Cell type specific infection of Epstein–Barr virus (EBV) in EBV-associated hemophagocytic lymphohistiocytosis and chronic active EBV infection Yoshihito.

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Cell type specific infection of Epstein–Barr virus (EBV) in EBV-associated hemophagocytic lymphohistiocytosis and chronic active EBV infection Yoshihito Kasahara, Akihiro Yachie Critical Reviews in Oncology / Hematology Volume 44, Issue 3, Pages 283-294 (December 2002) DOI: 10.1016/S1040-8428(02)00119-1

Fig. 1 Frequencies of EBV infected cells in acute IM patients and seropositive normal subjects. Frequency of EBV genome positive cells in T cells and B cells from acute IM patients and seropositive normal adults was investigated by EBER-1 ISH method. B cells from acute IM showed a high frequency with 0.03–10.5% of EBER-1 mRNA positive expression. Critical Reviews in Oncology / Hematology 2002 44, 283-294DOI: (10.1016/S1040-8428(02)00119-1)

Fig. 2 Expression of EBER-1 mRNA in lymphocyte subpopulations from typical case of acute EBV-HLH. Lymphocyte subpopulations were separated by electronic sorting methods after immunostaining with anti-CD4, Cd8, CD16, or CD20 monoclonal antibodies. EBV infection in each subpopulation was analyzed by EBER-1 ISH. Dark nuclear staining indicated EBER-1 positive cells. Arrow indicates positive signal for EBER-1 mRNA. High frequency of EBV infection to CD8+ T cells is found. Critical Reviews in Oncology / Hematology 2002 44, 283-294DOI: (10.1016/S1040-8428(02)00119-1)

Fig. 3 Differential cellular targets between acute EBV-HLH and CAEBV. EBER-1 expression in lymphocyte subpopulations was estimated by the same method as mentioned in Fig. 2. In EBV-HLH patients, the main EBV-infected population was CD8+ T cells, while CD4+ T cells or CD16+ NK cells were the main targets for EBV infection. Critical Reviews in Oncology / Hematology 2002 44, 283-294DOI: (10.1016/S1040-8428(02)00119-1)

Fig. 4 Changes in EBV-infected cells in EBV-HLH patients during the clinical course. Frequencies of EBV-infected cells in blood lymphocytes from five EBV-HLH patients were analyzed by EBER-1 ISH on different days after onset of the disease. All patients received combination immuno-therapy of plasma exchange, blood exchange, methyl-prednisolone pulse therapy, oral prednisolone, cyclosporine A, or etoposide. Four cases achieved remission without relapse with this therapy, but one case died of multiple organ failure and uncontrolled coagulopathy. Disappearance of EBV-infected cells from the circulation was noted in four cured cases, while a re-increase of EBV-infected cells was found before death in the fatal case. Critical Reviews in Oncology / Hematology 2002 44, 283-294DOI: (10.1016/S1040-8428(02)00119-1)