• Childhood Kidney Diseases
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• 제19권2호
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• pp.176-179
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• 2015

Rituximab (RTX), a monoclonal antibody against the B-cell marker CD20, is commonly used as a treatment for antibody-mediated diseases or B-lymphocyte-mediated diseases. Destruction of B cells may reverse the disease course in many conditions; however, patients who are treated with RTX cannot respond appropriately to de novo infection due to lack of B lymphocytes. Here, we report one such case. A 7-year-old renal allograft recipient presented with severe anemia due to parvovirus infection after RTX treatment. The patient had focal segmental glomerulosclerosis and had received cadaveric kidney transplantation 6 months previously. She was treated with high-dose steroid for acute rejection and RTX for Epstein Barr Virus infection 3 months previously. At presentation, her hemoglobin level was 5.4 g/dL and leukocyte and platelet counts were normal. She had microcytic normochromic anemia and high viral load of parvovirus B19(70,578 copies/mL). Intravenous immunoglobulin ($200mg/kg{\cdot}d$) treatment controlled the progression of anemia and parvovirus infection. De novo parvovirus infection during the B lymphocyte-depletion period may have precipitated the severe anemia in this case. Close monitoring of infection is required after RTX therapy.

• Childhood Kidney Diseases
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• 제6권1호
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• pp.123-130
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• 2002

이식후 발생하는 림프증식성 질환(PTLD)은 양성 다크론성 B림프구 증식증으로부터 악성의 단크론 림프종에 이르기까끼 다양한 임상상을 보이는 질환이다. PTLD는 Epstein-Barr virus(EBV)와 과도한 면역억제와 밀접한 관계가 있다. 국내에서는 1997년 성인에서 신 이식 후 발생한 예가 처음 보고되었으며, 소아에서는 간 이식 후 발생한 예가 있을 뿐 신 이식 후 발생한 증례의 보고는 없어 이 보고가 국내 최초로 신이식 소아에서 발생한 PTLD 증례이다. 환자는 9세 남아로서 긴이식후 4개월후에 PTLD가 발생하였으며 주된 임상 양상은 발열, 림프절 종대와 혈변이었다. 림프절과 대장의 생검조직 에서 EBV in situ hybridization이 양성이고, 조직학적으로 B 세포계열의 PTLD에 합당한 소견이었다. 모든 증상은 면역억제제 감소와 ganciclovir 치료로 완전 관해되었다.

• Genomics & Informatics
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• 제9권3호
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• pp.127-133
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• 2011

The Epstein-Barr virus-transformed lymphoblastoid cell line (LCL) is one of the major genomic resources for human genetics and immunological studies. Use of LCLs is currently extended to pharmacogenetic studies to investigate variations in human gene expression as well as drug responses between individuals. We evaluated four common internal controls for gene expression analysis of selected hematopoietic transcriptional regulatory genes between B cells and LCLs. In this study, the expression pattern analyses showed that TBP (TATA box-binding protein) is a suitable internal control for normalization, whereas GAPDH (glyceraldehyde-3-phosphate dehydrogenase) is not a good internal control for gene expression analyses of hematopoiesis-related genes between B cells and LCLs at different subculture passages. Using the TBP normalizer, we found significant gene expression changes in selected hematopoietic transcriptional regulatory genes (downregulation of RUNX1, RUNX3, CBFB, TLE1, and NOTCH2 ; upregulation of MSC and PLAGL2) between B cells and LCLs at different passage numbers. These results suggest that these hematopoietic transcriptional regulatory genes are potential cellular targets of EBV infection, contributing to EBV-mediated B-cell transformation and LCL immortalization.

• Laboratory Medicine Online
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• 제1권2호
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• pp.110-114
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• 2011

혈구포식 림프조직구증(hemophagocytic lymphogistiocytosis, HLH)에서 관찰되는 클론성 염색체이상은 혈액종양이 골수조직을 침범한 경우에 흔하게 발견되며, 혈액종양의 근거가 없는 환자에서 EBV 감염과 관련되어 드물게 보이는 경우가 있다. 본 저자들은 혈액종양 병력도 없고 EBV 감염도 없이 클론성 염색체이상을 동반하였으며 치명적인 임상경과를 보인 HLH 1예를 경험하여 보고하는 바이다. 본 증례는 지속적인 발열 및 상기도감염 증상을 주소로 내원한 75세 남자환자였다. 검사소견에서 범혈구감소증, 저섬유소원증, 간기능 이상과 비장종대, 골수에서 현저한 혈구탐식을 보이는 성숙한 양성 조직구의 증식이 관찰되었다. 전혈에서 실시한 EBV RT-PCR 결과는 음성이었으나 CMV RT-PCR에서는 319 copies/mL의 양성소견이 관찰되었다. 골수검체를 이용한 핵형 분석결과에서는 복잡한 클론성이상을 보이는 비정상 염색체가 존재하였다. 본 환자는 염색체이상을 동반한 HLH 진단 하에 스테로이드 충격요법과 감염에 대한 예방적 항생제치료를 시행하였으나, 내원 13일째 파종성 혈관내응고로 사망하였다.

• Tuberculosis and Respiratory Diseases
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• 제73권6호
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• pp.336-341
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• 2012

Primary effusion lymphoma (PEL) is a rare type of lymphoma that arises in the body cavity without detectable masses. It is associated with human herpes virus-8 (HHV-8), Epstein-Barr virus (EBV), and human immunodeficiency virus (HIV). Recently, PEL unrelated to viral infection has been reported and it has been termed HHV-8 unrelated primary effusion lymphoma-like lymphoma (HHV-8 unrelated PEL-like lymphoma). Here, we report a case of HHV-8 unrelated PEL-like lymphoma in an 80-year-old woman. Chest X-ray and computed tomography revealed left-sided pleural effusion. Pleural effusion analysis and mediastinoscopic biopsy showed atypical cells that had originated from the B cells. The cells were positive for CD20 and bcl-2, but negative for CD3, CD5, CD21, CD30, CD138, epithelial membrane antigen, and HHV-8. Serological tests for HIV and EBV were negative. Considering the patient's age, further treatments were not performed. She has shown good prognosis without chemotherapy for more than 18 months.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1705-1712
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• 2016

Background: The aim of this study was to determine and evaluate the association of different viral infections, with hepatitis B and C viruses, Epstein-Barr virus, cytomegalovirus and human herpes virus-8 (HBV, HCV, EBV, CMV, HHV-8) with the risk of lymphomas (Hodgkin and non-Hodgkin) among Egyptian patients, and correlate with the histopathological staging and typing as well as the prevalence of combined infections. Materials and Methods: A total of 100 newly diagnosed lymphoma patients with 100 healthy age and sex matched normal controls were assayed for viral infection using enzyme linked immunosorbant assay (ELISA) followed by real time polymerase chain reaction (RT-PCR). Results: Our results showed a high statistical significant difference between cases and controls as regards clinical and laboratory findings (P<0.001 and=0.003). A high statistical difference was seen for the association of most viruses and lymphoma cases (p<0.001) except for positive HBs Ag, positive CMV IgG and HHV-8 (p=0.37, 0.70 and 1.0 respectively). No statistical significant difference was found between Hodgkin (HL) and non-Hodgkin (NHL) as regards viral prevalence except HCV antigen, 57.1% for HL and 26.5% for NHL (p = 0.03). Only, HBV DNA showed a high significant value among infiltrated bone marrow cases (p=0.003) and finally, a high significant association of 2 combined viral infections with infiltrated bone marrow lymphoma cases (p=0.04). Conclusions: Our results showed that infection with HBV, HCV, CMV and EBV were associated with increased risk of lymphoma among the Egyptian population. Detection of new associations between infectious agents and risk of cancer development will facilitate progress in elaboration of prophylactic measures, early diagnostic methods and, hopefully, novel therapy of malignant tumours.

• 생명과학회지
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• 제13권2호
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• pp.236-240
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• 2003

인간의 면역계는 외부의 병원균 등의 침입에 대하여 매우 강력한 방어작용을 수행하고 있다. 하지만, 때로 면역계의 손상으로 인해 비정상적인 면역작용이 유발됨으로써 면역성 질환이 야기되기도 한다. 특히, 자가면역 질환은 그 종류가 매우 다양하며 심각한 위험을 초래하기도 한다 이들 질환에 대한 활발한 병인학적 연구가 진행되고 있으나, 아직 정확한 메커니즘을 밝히지는 못하고 있다. 자가면역성 당뇨병의 원인 유전자로 인간의 게놈에 내생하고 있는 HERV가 거론된 후, 사이토카인의 변화나 외생 레트로바기러스의 감염에 의해 HERV의 발현이 활성화되어 superantigen으로 작용함으로써 비정상적인 면역반응이 유도된다는 새로운 사실이 밝혀져 많은 주목을 끌고 있다. 이는 내생 레트로바이러스 유래의 superantigen과 인간의 질병과의 관련성을 비교적명확하게 제시함으로써, 자가면역 질환의 극복을 위한 향후 연구에 주요한 실마리를 제공하고 있다.

• Journal of Chest Surgery
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• 제48권1호
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• pp.82-85
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• 2015

Pyothorax-associated lymphoma is a relatively rare type of lymphoma that occurs in patients who have long histories of tuberculous pleuritis or induced pneumothorax. It is a type of non-Hodgkin's lymphoma of mainly the B-cell phenotype and is strongly associated with Epstein-Barr virus infection. A majority of these cases have been reported in Japan, although some cases have occurred in Western countries. Here, we describe a case of pyothorax-associated lymphoma in a patient with a 30-year history of chronic tuberculous empyema. The patient underwent decortication under the impression of chronic empyema with fistula. The histopathologic diagnosis was a diffuse large B-cell lymphoma associated chronic inflammation.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7583-7587
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• 2015

Epstein-Barr virus (EBV) is an extremely common herpesvirus that may cause asymptomatic infection or various diseases, including infectious mononucleosis, certain lymphoproliferative diseases and several types of neoplasms. Vaccine development is an important strategy to reduce the burden of EBV-associated diseases and the timing of vaccinations should be before primary infection occurs. In the past, more than 90% of Thai children were infected with EBV in early childhood. Now, due to the improved healthcare system in Thailand, we aim to determine current prevalence of EBV infection among people in different age groups. A total of 538 sera were collected from residents of Khon Kaen province in northeastern Thailand for detecting anti-EBV IgG. Sera of infants under 2-years-old were also tested for anti-EBV IgM and EBV-DNA. The prevalence of anti-EBV IgG was 47.1% (95% CI: 23.3-70.8) in infants aged 0-6 months, 34.9% (95% CI: 23.1-46.7) in those aged 6-24 months, 87.9% (95% CI: 79.5-96.3) in children aged 3-5 years and then maintained at above 95% through adulthood. These seropositivity rates among Thai children remain similar to those found in a previous study conducted 20 years ago. Thai children are still exposed to EBV from an early age. Therefore, a prophylactic vaccine should be given within the first two years of life.

• IMMUNE NETWORK
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• 제3권1호
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• pp.29-37
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• 2003

Background: CC chemokine receptor (CCR) 7 and cognate CCR7 ligands, CCL21 (formerly secondary lymphoid tissue chemokine [SLC]) and CCL19 (formerly Epstein-Barr virus-induced molecule 1 ligand chemokine [ELC]), were known to establish microenvironment for the initiation of immune responses in secondary lymphoid tissue. As described previously, coadministration of DNA vaccine with CCR7 ligand-encoding plasmid DNA elicited enhanced humoral and cellular immunity via increasing the number of dendritic cells (DC) in secondary lymphoid tissue. The author hypothesized here that CCR7 ligand DNA could effectively expand memory CD4+ T cells to protect from viral infection likely via increasing DC number. Methods: To evaluate the effect of CCR7 ligand DNA on the expansion of memory CD4+ T cells, DO11.10.BALB/c transgenic (Tg)-mice, which have highly frequent ovalbumin $(OVA)_{323-339}$ peptide-specific CD4+ T cells, were used. Tg-mice were previously injected with CCR7 ligand DNA, then immunized with $OVA_{323-339}$ peptide plus complete Freund's adjuvant. Subsequently, memory CD4+ T cells in peripheral blood lymphocytes (PBL) were analyzed by FACS analysis for memory phenotype ($CD44^{high}$ and CD62 $L^{low}$) at memory stage. Memory CD4+ T cells recruited into inflammatory site induced with OVA-expressing virus were also analyzed. Finally, the protective efficacy against viral infection was evaluated. Results: CCR7 ligand DNA-treated Tg-mice showed more expanded $CD44^{high}$ memory CD4+ T cells in PBL than control vector-treated animals. The increased number of memory CD4+ T cells recruited into inflammatory site was also observed in CCR7 ligand DNA-treated Tg-mice. Such effectively expanded memory CD4+ T cell population increased the protective immunity against virulent viral infection. Conclusion: These results document that CCR7 and its cognate ligands play an important role in intracellular infection through establishing optimal memory T cell. Moreover, CCR7 ligand could be useful as modulator in DNA vaccination against viral infection as well as cancer.