Gratama J W, Lennette E T, Lönnqvist B, Oosterveer M A, Klein G, Ringdén O, Ernberg I
Department of Immunology, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
J Med Virol. 1992 May;37(1):39-47. doi: 10.1002/jmv.1890370107.
We have previously shown in 3 allogeneic bone-marrow transplant (BMT) recipients that complete replacement of recipient marrow was associated with the elimination of the pretransplant Epstein-Barr virus (EBV) strain of the recipient. To study the kinetics of EBV elimination and reinfection in more detail, we have performed a longitudinal study of BMT recipients combining serology, virus isolation from mouthwashes and peripheral blood, and EBV strain characterization. Oropharyngeal EBV excretion was found to persist after the cytoreductive therapy prior to BMT, whereas EBV-carrying cells in the blood were detected only after 5 weeks following BMT. During the first month post-BMT, 2 different EBV strains could be isolated from sequential mouth-washes of 3 patients. The initial strains were found to persist up to 7, 21, and 29 days post-BMT, whereas the subsequent strains appeared at 21, 42, and 34 days post-BMT, respectively. Thus, the original EBV strain may persist only for a limited time after BMT, and the oropharyngeal epithelium may be reinfected by a new EBV strain from the blood within 3 weeks. With respect to the coexistence of multiple EBV strains, 2 patterns were evident. From the day 62 mouthwash of 1 patient, 1 Type A and 1 Type B strain were isolated. From the day 180 mouthwash of a second patient, a dominant Type A strain was recovered, together with 6 "variant" strains that differed from each other by only a single EBNA protein (EBNA 1). This pattern may be explained by viral recombinations during replication, which may form the basis for the vast polymorphism of EBV observed in unrelated individuals.
我们之前在3名同种异体骨髓移植（BMT）受者中发现，受者骨髓的完全替代与受者移植前的爱泼斯坦-巴尔病毒（EBV）毒株的清除有关。为了更详细地研究EBV清除和再感染的动力学，我们对BMT受者进行了一项纵向研究，结合了血清学、从漱口水和外周血中分离病毒以及EBV毒株鉴定。发现口咽EBV排泄在BMT前的细胞减灭治疗后持续存在，而血液中携带EBV的细胞仅在BMT后5周才被检测到。在BMT后的第一个月，从3名患者连续的漱口中可以分离出2种不同的EBV毒株。最初的毒株在BMT后持续存在长达7、21和29天，而随后的毒株分别在BMT后21、42和34天出现。因此，原始的EBV毒株在BMT后可能仅持续有限的时间，并且口咽上皮可能在3周内被来自血液的新EBV毒株重新感染。关于多种EBV毒株的共存，有2种模式很明显。从1名患者第62天的漱口中，分离出1株A型和1株B型毒株。从第二名患者第180天的漱口中，回收了一株优势A型毒株，以及6株“变异”毒株，它们彼此之间仅在一种EBNA蛋白（EBNA 1）上有所不同。这种模式可能是由复制过程中的病毒重组所解释的，这可能构成了在无关个体中观察到的EBV广泛多态性的基础。
