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Gordon ER, Fahmy LM, Trager MH, Adeuyan O, Lapolla BA, Schreidah CM, Geskin LJ. From Molecules to Microbes: Tracing Cutaneous T-Cell Lymphoma Pathogenesis through Malignant Inflammation. J Invest Dermatol 2024:S0022-202X(24)00262-8. [PMID: 38703171 DOI: 10.1016/j.jid.2024.03.022] [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: 02/23/2024] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 05/06/2024]
Abstract
The etiology of CTCL is a subject of extensive investigation. Researchers have explored links between CTCL and environmental chemical exposures, such as aromatic hydrocarbons (eg, pesticides and benzene), as well as infectious factors, including various viruses (eg, human T-lymphotropic virus [HTLV]-I and HTLV-II) and bacteria (eg, Staphylococcus aureus). There has been growing emphasis on the role of malignant inflammation in CTCL development. In this review, we synthesize studies of environmental and infectious exposures, along with research on the aryl hydrocarbon receptor and the involvement of pathogens in disease etiology, providing insight into the pathogenesis of CTCL.
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Affiliation(s)
- Emily R Gordon
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Lauren M Fahmy
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Megan H Trager
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York, USA
| | - Oluwaseyi Adeuyan
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Brigit A Lapolla
- Department of Dermatology, Columbia University Irving Medical Center, New York, New York, USA
| | - Celine M Schreidah
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Larisa J Geskin
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA; Department of Dermatology, Columbia University Irving Medical Center, New York, New York, USA.
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2
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Single-Cell Heterogeneity of Cutaneous T-Cell Lymphomas Revealed Using RNA-Seq Technologies. Cancers (Basel) 2020; 12:cancers12082129. [PMID: 32751918 PMCID: PMC7464763 DOI: 10.3390/cancers12082129] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/16/2020] [Accepted: 07/29/2020] [Indexed: 01/04/2023] Open
Abstract
Cutaneous T-cell lymphomas (CTCLs) represent a large, heterogeneous group of non-Hodgkin lymphomas that primarily affect the skin. Among multiple CTCL variants, the most prevalent types are mycosis fungoides (MF) and Sézary syndrome (SS). In the past decade, the molecular genetics of CTCL have been the target of intense study, increasing the knowledge of CTCL genomic alterations, discovering novel biomarkers, and potential targets for patient-specific therapy. However, the detailed pathogenesis of CTCL development still needs to be discovered. This review aims to summarize the novel insights into molecular heterogeneity of malignant cells using high-throughput technologies, such as RNA sequencing and single-cell RNA sequencing, which might be useful to identify tumour-specific molecular signatures and, therefore, offer guidance for therapy, diagnosis, and prognosis of CTCL.
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3
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Ghazawi FM, Alghazawi N, Le M, Netchiporouk E, Glassman SJ, Sasseville D, Litvinov IV. Environmental and Other Extrinsic Risk Factors Contributing to the Pathogenesis of Cutaneous T Cell Lymphoma (CTCL). Front Oncol 2019; 9:300. [PMID: 31106143 PMCID: PMC6499168 DOI: 10.3389/fonc.2019.00300] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 04/01/2019] [Indexed: 01/17/2023] Open
Abstract
The applications of disease cluster investigations in medicine have developed rather rapidly in recent decades. Analyzing the epidemiology of non-random aggregation of patients with a particular disease fostered identification of environmental and external exposures as disease triggers and promoters. Observation of patient clusters and their association with nearby exposures, such as Dr. John Snow's astute mapping analysis in the mid-1800's, which revealed proximity of cholera patients in London to a contaminated water pump infected with Vibrio cholerae, have paved the way for the field of epidemiology. This approach enabled the identification of triggers for many human diseases including infections and cancers. Cutaneous T-cell lymphomas (CTCL) represent a group of non-Hodgkin lymphomas that primarily affect the skin. The detailed pathogenesis by which CTCL develops remains largely unknown. Notably, non-random clustering of CTCL patients was reported in several areas worldwide and this rare malignancy was also described to affect multiple members of the same family. These observations indicate that external factors are possibly implicated in promoting CTCL lymphomagenesis. Here, we review the epidemiology of CTCL worldwide and the clinical characteristics of CTCL patients, as revealed by global epidemiological data. Further, we review the known risk factors including sex, age, race as well as environmental, infectious, iatrogenic and other exposures, that are implicated in CTCL lymphomagenesis and discuss conceivable mechanisms by which these factors may trigger this malignancy.
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Affiliation(s)
- Feras M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, ON, Canada
| | - Nebras Alghazawi
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | - Michelle Le
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | | | | | - Denis Sasseville
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | - Ivan V Litvinov
- Division of Dermatology, McGill University, Montréal, QC, Canada
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4
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Eliassen E, Lum E, Pritchett J, Ongradi J, Krueger G, Crawford JR, Phan TL, Ablashi D, Hudnall SD. Human Herpesvirus 6 and Malignancy: A Review. Front Oncol 2018; 8:512. [PMID: 30542640 PMCID: PMC6277865 DOI: 10.3389/fonc.2018.00512] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/19/2018] [Indexed: 12/21/2022] Open
Abstract
In order to determine the role of human herpesvirus 6 (HHV-6) in human disease, several confounding factors, including methods of detection, types of controls, and the ubiquitous nature of the virus, must be considered. This is particularly problematic in the case of cancer, in which rates of detection vary greatly among studies. To determine what part, if any, HHV-6 plays in oncogenesis, a review of the literature was performed. There is evidence that HHV-6 is present in certain types of cancer; however, detection of the virus within tumor cells is insufficient for assigning a direct role of HHV-6 in tumorigenesis. Findings supportive of a causal role for a virus in cancer include presence of the virus in a large proportion of cases, presence of the virus in most tumor cells, and virus-induced in-vitro cell transformation. HHV-6, if not directly oncogenic, may act as a contributory factor that indirectly enhances tumor cell growth, in some cases by cooperation with other viruses. Another possibility is that HHV-6 may merely be an opportunistic virus that thrives in the immunodeficient tumor microenvironment. Although many studies have been carried out, it is still premature to definitively implicate HHV-6 in several human cancers. In some instances, evidence suggests that HHV-6 may cooperate with other viruses, including EBV, HPV, and HHV-8, in the development of cancer, and HHV-6 may have a role in such conditions as nodular sclerosis Hodgkin lymphoma, gastrointestinal cancer, glial tumors, and oral cancers. However, further studies will be required to determine the exact contributions of HHV-6 to tumorigenesis.
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Affiliation(s)
- Eva Eliassen
- HHV-6 Foundation, Santa Barbara, CA, United States
| | - Emily Lum
- HHV-6 Foundation, Santa Barbara, CA, United States
| | - Joshua Pritchett
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Joseph Ongradi
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Gerhard Krueger
- Department of Pathology and Laboratory Medicine, University of Texas- Houston Medical School, Houston, TX, United States
| | - John R Crawford
- Department of Neurosciences and Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA, United States
| | - Tuan L Phan
- HHV-6 Foundation, Santa Barbara, CA, United States.,Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, United States
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5
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Haverkos BM, Gru AA, Geyer SM, Bingman AK, Hemminger JA, Mishra A, Wong HK, Pancholi P, Freud AG, Caligiuri MA, Baiocchi RA, Porcu P. Increased Levels of Plasma Epstein Barr Virus DNA Identify a Poor-Risk Subset of Patients With Advanced Stage Cutaneous T-Cell Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 16 Suppl:S181-S190.e4. [PMID: 27521316 DOI: 10.1016/j.clml.2016.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 02/09/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Outcomes in advanced stage (AS) cutaneous T-cell lymphomas (CTCL) are poor but with great variability. Epstein-Barr virus (EBV) is associated with a subset of non-Hodgkin lymphomas. Frequency of plasma EBV-DNA (pEBVd) detection, concordance with EBV RNA (EBER) in tumor tissue, codetection of plasma cytomegalovirus DNA (pCMVd), and prognostic effect in AS CTCL are unknown. PATIENTS AND METHODS Patients (n = 46; 2006-2013) with AS CTCL (≥IIB) were retrospectively studied. pEBVd and pCMVd were longitudinally measured using quantitative real-time polymerase chain reaction. EBER in situ hybridization (ISH) was performed on tumor samples. Survival from time of diagnosis (ToD) and time of progression to AS was assessed. RESULTS Plasma EBV-DNA and pCMVd were detected in 37% (17 of 46) and 17% (8 of 46) of AS CTCL patients, respectively. pCMVd detection was significantly more frequent in pEBVd-positive (pEBVd(+)) than pEBVd(-) patients (35% vs. 7%; P = .038). Tumor tissue for EBER-ISH was available in 14 of 17 pEBVd(+) and 22 of 29 pEBVd(-) patients; 12 of 14 (85.7%) pEBVd(+) patients were EBER(+) versus 0 of 22 pEBVd(-) patients. Frequency of large cell transformation (LCT) tended to be greater in pEBVd(+) patients, but was not significant (10 of 14 pEBVd(+) vs. 10 of 23 pEBVd(-); P = .17). No notable differences in rates of increased levels of serum lactate dehydrogenase (LDH) were observed (17 of 17 pEBVd(+) vs. 27 of 29 pEBVd(-)). pEBVd detection was associated with significantly worse survival from ToD (P = .021) and time of progression to AS (P = .0098). CONCLUSION Detection of cell-free plasma EBV-DNA was highly concordant with the presence of EBERs in tumor tissue, predicted survival independent of LDH and LCT, and should be further studied as a biomarker in AS CTCL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers
- Biopsy
- DNA, Viral
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/virology
- Female
- Follow-Up Studies
- Herpesvirus 4, Human/genetics
- Humans
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/etiology
- Lymphoma, T-Cell, Cutaneous/mortality
- Lymphoma, T-Cell, Cutaneous/therapy
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
- Retrospective Studies
- Skin/pathology
- Survival Analysis
- Treatment Outcome
- Viral Load
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Affiliation(s)
| | - Alejandro A Gru
- Department of Pathology, University of Virginia, Charlottesville, VA
| | - Susan M Geyer
- Department of Pediatrics Health Informatics Institute, University of South Florida, Tampa, FL
| | - Anissa K Bingman
- Center for Biostatistics, The Ohio State University, Columbus, OH
| | | | - Anjali Mishra
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH; Division of Dermatology, The Ohio State University, Columbus, OH
| | - Henry K Wong
- Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, AR
| | - Preeti Pancholi
- Department of Pathology, The Ohio State University, Columbus, OH
| | - Aharon G Freud
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH
| | - Michael A Caligiuri
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH; Division of Hematology, The Ohio State University, Columbus, OH
| | - Robert A Baiocchi
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH; Division of Hematology, The Ohio State University, Columbus, OH
| | - Pierluigi Porcu
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH; Division of Hematology, The Ohio State University, Columbus, OH.
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6
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Abstract
The etiology of cutaneous T-cell lymphoma (CTCL) remains unknown, with potential infectious causes having been explored. This contribution evaluates the evidence suggesting an infectious etiology and pathogenesis of the disease, characterizes the relationships between various specific pathogens and CTCL, and discusses some of the difficulties in establishing a causal link between infectious agents and CTCL carcinogenesis. Researchers have evaluated CTCL specimens for evidence of infection with a variety of agents, including human T-lymphotropic virus, Epstein-Barr virus, human herpesvirus-8, and Staphylococcus aureus, although other pathogens also have been detected in CTCL. Although there is significant evidence implicating one or more infectious agents in CTCL, studies to date have not linked definitively any pathogen to disease development, and various studies have yielded conflicting results.
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7
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Fernandez KH, Bream M, Ali MA, Krogmann T, Zhao H, Li Y, Cohen JI, Damon I, Liu V. Investigation of molluscum contagiosum virus, orf and other parapoxviruses in lymphomatoid papulosis. J Am Acad Dermatol 2013; 68:1046-7. [PMID: 23680202 PMCID: PMC3670952 DOI: 10.1016/j.jaad.2012.12.972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/13/2012] [Accepted: 12/28/2012] [Indexed: 11/17/2022]
Affiliation(s)
- Kristen Heins Fernandez
- University of Missouri, Department of Dermatology, 1 Hopsital Drive, Room MA 111, Columbia, MO 65212, Phone: 573-882-1767, Fax: 573-884-5947
| | - Matthew Bream
- University of Iowa, Departments of Dermatology and Pathology, 200 Hawkins Drive, Iowa City, IA 52242, Phone: 319-631-8967, Fax: 319-356-8317
| | - Mir A. Ali
- National Institutes of Health, Laboratory of Infectious Disease and Medical Virology Section, Bldg 50, Rm. 6134, 50 South Drive, Bethesda, MD 20892, Phone: 301-496-5265, Fax: 301-496-8312
| | - Tammy Krogmann
- National Institutes of Health, Laboratory of Infectious Disease and Medical Virology Section, Bldg 50, Rm. 6134, 50 South Drive, Bethesda, MD 20892, Phone: 301-496-5265, Fax: 301-496-8312
| | - Hui Zhao
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 1600 Clifton Road NE, Atlanta, Georgia 30333, Phone: 404-639-4931, Fax: 404-639-1060
| | - Yu Li
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 1600 Clifton Road NE, Atlanta, Georgia 30333, Phone: 404-639-4931, Fax: 404-639-1060
| | - Jeffrey I. Cohen
- National Institutes of Health, Laboratory of Infectious Disease and Medical Virology Section, Bldg 50, Rm. 6134, 50 South Drive, Bethesda, MD 20892, Phone: 301-496-5265, Fax: 301-496-8312
| | - Inger Damon
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 1600 Clifton Road NE, Atlanta, Georgia 30333, Phone: 404-639-4931, Fax: 404-639-1060
| | - Vincent Liu
- University of Iowa, Departments of Dermatology and Pathology, 200 Hawkins Drive, Iowa City, IA 52242, Phone: 319-631-8967, Fax: 319-356-8317
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8
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Primary cutaneous Epstein-Barr virus-associated T-cell lymphoproliferative disorder-2 cases with unusual, prolonged clinical course. Am J Dermatopathol 2011; 32:832-6. [PMID: 20595887 DOI: 10.1097/dad.0b013e3181d68381] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hydroa vacciniforme-like lymphoma and extranodal-type natural killer (NK)/T-cell lymphoma are prototypes of Epstein-Barr virus (EBV)-associated cutaneous T- or NK-cell lymphomas. Hydroa vacciniforme-like lymphoma with systemic spread and extranodal-type NK/T-cell lymphoma are characterized by aggressive clinical course. We describe 2 patients with primary cutaneous EBV-associated T-cell lymphomas who did not satisfy the criteria for well-defined entities and showed unusual, prolonged clinical course. They presented with skin ulcerations and mass lesions confined to the extremities without systemic involvement. Skin biopsies demonstrated dense superficial and deep perivascular and periappendageal lymphoid infiltrates expressing CD3 and CD8, but not CD56. The EBV genomes were found within the tumor cells, and monoclonal T-cell receptor gene rearrangement was present. We suggest that these cases represent a peculiar subtype of EBV+ cutaneous T-cell lymphoma, with a tendency to localize in the skin of the extremities and has an indolent clinical course.
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9
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Quéreux G, André-Garnier E, Knol AC, Imbert-Marcille BM, Dréno B. Evaluation of the role of human herpes virus 6 and 8 in parapsoriasis. Exp Dermatol 2009; 18:357-61. [DOI: 10.1111/j.1600-0625.2008.00787.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Willemze R, Meijer CJLM. Primary cutaneous CD30-positive lymphoproliferative disorders. Hematol Oncol Clin North Am 2003; 17:1319-32, vii-viii. [PMID: 14710887 DOI: 10.1016/s0889-8588(03)00117-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Primary cutaneous CD30-positive (anaplastic) large T-cell lymphoma and lymphomatoid papulosis have many overlapping clinical, histologic, and immunophenotypic features. These entities are currently considered as parts of a spectrum of primary cutaneous CD30-positive lymphoproliferative disorders. We provide the clinician with practical guidelines for the diagnosis, management, and treatment of patients within this spectrum of primary cutaneous CD30-positive lymphoproliferative disorders. Most patients within this spectrum of disease have an excellent prognosis. Multi-agent chemotherapy should be reserved for patients who have extracutaneous disease.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Cell Transformation, Neoplastic
- Child
- Child, Preschool
- Diagnosis, Differential
- Female
- Humans
- Infant
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/epidemiology
- Lymphoma, Large-Cell, Anaplastic/etiology
- Lymphoma, Large-Cell, Anaplastic/pathology
- Lymphoma, Large-Cell, Anaplastic/therapy
- Lymphomatoid Papulosis/etiology
- Lymphomatoid Papulosis/pathology
- Male
- Middle Aged
- Remission, Spontaneous
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
- Virus Diseases/complications
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Affiliation(s)
- Rein Willemze
- Department of Dermatology, B1-Q-93 Leiden University, Medical Center Post Office Box 9600, 2300 RC Leiden, The Netherlands.
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11
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Erkek E, Sahin S, Atakan N, Kocagöz T, Olut AI. Absence of Epstein-Barr virus and human herpesvirus-6 in pityriasis lichenoides and plaque parapsoriasis. J Eur Acad Dermatol Venereol 2002; 16:536-7. [PMID: 12428859 DOI: 10.1046/j.1468-3083.2002.00555_4.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Erkek E, Sahin S, Atakan N, Kocagöz T, Olut A, Gököz A. Examination of mycosis fungoides for the presence of Epstein-Barr virus and human herpesvirus-6 by polymerase chain reaction. J Eur Acad Dermatol Venereol 2001; 15:422-6. [PMID: 11763382 DOI: 10.1046/j.1468-3083.2001.00309.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aetiology of cutaneous T-cell lymphoma (CTCL) remains unknown despite numerous investigations. In recent years, retroviruses and human herpesviruses have been implicated to play a causal part in CTCL. OBJECTIVE The aim of this study was to elucidate the possible aetiopathogenetic role of human herpesviruses (HHV) in mycosis fungoides (MF). METHODS Polymerase chain reaction was used to study formalin-fixed, paraffin-embedded lesional skin biopsies from 92 subjects with MF to evidence possible presence of Epstein-Barr virus (EBV) and HHV-6. RESULTS Biopsy specimens from nine subjects (9.8%) evidenced EBV DNA, whereas all except one of the subjects (1.1%) lacked HHV-6 DNA. CONCLUSIONS Although these findings do not support a primary aetiological role for EBV and HHV-6 in classical CTCL, the possibility remains that both viruses, particularly EBV, may act as potential cofactors in the development of CTCL.
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Affiliation(s)
- E Erkek
- Hacettepe University, Faculty of Medicine, Ankara, Turkey.
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13
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Shimakage M, Sasagawa T, Kawahara K, Yutsudo M, Kusuoka H, Kozuka T. Expression of Epstein-Barr virus in cutaneous T-cell lymphoma including mycosis fungoides. Int J Cancer 2001; 92:226-31. [PMID: 11291050 DOI: 10.1002/1097-0215(200102)9999:9999<::aid-ijc1172>3.0.co;2-o] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cutaneous T-Cell lymphoma (CTCL) is a non-Hodgkin's lymphoma of unknown pathogenesis. Mycosis fungoides (MF) is a clinically determined subset of CTCL with intensive infiltration of lymphoma cells into the epidermis. To determine whether Epstein-Barr virus (EBV) is associated with these lymphoma cells, we performed mRNA in situ hybridization in 5 cases of CTCL and 7 cases of MF using an RNA probe transcribed from BamHI W fragment of EBV genome. These transcripts were detected in the majority of lymphoma cells in all cases examined. We also detected intensive hybridization signals on epidermal squamous cells contiguous to strong infiltration with lymphoma cells into the subcutaneous connective tissue. Similarly, positive signals were detected using the probes transcribed from the sequences of EBV-encoded small nonpolyadenylated RNAs-1 (EBER1) and EBV-determined nuclear antigen-2 (EBNA2). The EBNA2 latent membrane protein-1 (LMP1) and BZLF1 product (ZEBRA) were also detected by immunofluorescence staining using monoclonal antibodies. Further in the same experiment, we detected immunofluorescence of epidermal cells. EBV DNA was detected in all cases tested by DNA in situ hybridization. Moreover, we also identified the signals on epidermal cells via this technique. Polymerase chain reaction revealed amplified EBV DNA for most cases tested. Double staining with immunohistochemistry and RNA in situ hybridization showed that T-cell marker-positive cells, but not EBV-carrying B-cells, exhibited signals for the EB viral RNA. These findings suggest that EBV is involved in the neoplastic transformation of CTCL and MF.
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MESH Headings
- Adult
- Aged
- DNA, Viral/analysis
- Epstein-Barr Virus Nuclear Antigens/biosynthesis
- Epstein-Barr Virus Nuclear Antigens/genetics
- Epstein-Barr Virus Nuclear Antigens/immunology
- Female
- Fluorescent Antibody Technique, Indirect
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 4, Human/metabolism
- Humans
- In Situ Hybridization
- Lymphoma, T-Cell, Cutaneous/virology
- Male
- Middle Aged
- Mycosis Fungoides/virology
- RNA, Messenger/biosynthesis
- RNA, Viral/biosynthesis
- RNA, Viral/genetics
- Transcription, Genetic
- Viral Proteins
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Affiliation(s)
- M Shimakage
- Clinical Research Institute, Osaka National Hospital, 2-1-14 Hoenzaka Chuo-ku, Osaka 540-0006, Japan.
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14
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Brice SL, Cook D, Leahy M, Huff JC, Weston WL. Examination of the oral mucosa and peripheral blood cells of patients with recurrent aphthous ulceration for human herpesvirus DNA. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 89:193-8. [PMID: 10673655 DOI: 10.1067/moe.2000.102041] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The purpose of this study was to exam the oral mucosa and peripheral blood cells of patients with recurrent aph-thous ulceration (RAU) for the presence of the following human herpesviruses: herpes simplex viruses 1 and 2, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, human herpesvirus-6, and human herpesvirus-7. STUDY DESIGN Fifty-eight subjects with RAU and 10 control subjects were recruited at an academic referral center and enrolled in this prospective, nonrandomized, case-controlled study. Each of the subjects with RAU was seen during an acute episode, and swab specimens from lesional (RAU-acute/lesion) and clinically normal (RAU-acute/normal) oral mucosa were obtained. Each of 2 subjects with RAU was evaluated during more than one acute episode. Three subjects with RAU were seen between active episodes, and swab specimens were taken from clinically normal (RAU-convalescent) oral mucosa. Swab specimens from clinically normal (control/normal) oral mucosa were obtained from the control subjects. Peripheral blood specimens were obtained from subjects with RAU and control subjects at the time the swab specimens were performed. Through use of polymerase chain reaction, all swab and peripheral blood specimens were examined for the presence of human herpesvirus DNA. Statistical significance was determined by means of chi(2) analysis. RESULTS Herpes simplex virus and human herpesvirus-6 were found in a higher percentage of mucosal specimens from the control subjects (herpes simplex virus, 4/10; human herpesvirus-6, 5/9) than from the subjects with RAU (RAU-acute/lesion: 3/45 herpes simplex virus, 13/53 human herpesvirus-6; RAU-acute/normal: 7/48 herpes simplex virus, 9/53 human herpesvirus-6). No difference was demonstrated between RAU-acute/lesion, RAU-acute/normal, and RAU-convalescent mucosal specimens for any of the human herpesviruses. Different human herpesviruses were identified from individual subjects with RAU during subsequent episodes of disease. Epstein-Barr virus (6/35), human herpesvirus-6 (3/40), and human herpesvirus-7 (7/43) were detected in the peripheral blood mononuclear cells during acute RAU but not in RAU-convalescent or control peripheral blood mononuclear cells. CONCLUSIONS The detection of human herpesvirus DNA from the oral mucosa and peripheral blood mononuclear cells of patients with RAU appears to represent normal viral shedding rather than a direct causal mechanism in this disorder.
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Affiliation(s)
- S L Brice
- Department of Dermatology, School of Medicine, University of Colorado, Denver, CO 80262, USA
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15
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Abstract
Epstein-Barr virus (EBV) infection of humans has been associated with the development of lymphoid malignancies mainly of B-cell lineage, although occasionally T-cell lymphomas have been reported. We describe here the characterization of a novel EBV-like virus (HVMNE) isolated from a simian T-cell lymphotropic virus type I/II (STLV-I/II) seronegative pigtailed macaque (Macaca nemestrina) with a cutaneous T-cell lymphoma. Immunohistochemistry studies on the skin lesions demonstrated that the infiltrating cells were of the CD3+/CD8+ phenotype. Two primary transformed CD8+ T-cell lines were obtained from cultures of peripheral blood mononuclear cells (PBMC) and skin, and, with time, both cell lines became interleukin-2–independent and acquired the constitutive activation of STAT proteins. Polymerase chain reaction analysis of the DNA from the cell lines and tissues from the lymphomatous animal demonstrated the presence of a 536-bp DNA fragment that was 90% identical to EBV polymerase gene sequences, whereas the same DNA was consistently negative for STLV-I/II sequences. Electron microscopy performed on both cell lines, after sodium butyrate treatment, showed the presence of a herpes-like virus that was designated HVMNE according to the existing nomenclature. In situ hybridization studies using EBV Epstein-Barr viral-encoded RNA probes showed viral RNA expression in both CD8+ T-cell lines as well as in the infiltrating CD8+ T cells of skin-tissue biopsies. Phylogenetic analysis of a 465-bp fragment from the polymerase gene of HVMNE placed this virus within theLymphocryptovirus genus and demonstrated that HVMNEis a distinct virus, clearly related to human EBV and other EBV-like herpesviruses found in nonhuman primates.
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Abstract
Abstract
Epstein-Barr virus (EBV) infection of humans has been associated with the development of lymphoid malignancies mainly of B-cell lineage, although occasionally T-cell lymphomas have been reported. We describe here the characterization of a novel EBV-like virus (HVMNE) isolated from a simian T-cell lymphotropic virus type I/II (STLV-I/II) seronegative pigtailed macaque (Macaca nemestrina) with a cutaneous T-cell lymphoma. Immunohistochemistry studies on the skin lesions demonstrated that the infiltrating cells were of the CD3+/CD8+ phenotype. Two primary transformed CD8+ T-cell lines were obtained from cultures of peripheral blood mononuclear cells (PBMC) and skin, and, with time, both cell lines became interleukin-2–independent and acquired the constitutive activation of STAT proteins. Polymerase chain reaction analysis of the DNA from the cell lines and tissues from the lymphomatous animal demonstrated the presence of a 536-bp DNA fragment that was 90% identical to EBV polymerase gene sequences, whereas the same DNA was consistently negative for STLV-I/II sequences. Electron microscopy performed on both cell lines, after sodium butyrate treatment, showed the presence of a herpes-like virus that was designated HVMNE according to the existing nomenclature. In situ hybridization studies using EBV Epstein-Barr viral-encoded RNA probes showed viral RNA expression in both CD8+ T-cell lines as well as in the infiltrating CD8+ T cells of skin-tissue biopsies. Phylogenetic analysis of a 465-bp fragment from the polymerase gene of HVMNE placed this virus within theLymphocryptovirus genus and demonstrated that HVMNEis a distinct virus, clearly related to human EBV and other EBV-like herpesviruses found in nonhuman primates.
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Chang YT, Liu HN, Chen CL, Chow KC. Detection of Epstein-Barr virus and HTLV-I in T-cell lymphomas of skin in Taiwan. Am J Dermatopathol 1998; 20:250-4. [PMID: 9650697 DOI: 10.1097/00000372-199806000-00005] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Viral etiology has been associated with the pathogenesis of T-cell lymphomas of skin (TCLS). Therefore, we studied the presence of Epstein-Barr virus (EBV) and type I human T-cell lymphotropic virus (HTLV-I) in tumor cells of TCLS to determine the significance of these viruses with the disease. A retrospective study was conducted on the skin tissues from 28 Chinese patients with TCLS. We used in situ hybridization, immunohistochemistry, and polymerase chain reaction to determine the presence of viruses. Among the 28 cases, HTLV-I was only detected in two cases with adult T-cell leukemia/lymphoma, not in other cases of TCLS. This suggests that HTLV-I may not play a significant role in the oncogenesis of TCLS in Chinese patients. Conversely, EBV was detected in 12 cases (42.9%), including the secondary TCLS, large cell lymphoma, mycosis fungoides, adult T-cell leukemia/lymphoma, and angiocentric lymphoma. Nevertheless, latent membrane protein 1 was not detected in any of the EBV-positive cases. Neither was any correlation found between the presence of EBV in TCLS and the prognosis or the severity of the skin lesion. Although there is a close association of EBV with a portion of TCLS, its pathogenic role needs further investigation.
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Affiliation(s)
- Y T Chang
- Department of Dermatology, Veterans General Hospital-Taipei, National Yang-Ming University, Taiwan
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Angel CA, Slater DN, Royds JA, Nelson SN, Bleehen SS. Absence of Epstein-Barr viral encoded RNA (EBER) in primary cutaneous t-cell lymphoma. J Pathol 1996; 178:173-5. [PMID: 8683385 DOI: 10.1002/(sici)1096-9896(199602)178:2<173::aid-path428>3.0.co;2-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Epstein-Barr virus (EBV) has been associated with various extracutaneous lymphoproliferative diseases and it has been suggested that EBV may have a similar aetiological role in cutaneous T-cell lymphoma. In this study, in situ hybridization was used to investigate the presence of EBV encoded RNAs (EBER-1 and EBER-2) in 37 biopsies from 28 cases of primary cutaneous T-cell lymphoma originating from the U.K. The results showed that EBV had no demonstrable pathogenic role in the lymphomas studied, as EBER was not detected in any case.
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Affiliation(s)
- C A Angel
- Department of Pathology, University of Sheffield Medical School, UK
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