EXPRESSION OF EPSTEIN-BARR VIRUS-ENCODED SMALL RNA (BY THE EBER-1 GENE) IN LIVER SPECIMENS FROM TRANSPLANT RECIPIENTS WITH POSTTRANSPLANTATION LYMPHOPROLIFERATIVE DISEASE

被引:156
作者
RANDHAWA, PS
JAFFE, R
DEMETRIS, AJ
NALESNIK, M
STARZL, TE
CHEN, YY
WEISS, LM
机构
[1] UNIV PITTSBURGH, DIV TRANSPLANTAT BIOL, PITTSBURGH, PA 15260 USA
[2] PRESBYTERIAN UNIV HOSP, PITTSBURGH TRANSPLANT INST, PITTSBURGH, PA USA
[3] PRESBYTERIAN UNIV HOSP, DEPT SURG, PITTSBURGH, PA USA
[4] CHILDRENS HOSP PITTSBURGH, DEPT PATHOL, PITTSBURGH, PA USA
[5] CITY HOPE NATL MED CTR, DEPT PATHOL, DUARTE, CA 91010 USA
关键词
D O I
10.1056/NEJM199212103272403
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Epstein-Barr virus (EBV)-associated post-transplantation lymphoproliferative disease (PTLD) develops in 1 to 10 percent of transplant recipients, in whom it can be treated by a reduction in the level of immunosuppression. We postulated that the tissue expression of the small RNA transcribed by the EBER-1 gene during latent EBV infection would identify patients at risk for PTLD. Methods. We studied EBER-1 gene expression in liver specimens obtained from 24 patients 2 days to 22 months before the development of PTLD, using in situ hybridization with an oligonucleotide probe. Control specimens were obtained from 20 recipients of allografts with signs of injury due to organ retrieval, acute graft rejection, or viral hepatitis in whom PTLD had not developed 9 to 71 months after the biopsy. Results. Of the 24 patients with PTLD, 17 (71 percent) had specimens in which 1 to 40 percent of mononuclear cells were positive for the EBER-1 gene. In addition, 10 of these 17 patients (59 percent) had specimens with histopathological changes suggestive of EBV hepatitis. In every case, EBER-1-positive cells were found within the lymphoproliferative lesions identified at autopsy. Only 2 of the 20 controls (10 percent) had specimens with EBER-1-positive cells (P<0.001), and such cells were rare. Conclusions. EBER-1 gene expression in liver tissue precedes the occurrence of clinical and histologic PTLD. The possibility of identifying patients at risk by the method we describe here and preventing the occurrence of PTLD by a timely reduction of immunosuppression needs to be addressed by future prospective studies.
引用
收藏
页码:1710 / 1714
页数:5
相关论文
共 30 条
[1]   SHORT INCUBATION NON-A, NON-B HEPATITIS TRANSMITTED BY FACTOR-VIII CONCENTRATES IN PATIENTS WITH CONGENITAL COAGULATION DISORDERS [J].
BAMBER, M ;
MURRAY, A ;
ARBORGH, BAM ;
SCHEUER, PJ ;
KERNOFF, PBA ;
THOMAS, HC ;
SHERLOCK, S .
GUT, 1981, 22 (10) :854-859
[2]   THE EPSTEIN-BARR VIRUS RECEPTOR [J].
BUSH, JL ;
RADICH, PC .
LABORATORY MEDICINE, 1989, 20 (05) :318-323
[3]   DETECTION OF EPSTEIN-BARR-VIRUS GENOMES IN NORMAL HUMAN LACRIMAL GLANDS [J].
CROUSE, CA ;
PFLUGFELDER, SC ;
CLEARY, T ;
DEMICK, SM ;
ATHERTON, SS .
JOURNAL OF CLINICAL MICROBIOLOGY, 1990, 28 (05) :1026-1032
[4]  
DEMETRIS AJ, 1987, PATHOL ANNU, V22, P347
[5]  
Gowing N F, 1975, Pathol Annu, V10, P1
[6]   EPSTEIN-BARR VIRUS (EBV) INDUCED POLYCLONAL AND MONOCLONAL B-CELL LYMPHOPROLIFERATIVE DISEASES OCCURRING AFTER RENAL-TRANSPLANTATION - CLINICAL, PATHOLOGIC, AND VIROLOGIC FINDINGS AND IMPLICATIONS FOR THERAPY [J].
HANTO, DW ;
GAJLPECZALSKA, KJ ;
FRIZZERA, G ;
ARTHUR, DC ;
BALFOUR, HH ;
MCCLAIN, K ;
SIMMONS, RL ;
NAJARIAN, JS .
ANNALS OF SURGERY, 1983, 198 (03) :356-369
[7]  
HANTO DW, 1981, SURGERY, V90, P204
[8]   LOCALIZATION OF EPSTEIN-BARR VIRUS-ENCODED SMALL RNAS BY INSITU HYBRIDIZATION [J].
HOWE, JG ;
STEITZ, JA .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1986, 83 (23) :9006-9010
[9]   LATENT AND REPLICATING FORMS OF EPSTEIN-BARR VIRUS-DNA IN LYMPHOMAS AND LYMPHOPROLIFERATIVE DISEASES [J].
KATZ, BZ ;
RAABTRAUB, N ;
MILLER, G .
JOURNAL OF INFECTIOUS DISEASES, 1989, 160 (04) :589-598
[10]   EPSTEIN-BARR VIRUS GENOME-POSITIVE LYMPHOCYTES-T IN A BOY WITH CHRONIC ACTIVE EBV INFECTION ASSOCIATED WITH KAWASAKI-LIKE DISEASE [J].
KIKUTA, H ;
TAGUCHI, Y ;
TOMIZAWA, K ;
KOJIMA, K ;
KAWAMURA, N ;
ISHIZAKA, A ;
SAKIYAMA, Y ;
MATSUMOTO, S ;
IMAI, S ;
KINOSHITA, T ;
KOIZUMI, S ;
OSATO, T ;
KOBAYASHI, I ;
HAMADA, I ;
HIRAI, K .
NATURE, 1988, 333 (6172) :455-457