2002 Background: Epstein-Barr virus (EBV) is associated with a variety of tumors including AIDS lymphoma, Burkitt’s lymphoma, nasopharyngeal carcinoma and Hodgkin’s lymphoma. We hypothesized that drugs used in practice might alter viral gene expression in tumor cells in ways that might be important to understand. For example induction of lytic viral gene expression leads to expression of immunodominant CD8 T cell antigens and expression of the viral thymidine kinase (which phosphorylates ganciclovir and other nucleotide analogues). Methods: A library of FDA-approved drugs that includes 2720 agents was screened to identify those that upregulated EBV lytic gene expression. The screen involved a Burkitt’s cell line with a recombinant GFP-EBV that assayed the impact of agents on replication of the complete viral genome, and assay of a lytic promoter reporter construct. Results: The assay identified 146 agents in the whole virus replication assay, 195 agents in the promoter assay, and 54 agents that were active in both assays. Agents with activity could be grouped into 4 families: anti-tubulin drugs, glucocorticoid and other steroid hormones, DNA damaging agents and nucleotide analogues (including cytarabine and gemcitabine), and the proteasome inhibitor bortezomib. Anti-tubulin drugs and nucleotide analogues were less active in thes whole virus assay than the promoter assay whereas bortezomib showed similar activity in both assays. Followup studies confirmed that bortezomib is a potent viral lytic activator that increases expression of the viral thymidine kinase and virion production in several different Burkitt’s lymphoma and primary effusion lymphoma cell lines. Although bortezomib decreases NFKB levels, in vitro investigations with an IKB repressor suggests that inhibition of NFKB alone does not account for lytic activation. Conclusions: Many cancer chemotherapeutic agents are upregulators of EBV lytic expression. Bortezomib is among the most potent. As strategies for using lytic induction therapeutically evolve, these agents may have an important role to play. No significant financial relationships to disclose.
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