Tsukamoto K, Hayakawa H, Sato A, Chida K, Nakamura H, Miura K
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Thorax. 2000 Nov;55(11):958-61. doi: 10.1136/thorax.55.11.958.
The role of Epstein-Barr virus (EBV) in idiopathic pulmonary fibrosis (IPF) is uncertain. A study was undertaken to detect the virus in IPF as well as to clarify the influence of EBV on the clinical features of the disease.
Twenty nine lung specimens were obtained from patients with IPF, as well as five specimens from patients with systemic sclerosis with pulmonary fibrosis (SSc) and 15 specimens from controls. EBV DNA and EBV latent membrane protein 1 (LMP1) were detected using the PCR method and immunohistochemical analysis, respectively.
EBV DNA was detected in 24 of 25 patients with IPF (96%), in all five patients with SSc (100%), and in 10 of 14 controls (71%). The detection ratio was significantly higher in patients with IPF than in controls (p = 0.047, odds ratio (OR) = 9.60, 95% confidence interval (CI) 0.9 to 96.9). Immunohistochemical analysis revealed that cuboidal epithelial cells were positively stained with anti-LMP1 antibody in nine of the 29 lung specimens from IPF patients. In contrast, neither the patients with SSc nor the control subjects showed positive staining. In the follow up periods LMP1 positive patients with IPF died more frequently from respiratory failure than LMP1 negative patients (4/9 versus 1/20; p = 0.022, OR = 15.20, 95% CI 1. 3 to 168.0).
EBV LMP1 positivity may be associated with more rapid disease progression in IPF.
爱泼斯坦 - 巴尔病毒（EBV）在特发性肺纤维化（IPF）中的作用尚不确定。本研究旨在检测IPF患者体内的该病毒，并阐明EBV对该疾病临床特征的影响。
从IPF患者中获取29份肺标本，从合并肺纤维化的系统性硬化症（SSc）患者中获取5份标本，以及从对照组中获取15份标本。分别采用聚合酶链反应（PCR）法和免疫组织化学分析检测EBV DNA和EBV潜伏膜蛋白1（LMP1）。
25例IPF患者中有24例（96%）检测到EBV DNA，5例SSc患者全部（100%）检测到，14例对照组中有10例（71%）检测到。IPF患者的检测率显著高于对照组（p = 0.047，优势比（OR）= 9.60，95%置信区间（CI）0.9至96.9）。免疫组织化学分析显示，在29份IPF患者的肺标本中，有9份的立方上皮细胞被抗LMP1抗体阳性染色。相比之下，SSc患者和对照受试者均未显示阳性染色。在随访期间，IPF中LMP1阳性患者因呼吸衰竭死亡的频率高于LMP1阴性患者（4/9对1/20；p = 0.022，OR = 15.20，95%CI 1.3至168.0）。
EBV LMP1阳性可能与IPF中疾病进展更快有关。
