Epstein–Barr virus and regulatory T cells in Egyptian paediatric patients with acute B lymphoblastic leukaemia

2016 ◽  
Vol 70 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Mohamed E Ateyah ◽  
Mona E Hashem ◽  
Mohamed Abdelsalam
Keyword(s):  
Lymphoblastic Leukaemia ◽  
Epstein Barr Virus ◽  
Acute Infection ◽  
Treg Cells ◽  
Control Group ◽  
Healthy Children ◽  
Barr Virus ◽  
Ebv Infection ◽  
High Incidence ◽  
Epstein Barr

ObjectiveAcute B lymphoblastic leukaemia (B-ALL) is the most common type of childhood malignancy worldwide but little is known of its origin. Recently, many studies showed both a high incidence of Epstein–Barr virus (EBV) infection and high levels of CD4+CD25+Foxp3+(Treg cells) in children with B-ALL. In our study, we investigated the possible relationship between EBV infection and the onset of B-ALL, and its relation to expression of CD4+, CD25high+Foxp3+ T regulatory cells.Subject and methodsWe analysed expression and mean fluorescence intensity (MFI) of Treg cells in peripheral blood of 45 children with B-ALL and in 40 apparently healthy children as a control, using flow cytometry. Serum anti-EBV viral capsid antigen (VCA) IgG, anti-EBV nuclear antigen (EBNA) IgG (for latent infection) and anti-EBV VCA IgM (for acute infection) were investigated using ELISA.ResultsAnalysis of the Treg cells population in patients and controls revealed that expression of CD4+ CD25high+ T lymphocytes was higher in patients than in controls (mean±SD 15.7±4.1 and 10.61±2.6 in patients and controls, respectively, and MFI of Foxp3 was 30.1±7.1 and 16.7±3.7 in patients and controls, respectively (p<0.001)). There was a high incidence of latent EBV infection in patients (31%) compared with controls (10%) while the incidence of acute infection was 12% in patients and 0% in the control group. To study the role of latent EBV infection in the pathogenesis of acute B-ALL, OR was calculated (OR=4.06, coefficient index 1.2–13.6).ConclusionsThese findings suggest a possible role for Treg cells and EBV in the pathogenesis of B-ALL. Further studies are needed on the possible mechanisms of tumour genesis related to Treg cells and EBV in children with B-ALL.

scholarly journals Epstein–Barr Virus-Induced Mononucleosis as an Imitator of Severe Preeclampsia

2017 ◽  
Vol 07 (01) ◽  
pp. e5-e7
Author(s):  
S. Staley ◽  
Marcela Smid ◽  
Sarah Dotters-Katz ◽  
Elizabeth Stringer
Keyword(s):  
Differential Diagnosis ◽  
Epstein Barr Virus ◽  
Liver Enzymes ◽  
Acute Infection ◽  
Supportive Treatment ◽  
Barr Virus ◽  
Ebv Infection ◽  
Elevated Liver Enzymes ◽  
Epstein Barr ◽  
In Pregnancy

Background In pregnancy, conditions presenting with hematologic abnormalities, transaminitis, and proteinuria pose diagnostic challenges in pregnancy. Case We present the case of an 18-year-old woman, G1P0, at 33 weeks' gestation with fever of unknown cause, who developed progressively elevated liver enzymes, proteinuria, and thrombocytopenia, due to Epstein–Barr virus (EBV) infection. Conclusion Acute infection with EBV should be included in the differential diagnosis of preeclampsia with severe features, particularly in the setting of fever. Supportive treatment and observation may prevent iatrogenic preterm birth.

Primary Epstein–Barr Virus Infection in Healthy Children in Saudi Arabia: A Single Hospital-Based Study

2020 ◽  
Author(s):  
Ahmed Zaki
Keyword(s):  
Early Childhood ◽  
Saudi Arabia ◽  
Epstein Barr Virus ◽  
Age Groups ◽  
Epstein Barr Virus Infection ◽  
Healthy Children ◽  
Atypical Symptoms ◽  
Barr Virus ◽  
Ebv Infection ◽  
Epstein Barr

Abstract Background Primary Epstein–Barr virus (EBV) infection presents typically with features of infectious mononucleosis (IM) but it may present with atypical symptoms. We aim to evaluate the epidemiological, clinical and laboratory characteristics of primary EBV infection in children in western Saudi Arabia. Methods A retrospective analysis of the electronic data of all children who were admitted to the hospital and were tested for EBV-viral capsid antigen (VCA) IgM in the period from 1 January 2018 to 31 December 2019. All data of the children with positive EBV-VCA IgM were collected. Patients were divided into two groups; IM and the non-typical presentations groups. Results Fort-two patients had positive EBV-VCA IgM; 71% had IM and 29% had non-typical presentations. IM was more common in early childhood (46.7%). The non-typical presentations were more in infants below 1 year (50%). Adolescents were less affected (6.7% and 16.7%, respectively). Time to diagnose EBV in the non-typical presentations group was longer than IM group; [3.4 (3.2–4.6) vs. 4.7 (4.1–5.5), p = 0.039]. The total leucocytes count was higher in the IM syndrome group compared to the non-typical presentation group [11 (10.3–17.7) vs. 5.5 (4.5–6.4), p &lt; 0.0001]. Conclusions Primary EBV infection in healthy children in Saudi Arabia occurs more frequently in the younger age groups. IM syndrome occurs more frequently in early childhood. The non-typical presentation occurs more frequently in infants. While adolescents are less commonly affected by primary EBV.

scholarly journals EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS OF HENOCH-SCHÖNLEIN PURPURA ASSOCIATED WITH EPSTEIN-BARR VIRUS INFECTION

2021 ◽  
Vol 13 (1) ◽  
pp. e2021064
Author(s):  
Hongbo Hu ◽  
Jiangang Wu ◽  
Ying Cheng ◽  
Jian jun Li
Keyword(s):  
Abdominal Pain ◽  
Clinical Characteristics ◽  
Epstein Barr Virus ◽  
Control Group ◽  
Infection Group ◽  
Barr Virus ◽  
Ebv Infection ◽  
Healthy Control ◽  
Epstein Barr ◽  
Schonlein Purpura

Introduction: Henoch-Schönlein purpura (HSP) is an immune-mediated vasculitis, and the formation of immune complexes may be triggered by exposure to Epstein-Barr virus (EBV) infection. Methods: We performed a five-year case-control study to evaluate the epidemiology and clinical characteristics of HSP associated with EBV infection. Results: The incidence of EBV-triggered HSP was 4.2%, while EBV infection in children with HSP was 0.9%; The EBV-triggered HSP cases had a significantly higher frequency of abdominal pain than the MP-triggered HSP group (χ2 = 8.024, p = 0.005); Significant differences were observed in the duration of abdominal pain (Z = -1.935, p = 0.027) between the two groups; C3 (t = 9.709, p < 0.001), IgA (t = 20.39, p < 0.001) and IgG (t = 6.407, p < 0.001) were significantly increased in the EBV infection group than those in the healthy control group. Notably, significantly higher proportion of CD19 (t = 6.773, p < 0.001) and lower proportion of CD56 (t = 11.13, p < 0.001) was found in EBV infection group compared with healthy control group. The IgA level was higher than that of the non-infectious group (t = 2.162, p = 0.032), but their CD4/CD8 ratio (t = 10.070, p < 0.001) and CD56 proportion (t = 2.096, p = 0.037) were significantly lower. Conclusions: Both cellular and humoral immunity were involved in the pathogenesis of EBV-triggered HSP, leading to increased production of inflammatory mediators and immunoglobulins. Those events may cause or promote the development of systemic vessel vasculitis.

scholarly journals Antibody-Mediated Immune Subset Depletion Modulates the Immune Response in a Rabbit (Oryctolagus cuniculus) Model of Epstein-Barr Virus Infection

2020 ◽  
Vol 70 (5) ◽  
pp. 312-322
Author(s):  
Andrea J Osborne ◽  
Hannah M Atkins ◽  
Karla K Balogh ◽  
Sarah A Brendle ◽  
Debra A Shearer ◽  
...  
Keyword(s):  
T Cell ◽  
Animal Models ◽  
Epstein Barr Virus ◽  
Clinical Signs ◽  
Control Group ◽  
Epstein Barr Virus Infection ◽  
Barr Virus ◽  
Ebv Infection ◽  
Cell Antibody ◽  
Epstein Barr

Epstein-Barr Virus (EBV) is a γ-herpesvirus which infects over 90% of the adult human population. Most notably, this virus causes infectious mononucleosis but it is also associated with cancers such as Hodgkin and Burkitt lymphoma. EBV is a species-specific virus and has been studied in many animal models, including nonhuman primates, guinea pigs, humanized mice, and tree shrews. However, none of these animal models are considered the "gold standard" for EBV research. Recently, rabbits have emerged as a viable alternative model, as they are susceptible to EBV infection. In addition, the EBV infection progresses after immune suppression with cyclosporine A (CsA), modeling the reactivation of EBV after latency. We sought to refine this model for acute or active EBV infections by performing antibody-mediated depletion of certain immune subsets in rabbits. Fourteen 16 to 20-wk old, NZW rabbits were intravenously inoculated with EBV and concurrently treated with either anti-CD4 T-cell antibody, anti-pan-T-cell antibody (anti CD45), CSA, or, as a control, anti-HPV antibody. Rabbits that received the depleting antibodies were treated with CsA 3 times at a dose of 15 mg/kg SC once per day for 4 d starting at the time of EBV inoculation then the dose was increased to 20 mg/kg SC twice weekly for 2 wk. Weights, temperatures, and clinical signs were monitored, and rabbits were anesthetized once weekly for blood collection. When compared with the control group, anti-CD4-treated rabbits had fewer clinical signs and displayed higher levels of viral DNA via qPCR in splenocytes; however, flow cytometry results showed only a partial depletion of CD4 T-cells. Treatment with anti-pan-T-cell antibody did not result in noticeable T-cell depletion. These data suggest the EBV-infected rabbit is a promising model for testing antiviral medications and prophylactic vaccines for EBV.

scholarly journals Acute hepatitis: a rare complication of Epstein-Barr virus (EBV) infection

2010 ◽  
Vol 4 (10) ◽  
pp. 668-673 ◽  
Author(s):  
Mehmet Uluğ ◽  
Mustafa Kemal Çelen ◽  
Celal Ayaz ◽  
Mehmet Faruk Geyik ◽  
Salih Hoşoğlu
Keyword(s):  
Liver Function ◽  
Acute Hepatitis ◽  
Epstein Barr Virus ◽  
Acute Infection ◽  
Healthy Woman ◽  
Liver Function Tests ◽  
Barr Virus ◽  
Ebv Infection ◽  
Function Tests ◽  
Epstein Barr

Infectious Mononucleosis (IM), a benign lymphoproliferative disease, is the best known clinical syndrome caused by Epstein-Barr Virus (EBV). It usually resolves over a period of weeks or months without sequelae but may occasionally be complicated by a wide variety of neurologic, hematologic, hepatic, respiratory, and psychological complications. In this report we describe a patient with acute hepatitis following EBV-IM in a previously healthy woman. A 26-year-old woman who presented with fever, generalized weakness, nausea, sore throat, yellowing of skin, and a generalized skin rash was admitted to our clinic. Tonsillar enlargement, pharyngeal erythema, palatal petechiae, lymphadenopathy, and jaundice were noted. Significant atypical lymphocytes ( > 10%) were seen on the peripheral blood smear. Liver function tests such as ALT: 303 U/L, AST: 172 U/L, ALP: 193 U/L and total bilirubin: 7.3 mg/dl were elevated. Serological tests for EBV infection were consistent with acute infection (EBV virus capsid antigen was reactive with IgM and IgG antibodies). The Monospot test was also positive. On the seventh day, liver function tests and bilirubin had risen to peak level and platelets were decreased. The patient was managed supportively and her critical condition improved and was finally stabilized. Although the prognosis for IM is very favorable, a variety of acute complications may occur.

scholarly journals Autoimmune hepatitis following Epstein-Barr virus infection: a diagnostic dilemma

2019 ◽  
Vol 12 (7) ◽  
pp. e229615 ◽  
Author(s):  
Haoran Peng ◽  
Tanna Lim ◽  
Jae Nam ◽  
Jin Lee
Keyword(s):  
Autoimmune Hepatitis ◽  
Epstein Barr Virus ◽  
Case Reports ◽  
Acute Infection ◽  
Epstein Barr Virus Infection ◽  
Diagnostic Dilemma ◽  
Barr Virus ◽  
Ebv Infection ◽  
Epstein Barr ◽  
Barr Virus Infection

Epstein-Barr virus (EBV) infections frequently affect the liver and cause hepatitis. EBV is a well-known trigger of certain autoimmune diseases. There are few case reports showing the evidence of autoimmune hepatitis (AIH) following EBV infection. However, the diagnosis of AIH is very challenging in the setting of an acute infection. Here, we demonstrate a case of AIH following EBV infection in a patient ultimately recovered after receiving treatment for AIH.

Relation between Epstein-Barr virus infection and Multiple Sclerosis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Aisha Yassin Abdul-Ghaffar ◽  
Dalia Youssef Samaha ◽  
Nancy Samir Wahba ◽  
Ahmed Essam Ali Hussein
Keyword(s):  
Multiple Sclerosis ◽  
Epstein Barr Virus ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Epstein Barr Virus Infection ◽  
Healthy Controls ◽  
University Hospitals ◽  
Barr Virus ◽  
Ebv Infection ◽  
Epstein Barr

Abstract Background Multiple sclerosis (MS) is an immune mediated inflammatory disease that attacks myelinated axons in the central nervous system (CNS), destroying the myelin and the axon in variable degrees. The aetiology and pathogenesis of MS is complex and multifactorial, involving many interlacing mechanisms. Many theories had considered viral infections as a possible cause of MS. One of these viruses is Epstein-Barr virus (EBV), a herpes virus belonging to the family herpesviridae. There is obvious similarity between EBV and MS regarding their epidemiological pictures, and it was observed that most MS patients had a history of infectious mononucleosis (IM) a few years before onset. The relation between EBV and MS may give hope for development of biomarkers for prediction of disease development, early diagnosis, prediction of prognosis, curing or even preventing MS through an anti EBV vaccine or antiviral therapies. Objectives This study aims to analyze the association between EBV infection and multiple sclerosis. Subjects and Methods This is a case control study carried in the MS outpatient clinic at Ain Shams University Hospitals during the period from April 2019 till November 2019. Subjects included in this study were classified into two groups. The first group included 30 patients diagnosed as having MS, on the basis of their MRI finding, clinical presentation and according to revised Mc Donald criteria 2017. The patient group included 11 males and 19 females, their age ranged from 18 to 48 years. The second group included 30 age and sex matched healthy controls without any neurological or medical diseases. The control group included 11 males and 19 females, their age ranged from 18 to 48 years. Both groups were tested quantitatively for immunoglobulin G against Epstein Barr viral capsid antigen (VCA) using the enzyme linked immunosorbent assay technique (ELISA). Results All patients with MS (100%) were positive for EBV VCA IgG, whereas (93.33%) of controls were positive. In the MS group, the EBV VCA IgG mean level was (161± 66.32) U/ml compared with (78.53±47.63) U/ml in controls. The difference in serum level of EBV VCA IgG between both groups was statistically highly significant (P = &lt; 0.001). Conclusion There were higher levels of EBV VCA IgG in the serum of MS patients compared to healthy controls. This finding postulates a relation between EBV infection and MS and its role in the pathogenesis of MS.

scholarly journals Does the Epstein–Barr Virus Play a Role in the Pathogenesis of Graves’ Disease?

2019 ◽  
Vol 20 (13) ◽  
pp. 3145 ◽  
Author(s):  
Aleksandra Pyzik ◽  
Ewelina Grywalska ◽  
Beata Matyjaszek-Matuszek ◽  
Jarosław Ludian ◽  
Ewa Kiszczak-Bochyńska ◽  
...  
Keyword(s):  
Clinical Picture ◽  
Epstein Barr Virus ◽  
Mononuclear Cells ◽  
Control Group ◽  
Graves Disease ◽  
Thyroid Disorder ◽  
Barr Virus ◽  
Ebv Infection ◽  
Ebv Dna ◽  
Epstein Barr

Graves’ disease (GD) it the most common chronic organ-specific thyroid disorder without a fully recognized etiology. The pathogenesis of the disease accounts for an interaction between genetic, environmental, and immunological factors. The most important environmental factors include viral and bacterial infections. The Epstein-Barr virus (EBV) is one of the most common latent human viruses. Literature has suggested its role in the development of certain allergic and autoimmune diseases. EBV also exhibits oncogenic properties. The aim of the study was to analyze and compare the presence of EBV DNA in peripheral blood mononuclear cells (PBMCs) in patients with newly recognized GD and to find a correlation between EBV infection and the clinical picture of GD. The study included 39 untreated patients with newly diagnosed GD and a control group of 20 healthy volunteers who were gender and age matched. EBV DNA was detected with reverse transcription polymerase chain reaction (RT PCR) assay. The studies showed a significantly higher incidence of EBV copies in PBMCs among GD patients compared to the control group. Whereas, no significant correlations were found between the incidence of EBV copies and the evaluated clinical parameters. Our results suggest a probable role of EBV in GD development. EBV infection does not affect the clinical picture of Graves’ disease.

scholarly journals Clinical features and outcomes of brucellosis complicated with Epstein-Barr virus infection

2019 ◽  
Author(s):  
Hai Jiang ◽  
Chaoxia Sun ◽  
Hongyan Zhao ◽  
Xiuying Ni ◽  
Li Zhao ◽  
...  
Keyword(s):  
Epstein Barr Virus ◽  
Antiviral Treatment ◽  
Clinical Manifestations ◽  
Control Group ◽  
Epstein Barr Virus Infection ◽  
Observation Group ◽  
Barr Virus ◽  
Ebv Infection ◽  
Number Of Patients ◽  
Epstein Barr

Abstract Objective To analyze the clinical, laboratory characteristics and prognosis of brucellosis patients with co-existing Epstein-Barr virus (EBV) infection at a major hospital in Shandong, a brucellosis epidemic region of China.Methods A total of 576 inpatients diagnosed with brucellosis at Yidu Central Hospital, between July 2013 and July 2018, were selected and tested for EBV DNA. 22 patients were found to be positive for co-infection with EBV. The clinical data of these 22 patients (observation group) and 100 patients (control group) with only brucellosis were retrospectively compared.Results The observation group (the group with the EBV co-infection) had more severe clinical manifestations in the form of fever, headache, and hepatosplenomegaly. Further, the observation group also had a significantly higher number of patients with elevated alanine transaminase(ALT) and aspartate-aminotransferase (AST), reduced WBC, and elevated PLT count. The incidence of abnormal levels of cardiac enzyme was also significantly higher in the observation group, as was the recovery time and average hospitalization period.Conclusions It is important to consider EBV infection and other potentially latent viral infections in patients with brucellosis, as these infections can further complicate the disease course. Further, patients diagnosed with a co-infection should be administered combined antibacterial and antiviral treatment and kept under observation and followed up for a longer period.

Epstein–Barr virus infection in primary immunodeficiency

2018 ◽  
Vol 5 (3) ◽  
pp. 65-85 ◽  
Author(s):  
Adi Ovadia ◽  
Ilan Dalal
Keyword(s):  
Primary Immunodeficiency ◽  
Epstein Barr Virus ◽  
Current Knowledge ◽  
Acute Infection ◽  
Epstein Barr Virus Infection ◽  
Barr Virus ◽  
Ebv Infection ◽  
Increased Risk ◽  
Abnormal Response ◽  
Epstein Barr

Primary immunodeficiency (PID) is a group of genetic disorders which affects immune cell development, differentiation, and function. The affected individuals are highly susceptible to infection by a diverse array of pathogens. Epstein–Barr virus (EBV) infection is ubiquitous in humans and usually involves an asymptomatic or self-limiting clinical course. In rare cases, EBV can cause not only an acute infection but also a severe exaggerated immune response and lymphoproliferative disease. Furthermore, EBV infection in patients with PID can lead to immune dysregulation and increased risk of malignancies, in addition to the severe course of the acute infection. Recognition of the different genetic defects and their effect on immunological pathways provide us with fundamental insights into the pathophysiology of EBV infection and associated disease, and may lead to developing better targeted therapies in the future. Here, we review all of PIDs with an abnormal response to EBV disease. Statement of novelty: Here we provide a review of the current knowledge of all PIDs reported to be associated with abnormal response to EBV infection and associated disease, such as hemophagocytic lymphohistiocytosis.

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