Abstract
Epstein-Barr virus (EBV) is a B lymphotropic human herpesvirus. Two models, germinal center (GC) and direct infection, describe how EBV infects B-cells. Since in Argentina primary infection is mostly subclinical at young ages, children represent an interesting population where to analyze EBV infection, especially considering that most studies are usually performed in adults. Tonsil biopsies from pediatric carriers were studied to describe infection characteristics. EBV+ lymphocytes at the interfollicular region were mainly observed. Latency III pattern in subepithelial (SubEp) lymphocytes was observed at young ages, probably indicating a recent infection. In older patients EBV was mostly detected in epithelial cells, suggesting that they could have been infected some time ago. This finding was sustained by tonsillar viral load, which was higher in cases with LMP1+SubEp cells vs. LMP1+nonSubEp cells (p = 0.0237, Mann-Whiney test). Latency III was prevalent and related to the GC, while latency II was associated with non-GC (p = 0.0159, χ2 test). EBERs+/IgD+ cells were statistically prevalent over EBERs+/CD27+ cells (p = 0.0021, χ2 test). These findings indicated that both EBV infection models are not mutually exclusive and provide some basis for further understanding of EBV infection dynamics. Moreover, we provide a more accurate explanation of EBV infection in pediatric asymptomatic carriers from a developing country.
Highlights
LMP1 and LMP2A in GC B-cells was demonstrated in vivo, based on the presence of high affinity antibodies in LMP1+ and -2A+ B-cells[7]
The aim of this study was to characterize in tonsils of pediatric carriers, the histological regions where viral antigen expression is located and to distinguish the B cell population infected by Epstein-Barr virus (EBV), in order to shed some light on EBV infection models taking place at the main site of infection
EBV infection models were never explored in recently infected pediatric carriers from a developing country, so, our series represents an interesting group to study the first steps of EBV infection
Summary
LMP1 and LMP2A in GC B-cells was demonstrated in vivo, based on the presence of high affinity antibodies in LMP1+ and -2A+ B-cells[7]. One hallmark of IM is global CD8+ T-cell lymphocytosis, mostly reflecting a huge expansion of activated EBV-specific CD8+ T-cells[14] It was recently described in African children that asymptomatic EBV infection elicits a specific CD8+ T-cell response that can control the infection without over-expansion[14]. EBV association with patients younger than 10 years described in several types of pediatric B-cell lymphomas may suggest a close relationship between low age of EBV seroconversion and increasing risk of B-cell lymphoma development[17]. The aim of this study was to characterize in tonsils of pediatric carriers, the histological regions where viral antigen expression is located and to distinguish the B cell population infected by EBV, in order to shed some light on EBV infection models taking place at the main site of infection
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