Sun A, Chang J G, Chu C T, Liu B Y, Yuan J H, Chiang C P
School of Dentistry, National Taiwan University, Taipei, ROC.
J Oral Pathol Med. 1998 Apr;27(4):168-75. doi: 10.1111/j.1600-0714.1998.tb01935.x.
In this study we used the polymerase chain reaction (PCR), slot blot and Southern blot hybridization, direct sequencing and in situ hybridization (ISH) to show the possible presence of EBV-DNA in pre-ulcerative oral aphthous lesions of patients with recurrent aphthous ulcers (RAU) or Behçet's disease (BD). For this purpose, formalin-fixed biopsy specimens were obtained from 13 pre-ulcerative oral aphthous lesions of nine RAU and four BD patients. Five specimens of normal oral mucosa (NOM) from five normal control subjects and 10 specimens of oral erosive or ulcerative lesions from 10 patients with erosive lichen planus (ELP) were also included. EBV-DNA was detected by PCR in 5 of the 13 (38.5%) pre-ulcerative oral aphthous lesions, two from RAU patients and three from BD patients. However, no EBV-DNA was demonstrated in five NOM specimens from normal control subjects and in 10 specimens of oral lesions from ELP patients. EBV-DNA was also demonstrated in patients' peripheral blood lymphocytes and/or plasma, suggesting that the lymphocytes may be the reservoir of latent EBV infection and there is EBV shedding in the plasma. EBV-DNA was detected by ISH in only one PCR-positive case; the reaction product was found to deposit on the nuclei of some of the epithelial cells and lymphocytes. By immunohistochemistry, expression of Epstein-Barr nuclear antigen and EBV/C3d receptors was also noted in some of the epithelial cells and lymphocytes in this ISH-positive case. Therefore, we suggest that the epithelial cells of pre-ulcerative oral aphthous lesions may be infected by EBV through EBV-infected lymphocytes; also, the cytotoxic T lymphocyte-induced lysis of the EBV-infected epithelial cells, but not the virus-induced cytolysis, may be the main mechanism causing oral ulcer formation. Our data provide preliminary evidence for an association of EBV with pre-ulcerative oral aphthous lesions in RAU and BD patients.
在本研究中，我们使用聚合酶链反应（PCR）、斑点印迹和Southern印迹杂交、直接测序以及原位杂交（ISH）来检测复发性阿弗他溃疡（RAU）或白塞病（BD）患者溃疡前期口腔阿弗他病变中是否可能存在EBV-DNA。为此，从9例RAU患者和4例BD患者的13个溃疡前期口腔阿弗他病变中获取了福尔马林固定的活检标本。还纳入了5名正常对照受试者的5份正常口腔黏膜（NOM）标本以及10例糜烂性扁平苔藓（ELP）患者的10份口腔糜烂或溃疡病变标本。通过PCR在13个溃疡前期口腔阿弗他病变中的5个（38.5%）检测到了EBV-DNA，其中2个来自RAU患者，3个来自BD患者。然而，在正常对照受试者的5份NOM标本以及ELP患者的10份口腔病变标本中均未检测到EBV-DNA。在患者的外周血淋巴细胞和/或血浆中也检测到了EBV-DNA，这表明淋巴细胞可能是EBV潜伏感染的储存库，并且血浆中有EBV脱落。仅在1例PCR阳性病例中通过ISH检测到了EBV-DNA；发现反应产物沉积在一些上皮细胞和淋巴细胞的细胞核上。通过免疫组织化学，在该ISH阳性病例的一些上皮细胞和淋巴细胞中也观察到了EB病毒核抗原和EBV/C3d受体的表达。因此，我们认为溃疡前期口腔阿弗他病变的上皮细胞可能通过EBV感染的淋巴细胞被EBV感染；此外，细胞毒性T淋巴细胞诱导的EBV感染上皮细胞的裂解，而非病毒诱导的细胞溶解，可能是导致口腔溃疡形成的主要机制。我们的数据为EBV与RAU和BD患者溃疡前期口腔阿弗他病变之间的关联提供了初步证据。
