Epstein-barr virus genotypes in NPC biopsies from North Africa

The genotypes of Epstein-Barr virus (EBV) were investigated in North African nasopharyngeal carcinoma (NPC) biopsies, nasopharyngeal chronic inflammation (NCI) biopsies, and saliva of healthy individuals from Algeria and Tunisia where there is an intermediate incidence of NPC. The prevalence of A-type virus in NPC, NCI biopsies and saliva of healthy individuals was found in these regions by means of a PCR assay. Restriction enzyme polymorphism analysis by Southern blotting revealed that all North African EBV variants have a conserved restriction site on BamHI W'-1′ and XhoI LMP gene. No additional BamHI enzyme site on the BamHI-F fragment was observed; however, the presence of an extra BamHI site on the BamHI-H fragment giving 2 H1 and H2 fragment-like EBV M-ABA strains was found. All EBV strains present in NPC or NCI biopsies at all ages were homogeneous in these polymorphisms and no correlation was observed between the EBV genotypes from NPC patients and clinical stages of the cancer. These characteristics revealed a significant difference between the EBV variants common in Chinese NPC and those in North African NPC.     

EB病毒与鼻咽癌相关性的研究进展

Epstein-Barr病毒（EBV）的潜伏感染与鼻咽癌（Nasopharyngeal carcinoma,NPC）密切相关,在感染人体后长期潜伏,可表达多种基因,其潜伏膜蛋白（LMP）编码基因、EB病毒核抗原（EBNA）基因及EBV编码的小RNA（EBER）可以通过不同的机制致鼻咽癌。本文就EBV与NPC的关系,与NPC相关的EBV的生物学特性和进展作一综述。     

Rearranged Epstein-Barr virus genomes and clonal origin in nasopharyngeal carcinoma

Epstein-Barr virus (EBV) is known to be associated with two malignant diseases, nasopharyngeal carcinoma (NPC) and endemic Burkitt's lymphoma. In this study, the genomes of EBV in biopsy specimens from 4 NPC patients in Japan were analyzed using Southern blot hybridization. The NPC tissues of all examined cases contained rearranged EBV genomes whose BamHI H fragments were larger than those of prototype EBV genomes. One of them had a BamHI fragment containing contiguous sequences of BamHI Y and H. A single-sized EBV DNA terminus was observed in these NPC tissues, implying the evolution of the carcinoma from a single EBV-infected cell.     

Expression of Epstein-Barr virus-encoded proteins in nasopharyngeal carcinoma

Expression of the Epstein-Barr virus (EBV) encoded nuclear antigens (EBNA 1 to 6) and membrane-associated protein (LMP) was investigated by immunoblotting in 83 nasopharyngeal carcinoma (NPC) biopsies and 25 other tumor and normal tissue specimens from the head and neck region. Fifty-eight of the 83 NPC biopsies were large enough to yield parallel data on virus DNA and viral expression. All 16 cases of clinically diagnosed and histologically confirmed NPCs from North Africa contained EBV DNA and expressed EBNA-1. Of 31 clinically diagnosed NPCs from China, 29 contained EBV DNA and 25 of these expressed EBNA-1. One control tissue biopsy from the oropharynx of NPC patients contained EBV DNA, but none expressed EBNA-1. The latent membrane protein (LMP) was detected in 22/31 of the Chinese and in 10/16 of the North African NPC biopsies. None of the NPC biopsies or control tissues expressed detectable amounts of EBNA 2 or any of the other 4 nuclear antigens which are invariably expressed in EBV-transformed B cells. A smaller number of tumors from Malaysia and East Africa exhibited a similar pattern of expression. EBV was rescued from a nude-mouse-passaged North African NPC tumor by co-cultivation of the tumor cells with umbilical cord blood lymphocytes. The tumor expressed EBNA 1 and LMP, but not EBNA 2 or the other 4 EBNAs. The resulting LCLs expressed all 6 nuclear antigens, EBNA 1 to 6 and LMP. Our data suggest that expression of the EBV genome is regulated in a tissue-specific fashion.     

Nasopharyngeal brush biopsies and detection of nasopharyngeal cancer in a high-risk population.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is an important tumor in many countries. Ethnic and regional factors strongly influence disease risk. NPC is usually diagnosed late in disease development, and 10-year survival rates are as low as 10%. Epstein-Barr virus (EBV), a possibly causative agent, is present in all cells of essentially all undifferentiated NPCs. We wished to determine the following: 1) whether an ambulatory nasopharyngeal brush biopsy could provide sufficient tumor cell DNA for the detection of EBV and 2) whether the detection of EBV in this locale reflects the presence of tumor cells or simply EBV carrier status. METHODS: We collected nasopharyngeal tissue via ambulatory brush biopsies from 21 patients with newly diagnosed NPC and from 157 subjects with other otolaryngologic complaints. The majority of study subjects were from high-risk populations. Sample DNA was analyzed for the presence of EBV genomic sequences by use of the polymerase chain reaction (PCR). RESULTS: Ninety-six percent of samples yielded sufficient DNA for PCR amplification. Nineteen of 21 patients with NPC brushed positive for EBV DNA, while all but two (1.3%) of 149 informative control subjects were negative for EBV (two-sided P<.0001). One of the EBV-positive control subjects had an EBV-positive inverted sinonasal papilloma; the other EBV-positive control subject exhibited no overt clinical disease. CONCLUSION: Demonstration of EBV DNA in nasopharyngeal brush biopsy specimens detects NPC with a sensitivity of at least 90% (95% confidence interval = 89.63%-91.32%) and a specificity of approximately 99% (95% confidence interval = 98.64%-98.68%). This technique merits further testing as a possible ambulatory screening strategy in high-risk populations.     

鼻咽癌组织中EBV潜伏膜蛋白2跨膜区CTL表位序列分析

背景与目的：Epstein-Barr病毒在华南地区鼻咽癌细胞中表达核抗原1（EBNA1）、潜伏膜蛋白1（LMP1）和潜伏膜蛋白2（LMP2）等病毒蛋白质。LMP2 mRNA不仅几乎100％表达于鼻咽肿瘤细胞,而且LMP2蛋白还具有较强的免疫原性,是一个较理想的免疫治疗靶点。本研究分析广州地区来源鼻咽癌组织的LMP2基因跨膜区的CTL表位序列,为设计以LMP2抗原为靶点的鼻咽癌免疫治疗提供依据。方法：收集广州地区鼻咽癌患者鼻咽活检组织20例和正常鼻咽粘膜活检组织3例,提取DNA,半巢式PCR扩增LMP2基因跨膜区．直接测序．分析CTL表位序列。结果：与标准株B95．8相比．鼻咽癌和正常鼻咽粘膜活检组织来源的LMP2基因跨膜区存在14处碱基替换,形成6处氨基酸替换．导致4处CTL表位序列变异（SSC、TYG、CLG和VMS）,其中VMS多态性为初次报道。由于从鼻咽癌组织扩增的LMP2序列与从正常鼻咽粘膜扩增的LMP2序列相同,表明这些变化是地域相关的病毒多态性而非鼻咽癌相关的病毒变异。结论：广州地区来源的Epstein-Barr病毒LMP2基因存在多态性．产生4处CTL表位序列变化。在设计以LMP2为靶点的免疫治疗时,应充分考虑病毒基因多态性的影响。     

鼻咽癌诊断和治疗的分子生物学新进展

鼻咽癌（nasopharyngeal carcinoma，NPC）是一种与EB病毒（Epstein-Barr virus，EBV）的感染密切相关的恶性肿瘤。在我国南方及东南亚地区患病率特别高，但几十年来，EBV参与和导致肿瘤发生的机制仍不清楚。最近的鼻咽癌基因组分析将其定义为遗传上均一性的癌症，认为主要是由NF-κB 负调控因子的突变或由于EBV潜伏膜蛋白1（latent membrane protein 1,LMP1）的过表达引起的，成为了鼻咽癌基因组学的标志。来自EBV阳性鼻咽癌模型的RNA测序数据也凸显了PI3K信号通路的异常表达在鼻咽癌中的重要性，并可以预判患者的预后。NF-κB信号通路的靶向治疗目前仍是一个挑战，应该探索更多创新药物的发现方法去针对鼻咽癌所特有的非典型NF-κB信号通路。我们对鼻咽癌的进一步研究应集中在鉴定复发性和转移性鼻咽癌的组学情况，开发基于基因的药物以及使用新开发的EBV阳性鼻咽癌模型进行大规模药物的筛选，找到有临床应用潜力的靶向药物，以进一步提高鼻咽癌患者的生存率。     

Frequent chromosome 9p losses in histologically normal nasopharyngeal epithelia from southern Chinese

Nasopharyngeal carcinoma (NPC) is a common cancer among the Chinese population in the southern part of China. The incidence of this cancer drops markedly in northern China. A 6- to 24-fold difference exists between southern and northern Chinese. To investigate the early genetic events involved in the development of this cancer, we have examined loss of heterozygosity (LOH) on chromosome 9p, being one of the most frequent genetic alterations in NPC, in nasopharyngeal tissues including normal epithelia (NP), dysplastic lesions (DNP) and invasive carcinoma (NPC) from high-risk and low-risk regions. We found similar frequencies of 9p LOH in NPC from high-risk (77.8%) and low-risk (63.6%) regions (p = 0.43). In contrast, 45% of normal nasopharyngeal epithelia from the high-risk region showed 9p LOH, while none of the NP from the low-risk region showed such abnormalities (p = 0.002). Deletions of chromosome 9p were found in 66.7% dysplastic nasopharyngeal lesions. These findings suggest that LOH of chromosome 9p is an early event in the tumorigenesis of NPC. The increased risk of NPC in southern Chinese may be related to early loss of genetic materials as indicated by 9p LOH in the NP from high- and low-risk regions. We also reported previously that Epstein-Barr virus (EBV) latent infection was present in all high-grade DNP and NPC but not in any NP from fetuses or normal adults. Thus, early genetic alterations such as 9p LOH may take place prior to EBV latent infection and expand clonally thereafter.     

用原位PCR方法检测鼻咽癌组织中的EB病毒

目的　探讨在鼻咽癌组织石蜡切片标本中原位检测EB病毒 (Epstein Barrvirus,EBV)的更灵敏的方法。方法　用地高辛标记的EBVDNA的BamHI W片段为探针 ,分别用原位杂交、原位PCR的方法检测鼻咽癌组织切片中EBV的分布情况。结果　原位PCR比原位杂交检测EB病毒的方法更灵敏。结论　用原位PCR检测鼻咽癌组织切片中EB病毒不失为一种灵敏的方法。     

V-val subtype of Epstein-Barr virus nuclear antigen 1 preferentially exists in biopsies of nasopharyngeal carcinoma

Epstein-Barr virus (EBV) has been suggested to be involved in pathogenesis of nasopharyngeal carcinoma (NPC). However, EBV infection is ubiquitous, whereas NPC occurs with strong geographic and racial distribution. Whether a substrain of EBV contributes to this phenomenon remains uncertain. Epstein-Barr virus nuclear antigen 1 (EBNA-1) is one of the most frequently detected EBV proteins in NPC tissues. Based on the polymorphism of amino acids at position 487, EBNA-1 is classified into five subtypes: P-ala, P-thr, V-val, V-leu and V-pro. To examine the relationship between subtypes of EBNA-1 and NPC, we determined the subtypes of EBNA-1 in biopsies of NPC, peripheral blood lymphocytes (PBL), and throat washings (TWs) obtained in endemic and non-endemic areas of NPC within China. The results revealed that V-val was the only subtype detected in NPC tissue, whereas three subtypes of EBNA-1, V-val, P-ala, and P-thr, were detected in PBL and TWs irrespective of origin, and mixed infection of V-val and P-ala was also observed. In addition, the variations of V-val derived from biopsies of NPC were identical to those derived from PBL and TWs in the context of N-terminus and C-terminus of EBNA-1. These facts indicate that a substrain of EBV with V-val subtype of EBNA-1 infects NPC preferentially and a susceptibility to a particular EBV isolate in the nasopharynx may exist during development of NPC.     

鼻咽癌中EB病毒LMP1基因N端Xho I酶切位点的丢失

背景与目的：众所周知,EB病毒LMP1基因在鼻咽癌变过程起着一定的作用。本研究通过检测广东地区鼻咽癌组织EB病毒LMP1基因N-末端区Xho I酶切位点的丢失,探讨LMP1基因变异在鼻咽癌发生发展中的作用。方法：收集中山大学肿瘤防治中心鼻咽癌患者鼻咽新鲜活检标本63例。收集EB病毒健康携带者外周血单个核细胞(PBMCs)10例作为对照。采用QIAamp DNA Mini Kit和QIAamp DNA Blood Mini Kit分别抽取组织和外周血单个核细胞的DNA,应用巢式PCR扩增EB病毒LMP1基因的N-末端区,并用Xho I对扩增产物进行酶切。采用四色荧光末端终止法对扩增产物进行序列分析。结果：10例健康携带者外周血单个核细胞的EB病毒LMP1基因N-末端区均未见Xho I酶切位点的丢失。63例鼻咽癌组织中有50例(79．37％)出现Xho I酶切位点的丢失(Xho I—loss),还有4例(6．34％,)为Xho I酶切位点部分丢失,只有9例(14．29％)未见Xho I酶切位点的丢失(wt-Xho I)。除了Xho I酶切位点的丢失(nt：169423～169428;GAGCTC→GA□TCTC)外,还发现四个错义点突变。结论：本研究所检测的广东地区EB病毒健康携带者外周血单个核细胞所携带的：EB病毒LMP1基因为wt—Xho I,而在鼻咽癌组织中主要为Xho I-loss。因此,我们认为EB病毒LMP1基因N-末端区Xho I酶切位点的丢失和其他的错义点突变可能是在鼻咽癌的发生发展过程中产生的。     

Amino-acid change in the Epstein-Barr-virus zebra protein in undifferentiated nasopharyngeal carcinomas from Europe and North Africa

Different Epstein-Barr-virus(EBV) variants were found to be associated with nasopharyngeal carcinoma (NPC). The type-C variant lacks the BamHI site between the BamHI W1* and I* regions and the type-f variant has an extra BamHI site in the BamHI F fragment. The BNLF1 gene (which encodes the LMP1 protein) from a nude-mouse-passaged CAO strain and from NPC biopsies from Taiwanese patients also exhibits variations resulting in structural and functional differences in the protein. The BZLF1 gene encodes the ZEBRA protein which triggers the EBV lytic cycle. A difference has been observed in 8 amino acids in the ZEBRA sequence in B95-8 (Z95) and P3HR1 (ZP3) cell lines. EBV found in NPC biopsies and peripheral-blood cells from Asians was predominantly of the ZP3 type (72%), while 81% of samples from different EBV-associated diseases and peripheral-blood cells from North Africa or Europe were of the Z95 type. We found that an alanine 206 had been replaced by a serine in the Z95 sequence in 72% of the NPC biopsies from European and North African patients. The Zser206 variant is found in a significantly lower percentage (p < 0.001 of other EBV-positive tissues from individuals in the same region (10\N33%). In contrast, a 30-bp deletion is observed near the 3` end of the LMP1 gene in the majority of EBV (86%) from NPC and peripheral-blood cells from Asians, whereas a significantly lower percentage (p < 0.001) of NPC biopsies from European and North African patients (56%) have this deletion, as do lymphocytes from control individuals from the same region (36 and 55% respectively). Int. J. Cancer 75:497-503, 1998. © 1998 Wiley-Liss, Inc.     

A comparison of EBV serology and serum cell-free DNA as screening tools for nasopharyngeal cancer: Results of the Singapore NPC screening cohort

We aimed to evaluate the effectiveness of nasopharyngeal cancer (NPC) screening by comprehensive clinical follow-up and adjunctive Epstein–Barr virus (EBV) testing. In a prospective cohort study, 524 individuals with a first-degree family history of NPC were recruited at a university clinical center in Singapore. The cohort was evaluated at baseline and at 6 monthly intervals, with a complete head and neck examination including nasopharyngeal endoscopy. Blood was taken at baseline and at yearly intervals for EBV Viral Capsid Antigen (VCA) IgA, EBV Early Antigen (EA) IgA serology and serum cell-free EBV DNA. Nasopharyngeal biopsy was performed when any irregularity in the nasopharynx was observed, or when EBV markers were elevated. The mean duration of follow-up was 57.7 months, with an average of 8.6 clinical visits per participant. Five participants (0.96%) were identified to have NPC, giving a prevalence of 199 per 100,000 person-years of screening. Four of the five NPC cases identified had asymptomatic T1 disease, at an earlier stage compared to NPC patients diagnosed in the clinic during the same time period (p = 0.0297). All NPC cases identified had elevated EBV-EA IgA titers ≥1:10, with a specificity of 94.6% and a positive predictive value of 15.2%, outperforming EBV-VCA IgA and serum EBV DNA. Two NPC cases were biopsied only because of elevated EBV serology titers, with increasing EBV-EA IgA titers preceding the diagnosis of NPC. In conclusion, screening for NPC is effective in identifying early-stage disease. Adjunctive EBV-EA IgA testing improved the effectiveness of screening.     

鼻咽癌前期病变中的EB病毒感染

背景与目的：鼻咽癌中的浸润性癌细胞均感染了EB病毒（Epstein-Barr virus．EBV）。前期病变可见于早期鼻咽癌癌旁上皮。本研究旨在通过检测前期病变中的EB病毒,探讨EB病毒感染存鼻咽癌变过程中的作用,及其基因型在鼻咽癌变过程中发生的宿主内演变。方法：采用核酸原位杂交检测15例早期鼻咽癌活检组织中的EB病毒编码RNA（EBV—encoded RNA,EBER）。采用巢式PCR法检测前期病变和癌巢中的EB病毒类型和潜伏膜蛋白1（latent membrane protein 1,LMPI）EB病毒株。具有代表性的LMPI基因羧基末端PCR产物采用四色荧光终止序列技术进行DNA序列分析。结果：所有15例早期鼻咽癌中的绝大多数浸润性癌细胞均呈EBER阳性。在15例的期病变中．14例可检测到EBER阳性的异常上皮细胞和／或浸润性淋巴细胞。单个A型EB病毒可在9例癌巢（11例适用）及9例前期病变（10例通用）的DNA样本中检测到。EB病毒LMP1基因羧基末端在15例癌巢DNA样本中均可检测到,其中14例是30bp缺失型LMP1 EB病毒株,1例是野生型和30bp缺失型LMP1株的混合感染。在11例适合做EB病毒LMP1基因羧基末端扩增的前期病变的DNA样本中,5例呈野生型和30bp缺失型LMP1 EB病毒株的混合感染,4例是单个缺大型LMP1 EB病毒株感染,1例呈单个野生型LMP1 EB病毒株感染,1例呈阴性反应。野生型LMP1基因羧基末端的DNA序列与B95—8细胞的DNA序列完全一致;30bp缺大型LMP1基因羧基末端的DNA序列却其有30bp缺失（密码子：346～355）和4个错义点突变（密码子：334、335、338和366）。结论：鼻咽上皮细胞的EB病毒感染是癌变过程中侵袭前的事件;而在鼻咽癌变过程中,EB病毒基因型会产生宿主内的演变。     

Elevated expression of ICAM1 (CD54) and minimal expression of LFA3 (CD58) in Epstein-Barr-virus-positive nasopharyngeal carcinoma cells.

Undifferentiated nasopharyngeal carcinoma (NPC) is a remarkable entity among human tumors because of its constant association with the Epstein-Barr virus (EBV). Malignant epithelial cells harbor the EBV genome and often express at least 2 species of latent EBV protein (EBNA1 and LMP1). Despite the massive presence of tumor-infiltrating lymphocytes, NPC cells obviously escape immune surveillance directed to EBV antigens. Previous investigations carried out on EBV-positive Burkitt lymphoma (BL) cells have shown that this fact may be partially accounted for by a lack of expression of ICAM1 (CD54) and LFA3 (CD58). ICAM1 and LFA3 have therefore been investigated in fresh NPC biopsies and transplanted NPCs. With only 1 exception out of 9 cases, NPC cells appear to express high levels of ICAM1 and low levels of LFA3. This is a complete inversion of the pattern observed in normal epithelial cells in vivo. Additional investigations will be required to determine to what extent these characteristics affect T-cell interactions with NPC cells, specially in the process of EBV-antigen recognition.