Detection of human herpesvirus 8 DNA in acute leukemia patients

目的　了解人类疱疹病毒 8型 (HHV 8)在急性白血病 (AL)患者的感染情况。方法　采用聚合酶链反应 (PCR)法对 5 0例AL患者的外周血单个核细胞 (PBMC)和骨髓单个核细胞 (BMMC)、30例健康献血员的PBMC以及 9株人血源细胞系进行HHV 8DNA特异序列的检测。结果　 5 0例被检测AL患者中 ,一例急性髓系白血病 (AML)检出HHV 8DNA ,该患者的骨髓、外周血和血清均为阳性。在所检测的健康献血员和人血源细胞系中未发现HHV 8DNA。结论　中国AL患者中HHV 8的感染率很低。     

卡波济肉瘤相关疱疹病毒体外感染人牙龈成纤维细胞初探

目的:探索卡波济肉瘤相关疱疹病毒(Kaposi's sarcoma-associated herpesvirus,KSHV)体外感染人牙龈成纤维细胞(human gingival fibroblast,HGF)的途径和方法,为研究KSHV导致口腔卡波济肉瘤病变的机制提供依据。方法:用12-O-十四烷酰佛波醇-13-乙酯(12-O-tetradecanoylphorbol-13-acetate,TPA)刺激人原发性渗出性淋巴瘤(primary effusion lymphoma,PEL)细胞系的BC-3细胞,收集细胞上清(含KSHV病毒颗粒),感染HGF细胞。观察细胞病变效应(cytopatric effect,CPE),采用RT-PCR和Western blot分别检测HGF细胞内KSHV编码基因的转录情况和蛋白表达水平。结果:KSHV感染HGF细胞后可出现CPE;感染后采用RT-PCR可检测到不同时间点ORF26和ORF73基因的转录;感染后12 h可检测到vIL-6蛋白的表达。结论:KSHV可感染HGF细胞并建立潜伏感染,为进一步研究KSHV导致的口腔KS发病机制提供了较好的体外模型。     

Primary human herpesvirus 8 infection in immunocompetent children

Context  Human herpesvirus 8 (HHV-8) infection causes Kaposi sarcoma and lymphoproliferative disorders in immunosuppressed adults. Its manifestations in immunocompetent hosts are unknown. Objectives  To determine whether HHV-8 primary infection is symptomatic in immunocompetent children and to identify the epidemiological and virological correlates of HHV-8 infection. Design and Setting  Prospective cohort study conducted in the pediatric emergency department of a hospital in Alexandria, Egypt, between December 1, 1999, and April 30, 2000. Patients  Eighty-six children aged 1 to 4 years who were evaluated for a febrile syndrome of undetermined origin. Main Outcome Measures  Serological assay and polymerase chain reaction of blood and saliva samples for HHV-8. Information on potential risk factors for HHV-8 infection was also collected. Results  Thirty-six children (41.9%) were seropositive; HHV-8 DNA sequences were detected in 14 (38.9%) of these 36 children (detected in saliva in 11 of 14). Significant associations were found between HHV-8 infection and close contact with at least 2 other children in the community (36 of 63 vs 6 of 23 for <2 children; adjusted odds ratio [OR], 3.50; 95% confidence interval [CI], 1.11-12.22) and admission to the emergency department in December or January (28 of 47 vs 14 of 39 for February-April; adjusted OR, 3.15; 95% CI, 1.23-8.58). Six children had suspected primary HHV-8 infection; all but 1 had a febrile cutaneous craniocaudal maculopapular rash, which was more common among these children (5 of 6 vs 10 of 75; P<.001). For 3 of these 6 children, a second blood sample was obtained after the convalescence phase, and all 3 seroconverted for HHV-8. Conclusions  Primary infection with HHV-8 may be associated with a febrile maculopapular skin rash among immunocompetent children. The finding of HHV-8 DNA sequences in saliva supports the hypothesis that transmission through saliva is the main mode of transmission in the pediatric age group.      

KSHV潜伏和裂解感染机制的研究进展

卡波氏肉瘤相关疱疹病毒(KSHV)是卡波氏肉瘤(kapois's sarcoma,KS)的病原,并与PEL、MCD等多种淋巴增殖紊乱性疾病相关。其生命周期可分为潜伏感染和裂解感染两个阶段。在潜伏感染阶段,KSHV的病毒基因表达受到严格调控,只有少数病毒潜伏相关基因的持续表达,潜伏感染对病毒长期持续感染复制是必不可少的。在裂解复制阶段,病毒基因绝大部分复制表达,并包装产生新的感染性病毒颗粒。现就KSHV病毒潜伏感染和裂解感染机制的研究进展作一综述。     

The preliminary efficacy of interferon-α and ribavirin combination treatment of chronic hepatitis C in HIV-infected patients

Background It is internationally accepted that in drug-naYve individuals with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection, chronic hepatitis C should be treated first if the CD4 cell count does not require the initiation of anti-retroviral therapy. Present paper evaluated the clinical effect and side-effect of interferon-α (IFN-α) and ribavirin (RBV) combination therapy for Chinese patients with HCVHIV co-infection, and compared with them for HIV infection alone. Methods Ten patients with HCV-HIV and 17 patients with HCV received 5 million unit IFNα-2b every other day intramuscularly, and 300 mg RBV triple daily by oral. Dynamic observations were made for HCV RNA and HIV RNA loads, CD4^ and CD8^ T lymphocyte counts, liver function and blood cell measurement, and the medicine side-effects.Results After 12-week and 24-week treatments of IFN-α and RBV combination therapy, mean HCV RNA levels reduced 1. 14 logs and 1.56 logs from the baseline at week 0 in HCV-HIV co-infection, and reduced 1.48 logs and 1.75 logs in HCV infection, respectively. The HIV RNA levels decreased 1.22 logs and 1.32 logs from the base line; however, there were no obvious different changes at T lymphocyte counts of HCV-HIV and HCV patients through 24-week treatments. Whole 27 patients showed satisfactory biochemical response to therapy. There were some mild or mediate influence-like symptoms, intestinal uncomfortable and depressed blood cell counts in early stage of the treatments. No neuropsychiatric and auto-immune disorders were found. Conclusions IFN-α and RBV combination therapy had similar anti-HCV effects during 24-week treatment for HCV-HIV and HCV infected Chinese patients, and some anti-HIV effect. There were no obvious different biochemical responses and side-effects between two groups above.     

Upper gastrointestinal Kaposi's sarcoma in patients positive for HIV antibody without cutaneous disease

Six patients with antibodies to the human immunodeficiency virus (HIV) and with persistent gastrointestinal symptoms of HIV infection but without cutaneous lesions of Kaposi's sarcoma underwent endoscopy. Four also underwent barium meal examination. In all six cases small lesions were seen in the stomach at endoscopy, and histological examination of biopsy specimens taken from the lesions confirmed the diagnosis of Kaposi's sarcoma. The barium meal examinations were reported as normal in three patients and showed oesophageal candidiasis in the fourth. These findings suggest that Kaposi's sarcoma of the upper gastrointestinal tract is common in patients positive for HIV antibody, even those without cutaneous lesions. Endoscopy, with biopsy of suspicious lesions, is necessary to make the diagnosis and is recommended in all HIV antibody positive patients with persistent upper gastrointestinal symptoms.     

Conjunctival Kaposi's sarcoma in a patient with acquired immune deficiency syndrome

A patient with confirmed acquired immune deficiency syndrome (AIDS) and disseminated Kaposi's sarcoma was seen in the Eye Clinic, Kenyatta National Hospital, and was found to have involvement of the conjunctiva and lids, confirmed by biopsy. He also had retinal haemorrhages and cotton-wool spots. Kaposi's sarcoma of the conjunctiva may be confused with a subconjunctival haemorrhage.     

安徽蚌埠地区卡波氏肉瘤相关疱疹病毒的血清阳性率研究

目的研究安徽蚌埠地区卡波氏肉瘤相关疱疹病毒(KSHV)在普通人群中的感染情况,并初步分析KSHV感染的危险因子。方法选择KSHV ORF65、ORF73和K8.1编码的病毒蛋白为抗原,采用酶联免疫法对1 008份普通人群血清进行了KSHV抗体检测。结果在检测的1 008份血样中,KSHV抗体的总阳性率为4.3%,其中男为3.9%,女为4.6%。统计学分析结果显示,KSHV感染率没有性别差异,在年龄上也基本无差异。结论在中国安徽北部地区的普通人群KSHV的感染率较低,且KSHV的感染与年龄及性别之间无明显相关性。     

Ketosis-prone type 2 diabetes mellitus and human herpesvirus 8 infection in sub-saharan africans

Eugène Sobngwi, MD, PhD; Siméon Pierre Choukem, MD; Felix Agbalika, MD, MSc; Bertrand Blondeau, PhD; Lila-Sabrina Fetita, MD; Céleste Lebbe, MD, PhD; Doudou Thiam, MD; Pierre Cattan, MD, PhD; Jérôme Larghero, MD, PhD; Fabienne Foufelle, PhD; Pascal Ferre, PhD; Patrick Vexiau, MD; Fabien Calvo, MD, PhD; Jean-François Gautier, MD, PhD

JAMA. 2008;299(23):2770-2776.

Context  An atypical form of type 2 diabetes mellitus (DM-2) is revealed by ketosis (ketosis-prone type 2 diabetes mellitus), frequently occurring in individuals who are black and of African origin, and characterized by an acute onset requiring transient insulin therapy. Its sudden onset suggests precipitating factors.

Objective  To investigate the putative role of human herpesvirus 8 (HHV-8) in the pathogenesis of ketosis-prone DM-2.

Design, Setting, and Participants  A cross-sectional study in which antibodies were searched against latent and lytic HHV-8 antigens using immunofluorescence. The presence of HHV-8 in genomic DNA was investigated in 22 of the participants at clinical onset of diabetes. We also tested whether HHV-8 was able to infect human pancreatic β cells in culture in vitro. The study was conducted at Saint-Louis University Hospital, Paris, France, from January 2004 to July 2005. All participants were black and of African origin: 187 were consecutive diabetic patients of whom 81 had ketosis-prone DM-2 and 106 had nonketotic DM-2, and 90 individuals were nondiabetic control participants who were matched for age and sex.

Main Outcome Measures  Seroprevalence of HHV-8 and percentage of patients with HHV-8 viremia at onset in ketosis-prone DM-2.

Results  HHV-8 antibodies were found in 71 patients (87.7%) with ketosis-prone DM-2 vs 16 patients (15.1%) with nonketotic DM-2 (odds ratio, 39.9; 95% confidence interval, 17.1-93.4; P < .001) and 36 of the control participants (40.0%) (odds ratio, 10.7; 95% confidence interval, 4.9-23.4; P < .001). HHV-8 in genomic DNA was present in 6 of 13 patients with ketosis-prone DM-2 tested at acute onset and in 0 of 9 patients with nonketotic DM-2. HHV-8 proteins were present in human islet cells that were cultured for 4 days in the presence of HHV-8.

Conclusions  In this preliminary cross-sectional study, the presence of HHV-8 antibodies was associated with ketosis-prone DM-2 in patients of sub-Saharan African origin. Longitudinal studies are required to understand the clinical significance of these findings.

     

Presentation of Kaposi's sarcoma in the acquired immune deficiency syndrome

Since the first reports of unusual opportunistic infections and Kaposi's Sarcoma (KS) in homosexual men in New York and California, attention has been focused on a new epidemic: The Acquired Immunodeficiency Syndrome (AIDS). One manifestation of this disease is Kaposi's Sarcoma. Usually a rare tumor, it occurs with a high incidence in patients with AIDS. In this paper Kaposi's Sarcoma as it appears in AIDS will be examined.     

Cytokine profile of HIV-positive Kaposi's sarcoma derived cells in vitro

Kaposi's sarcoma (KS) is the most frequent neoplastic complication observed in HIV-infected patients. Cutaneous KS is the most common manifestation but visceral and lymph node involvement may occur. HIV-infection does not only lead to a decrease of certain cell types (CD4 T-lymphocytes), but also modifies the function of non-infected cells such as B-lymphocytes and NK-cells by upregulating cytokine release of IL-1, IL-6, GM-CSF, IFN-gamma and TNF-alpha. These multifunctional mediators show both autocrine and paracrine proliferative effects on normal endothelial cells and AIDS-related KS-cells. Using ELISA-, RIA- and IRMA-techniques we analysed the influence of seven cytokines (IL-1beta, IL-6, TNF-alpha, GM-CSF, IFN-alpha, IFN-beta, IFN-gamma) and the soluble IL-2 receptor (sIL-2R) on the growth of eight different KS-derived cell lines compared with eight fibroblast cell lines, established from skin biopsies of HIV-positive individuals. Furthermore, we analysed the dose-dependent effect of the above mentioned cytokines on KS-derived cells in vitro. The KS-derived cell culture medium demonstrated significantly higher concentrations than the fibroblast cell lines in view of the following cytokines: sIL-2R, IL-1beta, IL-6, TNF-alpha, GM-CSF, IFN-gamma (p<0.05). The most pronounced differences between KS-cells and fibroblasts were observed for IL-1beta and IFN-gamma. The antiproliferative effect of IFN-beta and IFN-gamma began at a concentration of 20 and 50 IU/ml, respectively, whereas for IFN-alpha an antiproliferative effect was observed at a concentration of 100 U/ml. Furthermore we observed a proliferative effect in low concentrations (2-5 IU/ml) of IFN-gamma in our in vitro model     

A report of two non-AIDS associated Kaposi's sarcoma in Malaysia

Kaposi's sarcoma is an uncommon cutaneous neoplasm seen classically in elderly males of East European or Jewish extract. It has been known to be endemic in sub-Saharan Africa for many years. Numerous cases had been described in patients on long-term immunosuppressive therapy and in patients living with acquired immunodeficiency syndrome (AIDS). In spite of the increasing number of organ transplant recipients and people living with AIDS. Kaposi's sarcoma remains rare in Asia. We report two cases seen in Johor, Malaysia.     

人类疱疹病毒8型病毒干扰素调节因子编码基因的克隆及在真核细胞中的表达

目的:分离、克隆人类疱疹病毒8型(HHV-8)编码的病毒干扰素调节因子(virusinterferonregulatoryfactor,vIRF)基因K9,并将其导入真核细胞中进行表达。方法:根据GenBank登记的K9基因核苷酸序列设计一对PCR引物,其5′端分别引入HindⅢ和BamHⅠ酶切位点。以原发性渗出性淋巴瘤(PEL)细胞系BCBL-1细胞总DNA为模板,PCR扩增K9基因,经双酶切后克隆进真核表达载体pcDNA3.1( )中,构建重组真核表达质粒pK9。为了便于蛋白检测,再设计第二对引物,上游引物不变,在下游引物5′端引入了Flag序列。以质粒pK9为模板再次PCR,扩增K9-Flag基因,并把K9-Flag序列克隆入pcDNA3.1( )中,得到重组质粒pK9F。重组质粒经酶切鉴定,核酸序列测定和分析后瞬时转染NIH3T3细胞,用RT-PCR、Westernblot分别从核酸和蛋白水平检测K9基因的表达情况。结果:PCR分离、克隆的K9-Flag序列全长1380bp,核酸序列分析显示克隆的K9基因与GenBank中己经登记的K9基因序列100%同源,引入的Flag序列完全正确;RT-PCR和Westernblot都在K9预期位置检测到特异性条带。结论:HHV-8K9基因在NIH3T3细胞中获得了正确表达。