Department of Clinical Microbiology and Immunology, The Children's Memorial Health Institute, Warsaw, Poland.
J Med Virol. 2011 Dec;83(12):2182-90. doi: 10.1002/jmv.22242.
Immunosuppressed pediatric transplant recipients are at risk of developing Epstein-Barr virus (EBV)-associated complications (such as post-transplant lymphoproliferative disorders). Monitoring of the EBV DNA level in blood alone has a low predictive value for the post-transplant course of EBV infection and its complications. Therefore, additional prognostic markers are widely sought. The study aim was to analyze EBV gene expression patterns and LMP1 polymorphism in relation to EBV DNA levels in pediatric liver transplant recipients. EBV load measurement, LMP1 variant, and gene expression analysis were performed in collected prospectively multiple blood samples from 30 patients. Several distinct patterns of EBV gene expression were identified: latency 2 (71%), latency 3 (13%), latency 0 (11%), and lytic infection (5%). In most children's multiple blood samples, both EBV gene expression patterns and expression levels of individual EBV genes varied significantly over time. EBV gene expression patterns were not associated with the EBV load. However, the viral load correlated with the LMP1 and LMP2 expression (r = 0.34; P = 0.006, and r = 0.45; P = 0.001, respectively). Two variants of the LMP1 gene were detected, and they were consistent over time in individual patients. A wild type of LMP1 was associated with higher EBV-DNA loads (P = 0.03). This indicates that EBV infection in immunosuppressed patients is a very dynamic process, but changes in the state of EBV infection do not influence significantly the viral load. The latter, however, can be associated with the activity of LMP1 and LMP2 genes, as well as polymorphism of LMP1.
免疫抑制的儿科移植受者有发生 EBV（Epstein-Barr 病毒）相关并发症（如移植后淋巴组织增生性疾病）的风险。仅监测血液中的 EBV DNA 水平对 EBV 感染及其并发症的移植后病程预测价值较低。因此，广泛寻找其他预后标志物。本研究旨在分析小儿肝移植受者 EBV 基因表达模式与 EBV DNA 水平、LMP1 多态性的关系。在 30 例患者前瞻性采集的多个血液样本中进行 EBV 载量测量、LMP1 变体和基因表达分析。在大多数儿童的多个血液样本中，EBV 基因表达模式和单个 EBV 基因的表达水平随时间显著变化。EBV 基因表达模式与 EBV 载量无关。然而，病毒载量与 LMP1 和 LMP2 的表达相关（r=0.34；P=0.006，r=0.45；P=0.001）。检测到 LMP1 基因的两种变体，它们在个体患者中随时间保持一致。LMP1 野生型与 EBV-DNA 载量较高相关（P=0.03）。这表明，免疫抑制患者的 EBV 感染是一个非常动态的过程，但 EBV 感染状态的变化对病毒载量没有显著影响。然而，后者可能与 LMP1 和 LMP2 基因的活性以及 LMP1 多态性有关。
