Legason
- EMBLEM Study, Kuluva Hospital, Kuluva, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Hadijah Nabalende
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Herry Dhudha
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Hillary Ally
- EMBLEM Study, Bugando Medical Center, Mwanza, Tanzania
| | - Isaiah O. Genga
- EMBLEM Study, Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Mediatrix Mumia
- EMBLEM Study, Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Leona W. Ayers
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Ruth M. Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Robert J. Biggar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James J. Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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39
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Henriksen JR, Ramberg I, Mikkelsen LH, Heegaard S. The role of infectious agents in cancer of the ocular region. APMIS 2020; 128:136-149. [PMID: 32003084 DOI: 10.1111/apm.13017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022]
Abstract
The purpose of the study was to investigate the association between infectious agents and the development of cancer in the ocular adnexa. A comprehensive literary study was carried out, reviewing and summarizing previous reports on the topic. A broad range of malignancies of the ocular adnexa are associated with infectious agents. A strong association and possible causal relationship between the infectious agent and the development of ocular adnexal cancer are seen in Merkel cell carcinoma (Merkel cell polyomavirus), Burkitt lymphoma (Epstein-Barr virus) and Kaposi sarcoma (human herpesvirus 8). Infection with Chlamydia psittaci has been associated with the development of extranodal marginal zone B-cell lymphoma in Italy. Human papillomavirus infection has been associated with the development of squamous cell carcinomas of the ocular adnexa, although with a highly variable reported prevalence. By exploring the role of infectious agents in the ocular adnexa and the mechanism by which they contribute to oncogenesis, the diagnostics, management and prevention of these malignancies may also improve. Antibiotic treatment and vaccines against infectious agents may be valuable in future treatment. Additionally, the presence of infectious agents within the tumours may have a prognostic or predictive value.
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Affiliation(s)
- Josephine Raun Henriksen
- Eye Pathology Section, Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ingvild Ramberg
- Eye Pathology Section, Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lauge Hjorth Mikkelsen
- Eye Pathology Section, Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Steffen Heegaard
- Eye Pathology Section, Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Oral Epstein-Barr virus-positive mucocutaneous ulcer: gingival presentation of a benign lymphoproliferative lesion. Int J Oral Maxillofac Surg 2020; 49:1351-1354. [PMID: 31982237 DOI: 10.1016/j.ijom.2020.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/21/2019] [Accepted: 01/09/2020] [Indexed: 11/24/2022]
Abstract
Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a benign lymphoproliferative lesion related to iatrogenic or age-related immunosuppression in patients with prior Epstein-Barr virus (EBV) infection. Although the clinical presentation may resemble malignant disease, the course of EBVMCU is indolent, and regression is expected when immunosuppression is reduced. We present a case of EBVMCU in the gingiva of a 59-year-old male patient with long-standing pemphigus vulgaris. The initial presentation was suspicious for oral cavity cancer, which was ruled out by biopsy. After reduction of immunosuppression, the ulceration regressed and an area of exposed necrotic bone remained. Complete healing was achieved after sequestrectomy and primary closure with a local gingival flap.
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Abstract
B cell development and activation are accompanied by dynamic genetic alterations including V(D)J rearrangements and immunoglobulin-gene somatic hypermutation and class-switch recombination. Abnormalities in these genetic events can cause chromosomal translocations and genomic mutations, leading to altered expression and function of genes involved in B cell survival or proliferation and consequently B lymphomagenesis. In fact, B cell lymphoma accounts for 95% of the lymphomas. In this chapter, we summarize the morphology, immunophenotypes, clinical features, genetic defects that cause the malignancies, treatments, and prognosis of the most prevalent types of B cell lymphomas, including typical precursor B cell malignance (B-ALL/LBL) and mature B cell lymphoma (Hodgkin lymphoma and B cell non-Hodgkin lymphoma).
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Affiliation(s)
- Xin Meng
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Qing Min
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Ji-Yang Wang
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
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Edelbrock RM, Thapa B, Fritz MA, Recinos P, Borghei-Razavi H. Primary Infectious Mononucleosis Masquerading as Post-operative Fever in a Young Patient with Cemento-ossifying Fibroma of the Skull Base. Cureus 2019; 11:e6327. [PMID: 31938618 PMCID: PMC6948092 DOI: 10.7759/cureus.6327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The typical presentation of infectious mononucleosis (IM) is characterized by a triad of fever, pharyngitis, and lymphadenopathy. Epstein-Barr virus (EBV) is the most common etiologic agent for IM. Humans are the reservoir for EBV, and it is transmitted via intimate contact between individuals. This case presents a 19-year-old male with recurrent cemento-ossifying fibroma of the skull base with a complicated post-operative course including bacterial meningitis, cerebrospinal fluid (CSF) leak, and intermittent fevers despite treatment with intravenous cefepime. Head computed tomography (CT) revealed a nonspecific subdural collection that could represent an empyema. However, exploratory craniotomy revealed no empyema. CT chest demonstrated bilateral hilar mediastinal lymphadenopathy and splenomegaly. Blood work for fever of unknown origin was positive for EBV immunoglobulin M, and EBV deoxyribonucleic acid 180,565 IU/mL. The diagnosis of EBV IM in this case was elusive because it presented post-operatively, symptoms aligned with the patient’s CSF leak, and he reported no sexual or sick contacts. For post-operative young patients with recurrent fevers of unknown origin, it is important to consider EBV IM in the differential. Earlier diagnosis could have saved the patient unneeded tests, prevented surgical re-exploration, and resulted in a shorter hospital stay.
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Affiliation(s)
| | - Bicky Thapa
- Hematology/Oncology, Medical College of Wisconsin, Milwaukee, USA
| | - Michael A Fritz
- Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, USA
| | - Pablo Recinos
- Neurosurgery, Taussig Cancer Center, Cleveland Clinic, Cleveland, USA
| | - Hamid Borghei-Razavi
- Neurosurgery, Neurological Institute, Cleveland Clinic - Taussig Cancer Center, Cleveland, USA
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Horner MJ, Salima A, Chilima C, Mukatipa M, Kumwenda W, Kampani C, Chimzimu F, Mukunda B, Tomoka T, Mulenga M, Nyasosela R, Chasimpha S, Dzamalala C, Gopal S. Frequent HIV and Young Age Among Individuals With Diverse Cancers at a National Teaching Hospital in Malawi. J Glob Oncol 2019; 4:1-11. [PMID: 30085887 PMCID: PMC6223526 DOI: 10.1200/jgo.17.00174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Cancer surveillance provides a critical evidence base to guide cancer control efforts, yet population-based coverage in Africa is sparse. Hospital-based registries may help fill this need by providing local epidemiologic data to guide policy and forecast local health care needs. We report the epidemiology of patients with cancer recorded by a de novo hospital-based cancer registry at Kamuzu Central Hospital, Malawi, the sole provider of comprehensive oncology services for half the country and location of a high-volume pathology laboratory. Methods We conducted active case finding across all hospital departments and the pathology laboratory from June 2014 to March 2016. Patient demographics, tumor characteristics, treatment, and HIV status were collected. We describe epidemiology of the cancer caseload, registry design, and costs associated with registry operations. Results Among 1,446 registered patients, Kaposi sarcoma and cervical cancer were the most common cancers among men and women, respectively. Burkitt lymphoma was most common cancer among children. The current rate of pathology confirmation is 65%, a vast improvement in the diagnostic capacity for cancer through the hospital’s pathology laboratory. Among leading cancer types, an alarming proportion occurred at young ages; 50% of Kaposi sarcoma and 25% of esophageal, breast, and cervical cancers were diagnosed among those younger than 40 years of age. A systematic, cross-sectional assessment of HIV status reveals a prevalence of 58% among adults and 18% among children. Conclusion We report a high caseload among typically young patients and a significant burden of HIV infection among patients with cancer. In low- and middle-income countries with intermittent, sparse, or nonexistent cancer surveillance, hospital-based cancer registries can provide important local epidemiologic data while efforts to expand population-based registration continue.
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Affiliation(s)
- Marie-Josèphe Horner
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Ande Salima
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Chrissie Chilima
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Matthews Mukatipa
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Wiza Kumwenda
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Coxcilly Kampani
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Fred Chimzimu
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Bal Mukunda
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Tamiwe Tomoka
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Maurice Mulenga
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Richard Nyasosela
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Steady Chasimpha
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Charles Dzamalala
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
| | - Satish Gopal
- Marie-Josèphe Horner and Satish Gopal, University of North Carolina at Chapel Hill, Chapel Hill, NC; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, Coxcilly Kampani, Fred Chimzimu, Bal Mukunda, Tamiwe Tomoka, Maurice Mulenga, Richard Nyasosela, and Satish Gopal, University of North Carolina Project-Malawi; Marie-Josèphe Horner, Ande Salima, Chrissie Chilima, Matthews Mukatipa, Wiza Kumwenda, and Satish Gopal, Kamuzu Central Hospital Cancer Registry; Satish Gopal, Malawi Cancer Consortium & Regional Center of Research Excellence for Non-Communicable Diseases, Lilongwe; Steady Chasimpha and Charles Dzamalala, Malawi Cancer Registry; and Charles Dzamalala and Satish Gopal, University of Malawi College of Medicine, Blantyre, Malawi
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He YQ, Liao XY, Xue WQ, Xu YF, Xu FH, Li FF, Li XZ, Zhang JB, Wang TM, Wang F, Yu HL, Feng QS, Chen LZ, Cao SM, Liu Q, Mu J, Jia WH. Association Between Environmental Factors and Oral Epstein-Barr Virus DNA Loads: A Multicenter Cross-sectional Study in China. J Infect Dis 2019; 219:400-409. [PMID: 30307559 DOI: 10.1093/infdis/jiy542] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022] Open
Abstract
Background Oral Epstein-Barr virus (EBV) status reflects host EBV activity and potentially links to EBV-associated diseases, however, factors influencing oral EBV loads or reactivation, such as environmental exposures or host factors, are not fully understood. Methods A 2-stage, multicenter, cross-sectional study of 6558 subjects from 21 administrative cities of southern China and 3 populations from representative geographical areas in China (referred to as the south, north, and northeastern populations) was performed. The relationships between demographical factors and environmental exposures to EBV loads were analyzed by logistic regression models. Results Current smoking, with a dose-response effect, was found to be strongly associated with higher oral EBV loads in the pooled data, with an odds ratio of 1.58 (95% confidence interval, 1.39-1.79), as well as in each of the separate populations. The odds ratio increased to 3.06 when current smokers in southern China were compared to never smokers in northern China. Additionally, higher oral EBV loads tended to be detected in older participants, male participants, and participants in southern China. Conclusions This study provided evidence linking the effect of host-environmental factors, particularly smoking, to oral EBV activity. It could strengthen our understanding of the possible causal roles of EBV-related diseases, which may help to prevent or mitigate EBV-associated diseases.
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Affiliation(s)
- Yong-Qiao He
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Xiao-Yu Liao
- Department of Endocrinology, Xinqiao Hospital, Third Military Medical University, Chongqing
| | - Wen-Qiong Xue
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Ya-Fei Xu
- Shenzhen University Health Science Center, Shenzhen, China
| | - Feng-Hua Xu
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Fang-Fang Li
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Xi-Zhao Li
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Jiang-Bo Zhang
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Tong-Min Wang
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Fang Wang
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Huan-Lin Yu
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Qi-Sheng Feng
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Li-Zhen Chen
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Su-Mei Cao
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Qing Liu
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou
| | - Jianbing Mu
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Wei-Hua Jia
- Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Guangzhou.,Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou.,School of Public Health, Sun Yat-Sen University, Guangzhou.,Cancer Center of Guangzhou Medical University, Guangzhou
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Gammaherpesvirus entry and fusion: A tale how two human pathogenic viruses enter their host cells. Adv Virus Res 2019; 104:313-343. [PMID: 31439152 DOI: 10.1016/bs.aivir.2019.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The prototypical human γ-herpesviruses Epstein-Barr virus (EBV) and Kaposi Sarcoma-associated herpesvirus (KSHV) are involved in the development of malignancies. Like all herpesviruses, they share the establishment of latency, the typical architecture, and the conserved fusion machinery to initiate infection. The fusion machinery reflects virus-specific adaptations due to the requirements of the respective herpesvirus. For example, EBV evolved a tropism switch involving either the B- or epithelial cell-tropism complexes to activate fusion driven by gB. Most of the EBV entry proteins and their cellular receptors have been crystallized providing molecular details of the initial steps of infection. For KSHV, a variety of entry and binding receptors has also been reported but the mechanism how receptor binding activates gB-driven fusion is not as well understood as that for EBV. However, the downstream signaling pathways that promote the early steps of KSHV entry are well described. This review summarizes the current knowledge of the key players involved in EBV and KSHV entry and the cell-type specific mechanisms that allow infection of a wide variety of cell types.
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Vaillant V, Reiter A, Zimmermann M, Wagner HJ. Seroepidemiological analysis and literature review of the prevalence of Epstein-Barr virus and herpesvirus infections in pediatric cases with non-Hodgkin lymphoma in Central Europe. Pediatr Blood Cancer 2019; 66:e27752. [PMID: 30977593 DOI: 10.1002/pbc.27752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/17/2019] [Accepted: 03/26/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Epstein-Barr virus (EBV) is linked to a variety of malignancies; most endemic Burkitt lymphoma (BL) harbor EBV, whereas only a subset of the cases of sporadic BL is EBV positive. PROCEDURE We retrospectively determined the herpesvirus seroprevalence at the time of diagnosis in pediatric non-Hodgkin lymphoma (NHL) patients enrolled in NHL-BFM (Berlin-Frankfurt-Muenster) studies. We accessed the seroepidemiological data from 1147 patients that became available during 1990-2007. We included the records from patients 6 months to 18 years of age with BL, T-cell lymphoblastic lymphoma (T-LBL), lymphoblastic precursor B-cell lymphoma (pB-LBL), diffuse large B-cell lymphoma (DLBCL), or anaplastic large cell lymphoma (ALCL). RESULTS EBV seropositivity was significantly more frequent in patients with BL than in those with T-LBL. EBV was more prevalent in patients younger than 6 years of age and in patients with BL than in those with non-BL or T-LBL. Event-free survival was significantly lower in varicella-zoster-seronegative patients, but there was no indication of an association to complications due to varicella zoster infection. We found no associations between herpes simplex virus, varicella zoster virus, or human cytomegalovirus seroprevalence and the pediatric Central European NHL cases. CONCLUSION Early EBV exposure may increase the risk of BL in Central Europe. A higher involvement of EBV in European BL than originally reported appears at least probable. Our data support the thesis that the distinction between endemic and sporadic BL is artificial and should be replaced by the differentiation between EBV-positive and EBV-negative BL.
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Affiliation(s)
- Vera Vaillant
- Department of Pediatric Hematology and Oncology, Justus Liebig University Giessen, Giessen, Germany
| | - Alfred Reiter
- Department of Pediatric Hematology and Oncology, Justus Liebig University Giessen, Giessen, Germany
| | - Martin Zimmermann
- Department of Pediatric Hematology and Oncology, MHH Hannover Medical School, Hannover, Germany
| | - Hans-Joachim Wagner
- Department of Pediatric Hematology and Oncology, Justus Liebig University Giessen, Giessen, Germany
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Takahama A, de Lima HG, Ito FA, Ribeiro-Silva A, León JE. Epstein-Barr Virus–Positive Mucocutaneous Ulcer Mimicking Peri-Implantitis in a Patient With Systemic Lupus Erythematosus. J Oral Maxillofac Surg 2019; 77:977-984. [DOI: 10.1016/j.joms.2018.12.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 01/31/2023]
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Dugan JP, Coleman CB, Haverkos B. Opportunities to Target the Life Cycle of Epstein-Barr Virus (EBV) in EBV-Associated Lymphoproliferative Disorders. Front Oncol 2019; 9:127. [PMID: 30931253 PMCID: PMC6428703 DOI: 10.3389/fonc.2019.00127] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/13/2019] [Indexed: 12/29/2022] Open
Abstract
Many lymphoproliferative disorders (LPDs) are considered “EBV associated” based on detection of the virus in tumor tissue. EBV drives proliferation of LPDs via expression of the viral latent genes and many pre-clinical and clinical studies have shown EBV-associated LPDs can be treated by exploiting the viral life cycle. After a brief review of EBV virology and the natural life cycle within a host we will discuss the importance of the viral gene programs expressed during specific viral phases, as well as within immunocompetent vs. immunocompromised hosts and corresponding EBV-associated LPDs. We will then review established and emerging treatment approaches for EBV-associated LPDs based on EBV gene expression programs. Patients with EBV-associated LPDs can have a poor performance status, multiple comorbidities, and/or are immunocompromised from organ transplantation, autoimmune disease, or other congenital or acquired immunodeficiency making them poor candidates to receive intensive cytotoxic chemotherapy. With the emergence of EBV-directed therapy there is hope that we can devise more effective therapies that confer milder toxicity.
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Affiliation(s)
- James P Dugan
- Division of Hematology, University of Colorado, Aurora, CO, United States
| | - Carrie B Coleman
- Division of Immunology, University of Colorado, Aurora, CO, United States
| | - Bradley Haverkos
- Division of Hematology, University of Colorado, Aurora, CO, United States
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Derkach A, Otim I, Pfeiffer RM, Onabajo OO, Legason ID, Nabalende H, Ogwang MD, Kerchan P, Talisuna AO, Ayers LW, Reynolds SJ, Nkrumah F, Neequaye J, Bhatia K, Theander TG, Prokunina-Olsson L, Turner L, Goedert JJ, Lavstsen T, Mbulaiteye SM. Associations between IgG reactivity to Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) antigens and Burkitt lymphoma in Ghana and Uganda case-control studies. EBioMedicine 2018; 39:358-368. [PMID: 30579868 PMCID: PMC6355394 DOI: 10.1016/j.ebiom.2018.12.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 01/26/2023] Open
Abstract
Background Endemic Burkitt lymphoma (eBL) is an aggressive childhood B-cell lymphoma linked to Plasmodium falciparum (Pf) malaria in sub-Saharan Africa. We investigated antibody reactivity to several human receptor-binding domains of the Pf erythrocyte membrane protein 1 (PfEMP1) that play a key role in malaria pathogenesis and are targets of acquired immunity to malaria. Methods Serum/plasma IgG antibody reactivity was measured to 22 Pf antigens, including 18 to PfEMP1 CIDR domains between cases and controls from two populations (149 eBL cases and 150 controls from Ghana and 194 eBL cases and 600 controls from Uganda). Adjusted odds ratios (aORs) for case-control associations were estimated by logistic regression. Findings There was stronger reactivity to the severe malaria associated CIDRα1 domains than other CIDR domains both in cases and controls. eBL cases reacted to fewer antigens than controls (Ghana: p = 0·001; Uganda: p = 0·03), with statistically significant lower ORs associated with reactivity to 13+ antigens in Ghana (aOR 0·39, 95% CI 0·24–0·63; pheterogeneity = 0·00011) and Uganda (aOR 0·60, 95% CI 0.41–0·88; pheterogeneity = 0·008). eBL was inversely associated with reactivity, coded as quartiles, to group A variant CIDRδ1 (ptrend = 0·035) in Ghana and group B CD36-binding variants CIDRα2·2 (ptrend = 0·006) and CIDRα2·4 (ptrend = 0·033) in Uganda, and positively associated with reactivity to SERA5 in Ghana (ptrend = 0·017) and Uganda (ptrend = 0·007) and group A CIDRα1·5 variant in Uganda only (ptrend = 0·034). Interpretation eBL cases reacted to fewer antigens than controls using samples from two populations, Ghana and Uganda. Attenuated humoral immunity to Pf EMP1 may contribute to susceptibility to low-grade malaria and eBL risk. Funding Intramural Research Program, National Cancer Institute and National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services.
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Affiliation(s)
- Andriy Derkach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Isaac Otim
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Olusegun O Onabajo
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ismail D Legason
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | | | | | | | - Ambrose O Talisuna
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Leona W Ayers
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Janet Neequaye
- Department of Child Health, Korle Bu University Teaching Hospital in Accra, Ghana
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thor G Theander
- Centre for Medical Parasitology, Department of International Health, Immunology & Microbiology, University of Copenhagen and Department of Infectious Diseases, Rigs Hospitalet, Copenhagen, Denmark
| | - Ludmila Prokunina-Olsson
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Louise Turner
- Centre for Medical Parasitology, Department of International Health, Immunology & Microbiology, University of Copenhagen and Department of Infectious Diseases, Rigs Hospitalet, Copenhagen, Denmark
| | - James J Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thomas Lavstsen
- Centre for Medical Parasitology, Department of International Health, Immunology & Microbiology, University of Copenhagen and Department of Infectious Diseases, Rigs Hospitalet, Copenhagen, Denmark
| | - Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Uccini S, Al-Jadiry MF, Cippitelli C, Talerico C, Scarpino S, Al-Darraji AF, Al-Badri SAF, Alsaadawi AR, Al-Hadad SA, Ruco L. Burkitt lymphoma in Iraqi children: A distinctive form of sporadic disease with high incidence of EBV + cases and more frequent expression of MUM1/IRF4 protein in cases with head and neck presentation. Pediatr Blood Cancer 2018; 65:e27399. [PMID: 30207048 DOI: 10.1002/pbc.27399] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/03/2018] [Accepted: 07/16/2018] [Indexed: 12/13/2022]
Abstract
Epstein-Barr virus (EBV)-related lymphoproliferative disorders are relatively common in Iraqi children. Burkitt lymphoma (BL) accounted for 40% of lymphoma cases. The mean age of 125 BL cases was 5.9 ± 3.1 years, and the male-to-female ratio was 3.6:1. Clinical presentation was abdominal in 66% and head and neck in 34%. Bone marrow involvement was higher (P < 0.001) in children with head and neck disease. Tumor cells had MYC translocation (96%) and were CD20+ /CD10+ /MYC+ /BCL2- . MUM1/IRF4 staining was expressed by a fraction of tumor cells in 19 of 125 cases (15%) and was more frequent (P < 0.007) in head and neck disease (12/42; 29%). EBV-encoded RNA was positive in 100 of 125 (80%) BL cases.
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Affiliation(s)
| | - Mazin F Al-Jadiry
- Children's Welfare Teaching Hospital, Baghdad College of Medicine, Baghdad, Iraq
| | - Claudia Cippitelli
- Department of Clinical and Molecular Medicine, Pathology Unit, Sapienza University, Sant'Andrea Hospital, Rome, Italy
| | - Caterina Talerico
- Department of Clinical and Molecular Medicine, Pathology Unit, Sapienza University, Sant'Andrea Hospital, Rome, Italy
| | - Stefania Scarpino
- Department of Clinical and Molecular Medicine, Pathology Unit, Sapienza University, Sant'Andrea Hospital, Rome, Italy
| | - Amir F Al-Darraji
- Children's Welfare Teaching Hospital, Baghdad College of Medicine, Baghdad, Iraq
| | - Safaa A F Al-Badri
- Children's Welfare Teaching Hospital, Baghdad College of Medicine, Baghdad, Iraq
| | - Adel R Alsaadawi
- Department of Pathology, Baghdad Medical City Complex, Baghdad, Iraq
| | - Salma A Al-Hadad
- Children's Welfare Teaching Hospital, Baghdad College of Medicine, Baghdad, Iraq
| | - Luigi Ruco
- Department of Clinical and Molecular Medicine, Pathology Unit, Sapienza University, Sant'Andrea Hospital, Rome, Italy
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