EBV-driven B-cell lymphoproliferative disorders: from biology, classification and differential diagnosis to clinical management

摘要: Epstein–Barr virus (EBV) is a ubiquitous herpesvirus, affecting >90% of the adult population. EBV targets B-lymphocytes and achieves latent infection in circular episomal form. Different latency patterns are recognized based on gene expression pattern. Latent membrane protein-1 (LMP-1) mimics CD40 and, when self-aggregated, provides proliferation signal via activating nuclear factor-kappa B, Janus kinase/signal transducer activator transcription, phosphoinositide 3-kinase/Akt (PI3K/Akt) mitogen-activated protein kinase pathways to promote cellular proliferation. LMP-1 also induces BCL-2 escape from apoptosis gives for cell cycle progression by enhancing cyclin-dependent 2 phosphorylation retinoblastoma (Rb) inhibiting p16 p27. LMP-2A blocks surface immunoglobulin-mediated lytic reactivation. It activates Ras/PI3K/Akt pathway Bcl-xL B-cell survival. Recent studies have shown that ebv-microRNAs can provide extra signals proliferation, anti-apoptosis. well known association with various types B-lymphocyte, T-lymphocyte, epithelial mesenchymal neoplasms. lymphoproliferative disorders encompass broad spectrum diseases, benign malignant. Here we review our current understanding EBV-induced lymphomagenesis focus biology, diagnosis management EBV-associated disorders. unique therapeutic approaches will be needed combat Epstein-Barr infections depending way pathogen lies dormant. trigger range human including relatively conditions such as infectious mononucleosis, malignant cancers, many aggressive forms lymphoma. Disease manifestation often depends how persists latent, non-active or an active, state. Ken H Young colleagues MD Anderson Cancer Center, USA, interplay between replication, host immune control affects disease pathology presentation. The authors describe three different discovered basis expression. Each pattern might require strategy. Immunotherapies, vaccines, drugs targeted at microRNAs, compounds inhibit specific signaling other Chimeric Antigen Receptor Therapy all being explored manage