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Páez-Guillán EM, Campos-Franco J, Alende R, Vidal C, Gonzalez-Quintela A. Skin Rash During Epstein-Barr Virus-Induced Infectious Mononucleosis in Adolescents and Adults: Incidence, Predisposing Factors, and Prognostic Implications. J Investig Allergol Clin Immunol 2024; 34:118-120. [PMID: 37539851 DOI: 10.18176/jiaci.0927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Affiliation(s)
- E M Páez-Guillán
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - J Campos-Franco
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - R Alende
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - C Vidal
- Department of Allergy, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - A Gonzalez-Quintela
- Department of Internal Medicine, Complejo Hospitalario Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
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2
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Khan U, Aarebrot A, Mo S, Landa S, Rösler C, Sodha OK, Bjørneklett R, Dizdar V. Epstein-Barr in a Patient Presenting with Right Upper Quadrant Pain: A Case Report from the Emergency Department. J Emerg Med 2024; 66:e365-e368. [PMID: 38423863 DOI: 10.1016/j.jemermed.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/27/2023] [Accepted: 10/01/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Right upper quadrant abdominal pain and elevated cholestasis blood tests are usually associated with bacterial calculous cholecystitis. However, viral infections, such as Epstein-Barr virus (EBV) can also manifest with a similar clinical picture and is an important differential diagnosis. CASE REPORT This case report discusses a young woman presenting to the emergency department with acute right upper quadrant abdominal pain. The initial assessment revealed a positive Murphy's sign, elevated white blood count, and a cholestatic pattern on liver function tests, leading one to suspect bacterial calculous cholecystitis and initiating antibiotic therapy. However, clinical examination also revealed tonsillar exudates and differential white blood cell count revealed monocytosis and lymphocytosis rather than a high neutrophil count. The patient tested positive for EBV. Furthermore, ultrasound and magnetic resonance imaging revealed gallbladder wall edema with no gallstones, leading one to conclude that the clinical manifestation and laboratory results were due to an EBV infection. Antibiotic therapy was ceased and the patient did not require surgical intervention. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Calculous bacterial cholecystitis usually entails antibiotic therapy and cholecystectomy. It is important to be aware of the differential diagnosis of EBV, as it usually does not require either of these and resolves spontaneously.
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Affiliation(s)
- Umael Khan
- Department of Internal Medicine, Haukeland University Hospital, Bergen, Norway.
| | - Anders Aarebrot
- Deparment of Dermatology, Haukeland University Hospital, Bergen, Norway
| | - Solveig Mo
- Department of Surgery, Haraldsplass Hospital, Bergen, Norway
| | - Signe Landa
- Department of Radiology, Haukeland University Hospital, Bergen
| | - Cornelia Rösler
- Department of Radiology, Haukeland University Hospital, Bergen
| | - Ole Kamal Sodha
- Department of Emergency Medicine, Haukeland University Hospital, Bergen, Norway
| | - Rune Bjørneklett
- Department of Emergency Medicine, Haukeland University Hospital, Bergen, Norway
| | - Vernesa Dizdar
- Department of Emergency Medicine, Haukeland University Hospital, Bergen, Norway
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3
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Wang WT, Yang Y, Zhang Y, Le YN, Wu YL, Liu YY, Tu YJ. EBV-microRNAs as Potential Biomarkers in EBV-related Fever: A Narrative Review. Curr Mol Med 2024; 24:2-13. [PMID: 36411555 PMCID: PMC10825793 DOI: 10.2174/1566524023666221118122005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 07/31/2022] [Accepted: 10/11/2022] [Indexed: 11/23/2022]
Abstract
At present, timely and accurate diagnosis and effective treatment of Epstein- Barr Virus (EBV) infection-associated fever remain a difficult challenge. EBV encodes 44 mature microRNAs (miRNAs) that inhibit viral lysis, adjust inflammatory response, regulate cellular apoptosis, promote tumor genesis and metastasis, and regulate tumor cell metabolism. Herein, we have collected the specific expression data of EBV-miRNAs in EBV-related fevers, including infectious mononucleosis (IM), EBVassociated hemophagocytic lymphohistiocytosis (EBV-HLH), chronic active EBV infection (CAEBV), and EBV-related tumors, and proposed the potential value of EBVmiRNAs as biomarkers to assist in the identification, diagnosis, and prognosis of EBVrelated fever, as well as therapeutic targets for drug development.
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Affiliation(s)
- Wei-ting Wang
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai (201203), China
| | - Yun Yang
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai (201203), China
| | - Yang Zhang
- Information Center of Science and Technology, Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai (201203), China
| | - Yi-ning Le
- National Key Laboratory of Medical Immunology & Institute of Immunology, Second Military Medical University, Shanghai (200433), China
| | - Yu-lin Wu
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai (201203), China
| | - Yi-yi Liu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai (200032), China
| | - Yan-jie Tu
- Department of Febrile Disease, Basic Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai (201203), China
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4
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Golzarian H, Eapen D, Sandesh F, Chakraborty S, Hennon M, Bux J, Kim J, Kumar A, Patel SM. A case of Epstein-Barr virus-associated pericarditis progressing to complete atrioventricular block and cardiac arrest. HeartRhythm Case Rep 2023; 9:709-714. [PMID: 38047203 PMCID: PMC10691948 DOI: 10.1016/j.hrcr.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Affiliation(s)
- Hafez Golzarian
- Internal Medicine Residency Program, Mercy Health—St. Rita’s Medical Center, Lima, Ohio
| | - David Eapen
- Internal Medicine Residency Program, Mercy Health—St. Rita’s Medical Center, Lima, Ohio
| | - Fnu Sandesh
- Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Shudipan Chakraborty
- Internal Medicine Residency Program, Mercy Health—St. Vincent’s Medical Center, Toledo, Ohio
| | - Megan Hennon
- Internal Medicine Residency Program, Mercy Health—St. Rita’s Medical Center, Lima, Ohio
- Kentucky College of Osteopathic Medicine, Pikeville, Kentucky
| | - Jannat Bux
- Internal Medicine Residency Program, Mercy Health—St. Rita’s Medical Center, Lima, Ohio
| | - Jason Kim
- Internal Medicine Residency Program, Mercy Health—St. Rita’s Medical Center, Lima, Ohio
| | - Aakash Kumar
- Internal Medicine Residency Program, Mercy Health—St. Rita’s Medical Center, Lima, Ohio
| | - Sandeep M. Patel
- Structural Heart and Interventional Cardiology—St. Rita’s Medical Center, Lima, Ohio
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Aldrete J, Peterson CJ, Tarbox JA, Pixley JS. Polymyositis Presenting With Nontraumatic Rhabdomyolysis and Dysphagia: A Case Report. J Investig Med High Impact Case Rep 2022; 10:23247096221074589. [PMID: 35264047 PMCID: PMC8918959 DOI: 10.1177/23247096221074589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Idiopathic inflammatory myopathies (IIMs) are a rare, heterogeneous group of diseases with a characteristic clinical presentation consisting of muscle inflammation and weakness. They often present with accompanying extra-muscular findings, most notably in the skin, lungs, and joints. Inflammatory myopathies are also identified by their characteristic laboratory abnormalities, including a 10- to 50-fold increase in creatinine kinase, elevated liver enzymes, and characteristic electromyography and magnetic resonance imaging findings. Distinct autoimmune markers and clinical phenotypes have advanced our understanding of IIMs and have led to the recognition of 5 distinct entities, each with its unique pathophysiology, autoimmune markers, and clinical features. While autoimmune panels and muscle biopsies help clinicians distinguish one entity from the other, their sensitivity and specificity vary. Of the various inflammatory myopathies, polymyositis remains the most elusive. Often, the diagnosis is ultimately made by combining clinical findings and laboratory data. As our case report illustrates, clinicians must use this constellation of data to initiate treatment for suspected polymyositis despite negative autoimmune panels and negative muscle biopsy.
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Affiliation(s)
| | | | - James A Tarbox
- Texas Tech University Health Sciences Center, Lubbock, USA
| | - John S Pixley
- Texas Tech University Health Sciences Center, Lubbock, USA
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Ferrari de Freitas L, de Melo Silva J, Nogueira Barbosa A, Miranda Santos E, Pinheiro-Silva R, Soares Pontes G. Epidemiological and Liver Biomarkers Profile of Epstein-Barr Virus Infection and Its Coinfection with Cytomegalovirus in Patients with Hematological Diseases. Biomolecules 2021; 11:1151. [PMID: 34439817 DOI: 10.3390/biom11081151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 12/02/2022] Open
Abstract
Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are viruses globally distributed that have been associated with the development and prognosis of many pathologies, including hematological diseases. This study aimed to characterize the epidemiological profile of EBV infection and the infection-correlated hepatic manifestations in patients with hematological diseases of the northern Brazilian state of Amazonas. A total of 228 patients were serologically tested for the presence of anti-EBV and anti-CMV IgG antibodies through an enzyme-linked immunosorbent assay. The coinfection with CMV, sociodemographic and laboratory records of all patients were also assessed. The overall prevalence observed among the study population for EBV infection and EBV/CMV coinfection was 85.09% (95% CI: 0.80–0.90) and 78.51% (95% CI: 0.73–0.84), respectively. The age group 31–40 years old were more susceptible to EBV/CMV coinfection (95% CI: 1.59–93.41, p = 0.011), while young people aged 1–10 years old were less affected for both EBV infection (CI 95%; 0.66–0.91, p = 0.001) and EBV/CMV coinfection (95% CI: 0.52–0.81, p < 0.0001). High serum levels of the liver biomarker ferritin were associated with EBV infection (95% CI: 1.03–1.54, p = 0.031) and EBV/CMV coinfection (95% CI: 1.02–1.70, p = 0.038). Our findings indicated that the elevated prevalence of EBV infection is not associated with the hematological diseases or transfusion rates, but with the socioeconomic status of the study population. Also, this study suggests that the EBV infection and its coinfection with CMV are related to the increase of serum ferritin levels.
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7
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Tavakolian S, Goudarzi H, Eslami G, Darazam IA, Dehghan G, Faghihloo E. Detection of Enterovirus, Herpes Simplex, Varicella Zoster, Epstein-Barr and Cytomegalovirus in cerebrospinal fluid in meningitis patients in Iran. J Clin Lab Anal 2021; 35:e23836. [PMID: 34152040 PMCID: PMC8275001 DOI: 10.1002/jcla.23836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/14/2022] Open
Abstract
Background Despite medical advances, central nervous system (CNS) diseases put a pressure on the health care system. A number of risk factors, especially infectious agents can accelerate the progression of meningitis. As viruses probably account for most cases of meningitis, the diagnosis of them can reduce antibiotic prescriptions. Among various types of infectious diseases, the relationship between two important virus families, including Picornaviridae and Herpesviridae, and meningitis has attracted attraction. Methods In this study, one hundred and two samples were collected from patients who experienced symptoms, such as the loss of consciousness, seizures, muscle weakness, fever, headache, rash, and severe dementia, between November 2018 and September 2019. After RNA and DNA extraction, the prevalence of Enterovirus (EV), Cytomegalovirus (CMV), Epstein–Barr virus (EBV), Herpes simplex virus type 1 (HSV‐1), Herpes simplex virus type 2 (HSV‐2), and Varicella zoster virus (VZV) was evaluated using PCR, multiplex PCR, and nested PCR. Results Results indicated that there were two VZV DNA‐positive specimens, while six and five samples were infected with HSV‐1 and EBV, respectively. Conclusion We reported that the prevalence of EBV, HSV‐1, and VZV in patients, suffering from meningitis cannot be ignored; however, further investigation is needed.
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Affiliation(s)
- Shaian Tavakolian
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gita Eslami
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ilad Alavi Darazam
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Golnaz Dehghan
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ebrahim Faghihloo
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Cooper RS, Kowalczuk A, Wilkie G, Vickers MA, Turner ML, Campbell JDM, Fraser AR. Cytometric analysis of T cell phenotype using cytokine profiling for improved manufacturing of an EBV-specific T cell therapy. Clin Exp Immunol 2021; 206:68-81. [PMID: 34146397 PMCID: PMC8446406 DOI: 10.1111/cei.13640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/06/2021] [Accepted: 05/28/2021] [Indexed: 11/27/2022] Open
Abstract
Adoptive immunotherapy using Epstein–Barr Virus (EBV)‐specific T cells is a potentially curative treatment for patients with EBV‐related malignancies where other clinical options have proved ineffective. We describe improved good manufacturing practice (GMP)‐compliant culture and analysis processes for conventional lymphoblastoid cell line (LCL)‐driven EBV‐specific T cell manufacture, and describe an improved phenotyping approach for analysing T cell products. We optimized the current LCL‐mediated clinical manufacture of EBV‐specific T cells to establish an improved process using xenoprotein‐free GMP‐compliant reagents throughout, and compared resulting products with our previous banked T cell clinical therapy. We assessed effects of changes to LCL:T cell ratio in T cell expansion, and developed a robust flow cytometric marker panel covering T cell memory, activation, differentiation and intracellular cytokine release to characterize T cells more effectively. These data were analysed using a t‐stochastic neighbour embedding (t‐SNE) algorithm. The optimized GMP‐compliant process resulted in reduced cell processing time and improved retention and expansion of central memory T cells. Multi‐parameter flow cytometry determined the optimal protocol for LCL stimulation and expansion of T cells and demonstrated that cytokine profiling using interleukin (IL)‐2, tumour necrosis factor (TNF)‐α and interferon (IFN)‐γ was able to determine the differentiation status of T cells throughout culture and in the final product. We show that fully GMP‐compliant closed‐process culture of LCL‐mediated EBV‐specific T cells is feasible, and profiling of T cells through cytokine expression gives improved characterization of start material, in‐process culture conditions and final product. Visualization of the complex multi‐parameter flow cytometric data can be simplified using t‐SNE analysis.
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Affiliation(s)
- Rachel S Cooper
- Tissues, Cells and Advanced Therapeutics, Scottish National Blood Transfusion Service, Jack Copland Centre, Edinburgh, UK
| | - Aleksandra Kowalczuk
- Blood Transfusion Centre, Scottish National Blood Transfusion Service, Aberdeen, UK
| | - Gwen Wilkie
- Blood Transfusion Centre, Scottish National Blood Transfusion Service, Aberdeen, UK
| | - Mark A Vickers
- Blood Transfusion Centre, Scottish National Blood Transfusion Service, Aberdeen, UK
| | - Marc L Turner
- Tissues, Cells and Advanced Therapeutics, Scottish National Blood Transfusion Service, Jack Copland Centre, Edinburgh, UK
| | - John D M Campbell
- Tissues, Cells and Advanced Therapeutics, Scottish National Blood Transfusion Service, Jack Copland Centre, Edinburgh, UK
| | - Alasdair R Fraser
- Tissues, Cells and Advanced Therapeutics, Scottish National Blood Transfusion Service, Jack Copland Centre, Edinburgh, UK
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9
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Watanabe M, Panetta GL, Piccirillo F, Spoto S, Myers J, Serino FM, Costantino S, Di Sciascio G. Acute Epstein-Barr related myocarditis: An unusual but life-threatening disease in an immunocompetent patient. J Cardiol Cases 2019; 21:137-140. [PMID: 32256861 PMCID: PMC7102541 DOI: 10.1016/j.jccase.2019.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/11/2019] [Accepted: 11/16/2019] [Indexed: 11/21/2022] Open
Abstract
Myocarditis is an uncommon but potentially life-threatening disease. Clinical manifestations could range from subclinical disease to sudden death, due to fulminant heart failure and/or malignant ventricular arrhythmias. The most common cause of myocarditis is viral infection, including Epstein-Barr virus (EBV). Nevertheless, EBV rarely presents with cardiac involvement in immunocompetent hosts. We report a case of acute EBV-related myocarditis in a young female, complicated with malignant ventricular arrhythmias and cardiac arrest. After 20 days of hospitalization and treatment, the patient was fit for discharge on pharmacological therapy (tapering steroids, beta-blockers, amiodarone, angiotensin-converting enzyme inhibitors, and diuretics). Clinical course is described, cardiac magnetic resonance images are shown. This case underlines how myocarditis is a disease that should not be underestimated: it could present with life-threatening complications such as malignant arrhythmias and/or severe systolic dysfunction. <Learning objective: Although Epstein-Barr virus rarely presents with cardiac involvement in immunocompetent hosts, the risk should not be underestimated, as it could present with life-threatening complications.>
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Affiliation(s)
- Mikiko Watanabe
- «Doctors in Italy» Association, Rome, Italy.,Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Gaetano Luca Panetta
- «Doctors in Italy» Association, Rome, Italy.,San Giovanni Calibita - Fatebenefratelli Hospital, Rome, Italy
| | - Francesco Piccirillo
- Unit of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy
| | - Silvia Spoto
- Unit of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy
| | | | | | | | - Germano Di Sciascio
- Unit of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy
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10
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Abstract
Purpose While most adults are infected Epstein-Barr virus (EBV), 3-5% remain uninfected. The human leukocyte antigen (HLA) complex, which controls many pathogens, may influence infection and disease associated with EBV. Recent Findings Numerous EBV proteins and miRNAs down-regulate HLA class I and II expression on the cell surface. HLA class II functions as a receptor for EBV entry into B cells. Specific HLA class II alleles correlate with the susceptibility of B cells to EBV infection in vitro and with EBV seropositivity or seronegativity of humans. HLA class I polymorphisms correlate with development and severity of EBV infectious mononucleosis and with the risk of several virus-associated malignancies including nasopharyngeal carcinoma, Hodgkin lymphoma, and post-transplant lymphoproliferative disease. Significance These findings indicate that while EBV has evolved to use MHC class II as a receptor for virus entry, polymorphisms in MHC class II and class I influence virus infection and disease.
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Affiliation(s)
- Qingxue Li
- Medical Virology Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Jeffrey I Cohen
- Medical Virology Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
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11
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Torniainen-Holm M, Suvisaari J, Lindgren M, Härkänen T, Dickerson F, Yolken RH. Association of cytomegalovirus and Epstein-Barr virus with cognitive functioning and risk of dementia in the general population: 11-year follow-up study. Brain Behav Immun 2018; 69:480-5. [PMID: 29355820 DOI: 10.1016/j.bbi.2018.01.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/02/2018] [Accepted: 01/14/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Earlier studies have documented an association between cytomegalovirus and cognitive impairment, but results have been inconsistent. Few studies have investigated the association of cytomegalovirus and Epstein-Barr virus with cognitive decline longitudinally. Our aim was to examine whether cytomegalovirus and Epstein-Barr virus are associated with cognitive decline in adults. METHOD The study sample is from the Finnish Health 2000 Survey (BRIF8901, n = 7112), which is representative of the Finnish adult population. The sample was followed up after 11 years in the Health 2011 Survey. In addition, persons with dementia were identified from healthcare registers. RESULTS In the Finnish population aged 30 and over, the seroprevalence of cytomegalovirus was estimated to be 84% and the seroprevalence of Epstein-Barr virus 98%. Seropositivity of the viruses and antibody levels were mostly not associated with cognitive performance. In the middle-aged adult group, cytomegalovirus serointensity was associated with impaired performance in verbal learning. However, the association disappeared when corrected for multiple testing. No interactions between infection and time or between the two infections were significant when corrected for multiple testing. Seropositivity did not predict dementia diagnosis. CONCLUSIONS The results suggest that adult levels of antibodies to cytomegalovirus and Epstein-Barr virus may not be associated with a significant decline in cognitive function or with dementia at population level.
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12
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Sale S, Carone AE, Fumi M, Pancione Y, Rocco V. Detection of Apoptotic Lymphocytes Through Sysmex XN-1000 As a Diagnostic Marker for Mononucleosis Syndrome. J Clin Lab Anal 2016; 30:779-93. [PMID: 27094572 DOI: 10.1002/jcla.21938] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 12/28/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The infectious mononucleosis (IM) includes clue elements, apoptotic and atypical lymphocytes. In IM, the evaluation of dot plot provided by Sysmex XN-1000 analyzer revealed a stretched lymphocytic cluster, white cell differential channel (WDF), on cytogram. METHODS In this study, we analyzed 698 samples that include 39 IM, 76 chronic lymphoproliferative disorders, 25 nonclonal lymphocytosis, and 40 healthy donors. Five hundred eighteen samples with other diseases or interference were evaluated. The algorithm was validated on 40,000 files that were received from internal database of Sysmex-Dasit. RESULTS The analysis of flow cytometry standard (FCS) files in WDF channel and presumed apoptotic lymphocytes counts on side scatter/forward scatter (SSC/FSC) and SSC/SFL (where SFL is side fluorescence) dot plot revealed excellent correlation among apoptotic cells on peripheral blood smear (R(2) = 0.79 and 0.75). There was a variation of positional parameters in lymphocyte clusters WX, WY, and WZ. If WX-SSC > 500 and WY-SFL > 1,000 and WZ-FSC > 700, specificity equals to 99% and sensitivity equals to 100%. If nucleated red blood cell (NRBC) <0.03 × 10(3) /μl, specificity equals to 100%. In received files, positives were 1% adding the simultaneous presence of a percentage of events in the two gates relating to the apoptotic lymphocytes of 1.2% of WBC. CONCLUSION On Sysmex XN-1000, dot-plot observation allowed immediate detection of IM. Meanwhile, an algorithm based on the parameters on these plots can be calculated with excellent performance.
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Affiliation(s)
- Silvia Sale
- Clinical Pathology Laboratory, A.O.R.N. "G. Rummo,", Benevento, Italy
| | | | - Maurizio Fumi
- Clinical Pathology Laboratory, A.O.R.N. "G. Rummo,", Benevento, Italy
| | - Ylenia Pancione
- Clinical Pathology Laboratory, A.O.R.N. "G. Rummo,", Benevento, Italy
| | - Vincenzo Rocco
- Clinical Pathology Laboratory, A.O.R.N. "G. Rummo,", Benevento, Italy.
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13
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Traylen C, Ramasubramanyan S, Zuo J, Rowe M, Almohammad R, Heesom K, Sweet SMM, Matthews DA, Sinclair AJ. Identification of Epstein-Barr Virus Replication Proteins in Burkitt's Lymphoma Cells. Pathogens 2015; 4:739-51. [PMID: 26529022 PMCID: PMC4693162 DOI: 10.3390/pathogens4040739] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/20/2015] [Accepted: 10/23/2015] [Indexed: 12/11/2022] Open
Abstract
The working model to describe the mechanisms used to replicate the cancer-associated virus Epstein-Barr virus (EBV) is partly derived from comparisons with other members of the Herpes virus family. Many genes within the EBV genome are homologous across the herpes virus family. Published transcriptome data for the EBV genome during its lytic replication cycle show extensive transcription, but the identification of the proteins is limited. We have taken a global proteomics approach to identify viral proteins that are expressed during the EBV lytic replication cycle. We combined an enrichment method to isolate cells undergoing EBV lytic replication with SILAC-labeling coupled to mass-spectrometry and identified viral and host proteins expressed during the EBV lytic replication cycle. Amongst the most frequently identified viral proteins are two components of the DNA replication machinery, the single strand DNA binding protein BALF2, DNA polymerase accessory protein BMRF1 and both subunits of the viral ribonucleoside-diphosphate reductase enzyme (BORF2 and BaRF1). An additional 42 EBV lytic cycle proteins were also detected. This provides proteomic identification for many EBV lytic replication cycle proteins and also identifies post-translational modifications.
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Affiliation(s)
- Chris Traylen
- School of Life Sciences, University of Sussex, Brighton BN1 9QG, UK.
| | | | - Jianmin Zuo
- School of Cancer Sciences and Centre for Human Virology, University of Birmingham College of Medical and Dental Sciences, Edgbaston, Birmingham B15 2TT, UK.
| | - Martin Rowe
- School of Cancer Sciences and Centre for Human Virology, University of Birmingham College of Medical and Dental Sciences, Edgbaston, Birmingham B15 2TT, UK.
| | - Rajaei Almohammad
- School of Life Sciences, University of Sussex, Brighton BN1 9QG, UK.
| | - Kate Heesom
- School of Cellular and Molecular Medicine, University of Bristol, Medical Sciences Building, Bristol BS8 1TD, UK.
| | - Steve M M Sweet
- Genome Damage and Stability Centre, University of Sussex, Brighton BN1 9RQ, UK.
| | - David A Matthews
- School of Cellular and Molecular Medicine, University of Bristol, Medical Sciences Building, Bristol BS8 1TD, UK.
| | - Alison J Sinclair
- School of Life Sciences, University of Sussex, Brighton BN1 9QG, UK.
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Wang CH, Li YF, Shen CH. Epstein-Barr Virus Infection Mimicking Drug-Induced Hepatitis in a Critically ill Patient During Antituberculosis Therapy. Hepat Mon 2014; 14:e18865. [PMID: 25368656 PMCID: PMC4214122 DOI: 10.5812/hepatmon.18865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 08/11/2014] [Accepted: 09/05/2014] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Although hepatitis is frequently observed during antituberculosis (anti-TB) therapy, acute viral hepatitis should be ruled out first, especially in the endemic areas. In addition to common types of viral hepatitis, ie, hepatitis A, hepatitis B, and hepatitis C viruses, Epstein-Barr virus (EBV) may result in hepatitis in some cases. CASE PRESENTATION Herein, we reported a critically ill patient who developed cholestatic hepatitis in the intensive care unit during the anti-TB therapy, which was misdiagnosed as anti-TB agents-induced hepatitis in the beginning. Further serologic tests and liver biopsy confirmed the diagnosis of EBV hepatitis. In contrast to previously reported hepatitis by EBV, which had presented with transient liver dysfunction and self-limiting illness, hepatitis with progressive jaundice was followed by coagulopathy and encephalopathy in our case and the patient died of hepatic failure complications. CONCLUSIONS According to the presented case and subsequent literature review on fatal EBV hepatitis, clinicians should consider EBV infection in the differential diagnosis when hepatitis occurs in critically ill patients during the anti-TB therapy. Although hepatitis caused by EBV is mostly self-limited, some might be fetal.
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Affiliation(s)
- Ching-Hsun Wang
- Department of Internal Medicine, Division of Infectious and Tropical Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Yao-Feng Li
- Department of Pathology, Division of Anatomic Pathology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Hao Shen
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Corresponding Author: Chih-Hao Shen, Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan. Tel: +886-287927257, Fax: +886-287927258,, E-mail:
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Abstract
The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on infection and cancer, and includes commentaries on the influence of bacterial infections on mucin expression and cancer risk; the role of esophageal bacterial biota in the incidence of esophageal disease; the association between human papilloma virus (HPV) and esophageal squamous cell carcinoma; the role of HPV in esophageal adenocarcinoma; the role of Helicobacter pylori in cardiac carcinoma; and the role of Epstein-Barr virus infection in esophageal cancer.
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Affiliation(s)
- Sahar Al-Haddad
- Department of Laboratory Medicine, St. Michael's Hospital and the University of Toronto, Toronto, Canada
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Sidell D, Venick RS, Shapiro NL. Epstein-Barr DNA serology and positron-emission tomography imaging of the head and neck in pediatric transplant recipients. Laryngoscope 2013; 124:1236-41. [PMID: 24105893 DOI: 10.1002/lary.24376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/31/2013] [Accepted: 07/31/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Epstein-Barr virus (EBV) infection is a potential precursor of post-transplantation lymphoproliferative disorder (PTLD) in the pediatric transplant patient. Positron-emission tomography (PET) imaging is increasingly utilized in this population to monitor for neoplasia and PTLD. We assess the association between EBV serum titers and Waldeyer's ring and cervical lymph node PET positivity in the pediatric transplant recipient. STUDY DESIGN Retrospective analysis of EBV serology and PET imaging results in pediatric orthotopic liver transplantation (OLT) recipients. METHODS Imaging results and laboratory data were reviewed for all pediatric OLT recipients from January 2005 to July 2011 at a single institution. Charts were evaluated for PET positivity at Waldeyer's ring or cervical lymphatics, and for EBV serology results. Demographic data extracted include patient sex and age at transplantation. RESULTS A total of 122 pediatric OLT recipients were reviewed. Twelve patients (10%) underwent PET imaging. Overall, four patients (33%) had evidence of PET positivity at Waldeyer's ring or cervical lymphatics. Five patients (42%) had positive EBV serology. There was a significant association between PET imaging results and EBV DNA serology results (P = .01). CONCLUSIONS PTLD surveillance in the pediatric transplant recipient is an important component of long-term care in this population. Although PET imaging is a new modality in monitoring pediatric transplant recipients for early signs of PTLD, an association between EBV serology and PET imaging results appears to exist. With increased implementation, PET imaging will likely prove valuable in its ability to monitor the transplant recipient at risk for PTLD.
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Affiliation(s)
- Douglas Sidell
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, U.S.A
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Abstract
AIM: To investigate reactivated Epstein-Barr virus (EBV) infection as a cause for chronic hepatitis.
METHODS: Patients with occasionally established elevated serum aminotransferases were studied. HIV, HBV and HCV-infections were excluded as well as any other immunosuppressive factors, metabolic or toxic disorders. EBV viral capsid antigen (VCA) IgG and IgM, EA-R and EA-D IgG and Epstein-Barr nuclear antigen (EBNA) were measured using IFA kits. Immunophenotyping of whole blood was performed by multicolor flow cytometry. CD8+ T cell responses to EBV and PHA were determined according to the intracellular expression of IFN-γ.
RESULTS: The mean alanine aminotransferase (ALT) and gamma glutamyl transpeptidase (GGTP) values exceeded twice the upper normal limit, AST/ALT ratio < 1. Serology tests showed reactivated EBV infection in all patients. Absolute number and percentages of T, B and NK cells were within the reference ranges. Fine subset analysis, in comparison to EBV+ healthy carriers, revealed a significant decrease of naive T cells (P < 0.001), accompanied by increased percentage of CD45RA- (P < 0.0001), and terminally differentiated CD28-CD27-CD8+ T cells (P < 0.01). Moderately elevated numbers of CD38 molecules on CD8+ T cells (P < 0.05) proposed a low viral burden. A significantly increased percentage of CD8+ T cells expressing IFN-γ in response to EBV and PHA stimulation was registered in patients, as compared to controls (P < 0.05). Liver biopsy specimens from 5 patients revealed nonspecific features of low-grade hepatitis.
CONCLUSION: Chronic hepatitis might be a manifestation of chronic EBV infection in the lack of detectable immune deficiency; the expansion of CD28-CD27- and increase of functional EBV-specific CD8+ T cells being the only surrogate markers of viral activity.
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Affiliation(s)
- Mihaela Petrova
- Clinic of Gastroenterology, Medical Institute Ministry of Interior, Skobelev 79, Sofia 1606, Bulgaria.
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