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Objective: To evaluate the clinicopathological features of ocular natural killer(NK)/T cell lymphoma. Methods: Data of 21 patients (22 eyes) with ocular NK/T cell lymphoma treated at Eye & ENT Hospital of Fudan University from January 2006 to March 2018 were retrospectively analyzed for clinical data, morphology, immunophenotype and outcomes. Results: There were 10 males and 11 females with ages from 3 to 77 years (mean, 43 years). There were 20 unilateral cases (10 left eyes and 10 right eyes) and 1 bilateral case. Except for 1 case of corneal perforation resulting from the involvement of the conjunctiva and cornea, the other cases all involved the orbit (including eyelids and conjunctiva) as demonstrated by radiologic studies, with the lacrimal sac involved in 3 cases, and the nasal cavity or maxillary sinus involved in 2 cases. Three patients had been previously diagnosed sinonasal NK/T cell lymphoma with radiotherapy and chemotherapy. Two patients had a history of ovarian NK/T cell lymphoma with chemotherapy. One patient had multiple ulcers of skin and mucosa at presentation. There were 13 primary ocular NK/T cell lymphomas without evidence of nasal or systemic involvement. All patients presented with eyelid swelling and decreased visual acuity. There were proptosis in 18 cases, motility restriction in 13 cases, eyelid ulceration in 3 cases, and fever in 4 cases. They had all been previously diagnosed as orbital pseudotumor or cellulitis and there was no response to steroids and antibiotics. Pathological examination showed atypical lymphoid infiltration with an angioinvasive growth pattern causing coagulative necrosis. Cytologically, the medium-sized neoplastic cells showed irregular folded nuclei. The neoplastic cells were positive for cytoplasmic CD3ε, CD56, and cytotoxic molecules and Epstein-Barr virus-encoded RNA (EBER) in situ hybridization. Seven patients were lost to follow-up. Ten patients died 2.0 to 17.0 months after diagnosis (mean, 6.3 months) despite treatment with chemotherapy and radiotherapy. Conclusions: Ocular NK/T cell lymphoma is a rare form of ocular lymphoma. There are primary NK/T cell lymphoma and secondary ocular NK/T cell lymphoma with nasal or systemic involvement. The rarity of this tumor and inflammatory signs make it challenging to identify these tumors early. The neoplastic cells are positive for cytoplasmic CD3ε, CD56, cytotoxic molecules and EBER in situ hybridization. Despite aggressive therapy, it demonstrates high lethality with poor prognosis. (Chin J Ophthalmol, 2019, 55: 374-380) .

Objective: To investigate the clinical and pathological characteristics of chronic active Epstein-Barr virus associated enteritis (CAEAE) . Methods: The clinical data of 6 CAEAE patients in Peking Union Medical College Hospital were retrospectively analyzed from January 2010 to November 2017, including clinical manifestations, endoscopic, pathological features, medications and clinical outcome. Results: The male∶female ratio was 4∶2 and the average age was 34 years old. All patients did not have personal and family history of immunodeficiency. The common symptoms consisted of fever (6/6), abdominal pain (6/6), hematochezia (6/6) and diarrhea (5/6). The most frequently affected sites were colorectum (5/6), followed by small intestine (3/6). Further serologic tests revealed a high load of serum Epstein-Barr virus(EBV) DNA. The main manifestations under endoscopy were multifocal or diffuse irregular ulcers. There was inflammation in the ulcer bases and surrounding areas, where EBV-encoded small RNA (EBER) was positive by in situ hybridization (6/6). The common complications were massive hemorrhage (3/6) and intestinal perforation (2/6). None of treatment agents including glucocorticoid, ganciclovir, foscarnet sodium and cytotoxic drugs was effective. All patients died within 0.5 to 13 months after diagnosis. Conclusions: CAEAE in immunocompetent individuals is a rare disorder with poor prognosis. It is difficult to differentiate CAEAE from inflammatory bowel disease due to similar clinical and endoscopic manifestations.

Infectious diseases can be caused by multiple pathogens, which can produce specific immune response in human body. The immune response produced by T cells is cellular immunity, which plays an important role in the anti-infection process of human body, and can participate in immunological protection and cause immunopathology. The outcome of various infectious diseases is closely related to cellular immune function, especially the function of T cells. Jurkat cells belong to the human acute T lymphocyte leukemia cell line. Jurkat cell model can simulate the function T lymphocytes, so it is widely used in the in vitro studies of T cell signal transduction, cytokines, and receptor expression, and can provide reference and guidance for the treatment of various infectious diseases and the research on their pathogenesis. The Jurkat cell model has been widely used in the in vitro studies of viral diseases and atypical pathogens, but parasitic infection studies using the Jurkat cell model are still rare. This article reviews advances in the application of Jurkat cell model in the research on infectious diseases.

Objective: To explore the value of CD3 + CD4 + T cell count in prediction of viral infections after allogeneic hematopoietic stem cell transplantation(allo-HSCT) in the patients with severe aplastic anemia(SAA)., Methods: A total of 78 SAA patients with allo-HSCT in Guangzhou First People's Hospital from January 2014 to July 2016 were enrolled in this study. The absolute numbers of CD3 + CD4 + T cells were measured by flow cytometry at 1,2,3,6, and 12 month after allo-HSCT. According to the cell counts, the patients were divided into 3 groups: i.e. <50/µl (n=120), 50-100/µl(n=48) and >100/µl(n=123)groups. The infection incidences of human cytomegalovirus (HCMV) and Epstein-Barr virus(EBV) within 2 weeks around each time point were compared between different groups. According the counts of CD3 + CD4 + T cells at 3 months after-transplant, these patients were divided into 2 groups, i.e.>100/µl (n=30) and ≤100/µl (n=48). The incidences and duration of HCMV and EBV infection, overall survival rate were compared between 2 groups., Results: The incidences of CMV and EBV infection significantly decreased in CD3 + CD4 + T cell >100/µl group as compared with <50/µl and 50-100/µl groups. At 3 months after-transplant, there was lower incidence rates of CMV disease, EBV infection, shorter durations of CMV infection and better survival in CD3 + CD4 + T cell >100/µl group as compared with ≤100/µl group., Conclusion: CD3 + CD4 + T cell count is a good predictor for CMV and EBV infection after allo-HSCT in SAA patients. There are low risk of infe-ctions from CMV and EBV when CD3 + CD4 + T cell count >100/µl in any time after transplant, which means lower occurrence of CMV and EBV infection and better survival when CD3 + CD4 + T cell counts is >100/µl in 3 months after transplant in SAA patients.

Objective: To determine the immunophenotypic features of peripheral lymphocytes in adult patients with Epstein-Barr virus(EBV)-associated infectious mononucleosis(IM) and chronic active EBV infection (CAEBV)., Methods: Eighteen IM patients, 12 CAEBV patients and 18 healthy donors were included. Lymphocyte subsets including CD3(-)CD19(+) B cells, CD3(-)CD16/56(+) NK cells, CD4(+) and CD8(+) T cells in peripheral blood were measured by flow cytometry. The expression of activation markers (HLA-DR and CD38) on CD8(+) T cells and CD28 expression on T cells were also determined. Kruskal-Wallis H and Mann-Whitney U tests were used to compare variables among groups., Results: IM patients had dramatically increased CD8(+) T cell counts than healthy donors (5.22×10(9)/L vs 0.54×10(9)/L, P<0.001). B cell counts moderately reduced in patients with IM than in healthy donors. No difference was found in absolute CD4(+) T cell and NK cell counts between IM and healthy donors. The levels of HLA-DR and CD38 on CD8(+) T cells significantly increased in IM patients compared with those in healthy controls. The intensity of CD28 on CD8(+) T cells significantly decreased, which was not seen on CD4(+) T cells. The median cell counts of B, NK, CD4(+) T and CD8(+) T subsets in CAEBV patients were 0.02×10(9)/L, 0.06×10(9)/L, 0.26×10(9)/L and 0.21×10(9)/L respectively, which were significantly lower than those in healthy donors (0.22×10(9)/L, 0.38×10(9)/L, 0.78×10(9)/L, 0.54×10(9)/L)and IM patients (0.12×10(9)/L, 0.40×10(9)/L, 0.91×10(9)/L, 5.22×10(9)/L). The positive rates of HLA-DR and CD38 on CD8(+) T cells in CAEBV patients were higher than those in healthy controls, but lower than those in IM patients., Conclusions: The immunophenotypic pattern in adult patients with IM is characterized by a dramatic increase of extensively activated CD8(+) T cells, a moderate reduction of CD19(+) B cells and no significant change of CD4(+) T cells and CD16/56(+) NK cells. CAEBV is featured by an immunosuppression status as demonstrated by significantly decreased B, NK, CD4(+) T and CD8(+) T subsets.

Epstein-Barr virus (EBV) is the first identified human oncogenic DNA virus in the gamma-herpesvirus family. EBV triggers a cascade events of innate immune responses through Toll-like receptor signaling including the production of type I interferons and the activation of functional autophagy. However, EBV has developed much more elaborate and sophisticated strategies for subverting and escaping the host immune system, such as limiting its own gene expression, activing the host ubiquitin-specific protease system, and interfering ubiquitin modification. EBV impairs the host immune system, leading to lifelong persistent infections, which in turn result in the occurrence of EBV-associated diseases, such as nasopharyngeal carcinoma and infectious mononucleosis. Thus, to better understand the mechanisms regarding the infection latentency and oncogenicity of EBV invasion will be crucial for identifying potential immunotherapeutic targets for EBV- related diseases, such as infectious mononucleosis and nasopharyngeal carcinoma. In this article, we discuss the research advances regarding the virology and immunology of EBV in the modulation of the host immune response and evasion.

Objective: To study the clinical significance of CD163 in the diagnosis and the evaluation of severity and prognosis of childhood hemophagocytic lymphohistiocytosis (HLH)., Methods: Ninety-four children were classified into Epstein-Barr virus (EBV)-positive (n=55) and EBV-negative groups (n=39; control group). The EBV-positive group was subgrouped into infectious mononucleosis (IM; n=47) and HLH (n=8). Serum levels of soluble CD163 were measured using ELISA. Expression of CD163 on mononuclear cells was detected by flow cytometry., Results: The serum levels of soluble CD163 were>10 000 ng/mL in all eight HLH patients (>30 000 ng/mL in 3 cases). The mean serum levels of soluble CD163 in the HLH group were significantly higher than in the control and IM groups (P<0.05). The serum levels of soluble CD163 in EBV-positive children were positively correlated with EBV-DNA copies and serum levels of ferritin and LDH, but were negatively correlated with white blood cell count, neutrophil count, hemoglobin and platelet count. The follow-up after treatment for three HLH patients showed that serum levels of soluble CD163 were significantly reduced, but the soluble CD163 levels rebounded in one patient who was complicated by fungal pneumonia infection., Conclusions: The levels of serum soluble CD163 may be related to the severity in children with HLH. The EBV-positive children with soluble CD163 levels >10 000 ng/mL should be considered the possibility of HLH.

Objective: To study the clinical and laboratory characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV., Methods: The clinical data of 13 children with CAEBV, as well as 15 cases of acute EBV infection (AEBV) as controls, were analyzed, including clinical manifestations, EBV antibodies, EBV DNA, and peripheral blood lymphocyte subsets., Results: Both groups of patients had infectious mononucleosis-like symptoms such as fever, hepatomegaly, splenomegaly, and lymphadenectasis, but CAEBV patients had a longer course of disease and continuous and recurrent symptoms. Compared with the AEBV group, the CAEBV group had a significantly higher EBV DNA load in peripheral blood (P<0.05), a significantly higher VCA-IgG titer (P<0.05), and significantly lower numbers of white blood cells, lymphocytes, B cells, total T cells, CD4+ T cells, and CD8+ T cells in peripheral blood (P<0.05). Among 13 CAEBV patients followed up, 8 cases died, 2 cases showed an improvement, 2 cases had a recurrence, and 1 case was lost to follow-up after being transferred to another hospital. All the AEBV patients were cured and had no recurrence during the one-year follow-up., Conclusions: The clinical manifestations of CAEBV vary in children. It is difficult to distinguish CAEBV from AEBV early. More attention should be paid to CAEBV because of its severe complications, poor prognosis, and high mortality. Measurement of EBV DNA load, VCA-IgG titer, and lymphocyte subsets in peripheral blood may be helpful in the diagnosis and differential diagnosis of CAEBV.

This study aimed to construct recombinant adenovirus expressing Epstein-Barr nuclear antigen 1 (EBNA1) against nasopharyngeal carcinoma (NPC). The C-terminal region fragment of the ebna1 gene of Epstein-Barr virus was amplified from the standard strain B95-8 by polymerase chain reaction (PCR). The gene fragment was inserted into the pDC316 shuttle plasmid using the EcoRI and BgIII restriction enzyme sites. The pDC316-ebna1 shuttle plasmid and pBHG helper plasmid were cotransfected into HEK293 cells after sequencing. The soluble protein was extracted from HEK293 cells, which caused apparent cytopathic effects. The transcription and expression of the ebna1 gene were confirmed using flow cytometry and Western blotting. rAd-ebna1 titers were measured by the TCID50. rAd-ebna1 was injected into BALB/c mice at a dose of 2 x 10(8) VP per mouse, EBNA1 epitope-specific responses were measured at 1st, 2nd, 4th and 8th weeks post-immunization. The target fragment of ebna1 (939 bp) was obtained by PCR, and was in consensus with the sequence from the standard strain B95-8. Cytopathic effects were observed after the pDC316-ebna1 shuttle plasmid and pBHG helper plasmid were cotransfected into HEK293 cells. rAd-ebna1 was successfully recombined in HEK293 cells. EBNA1 protein was detected in HEK293 cells, rAd-ebna1 titers reached 10(8) TCID50/mL. Specific responses to CD4+ epitopes of EBNA1 were detected in the immunized mice. In conclusion, rAd-ebna1 was successfully constructed and induced specific responses to CD4+ epitopes of EBNA1 in immunized mice.

Objective: To provide evidence for Chinese medical treatment of children with EB virus infection by exploring its clinical efficacy from multiple angles., Methods: Totally 81 children patients were randomly assigned to the treatment group (46 cases) and the control group (35 cases). Patients in the treatment group took Chinese medical decoction, while those in the control received intravenous dripping of Ganciclovir and oral administration of pidotimod. The treatment period for the two groups was 2 weeks. Patients were followed-up till the 12th week. Clinical symptoms such as fever, lymphadenopathy and hepatosplenomegaly, as well as lab indices such as abnormal lymphocyte percentage, EB virus antibody, virus DNA load, T cell subsets, immunoglobulin, and so on were observed before and after treatment, at week 4 and 12 of follow-ups., Results: (1) The total effective rate at week 2 was 95.6% in the treatment group, higher than that of the control group (94.3%), but there was no statistical difference between the two groups. (2) The time for defervescence, duration of pharyngeal hyperemia, duration of swollen tonsils was shorter in the treatment group than in the control group (P<0.05). The subsidence of lymphadenopathy, hepatomegaly, and abnormal lymphocytes was better in the treatment group than in the control group (P < 0.05). (3) The positive cases of peripheral blood hetero-lymphocyte was significantly reduced after treatment, at week 4 and 12 of follow-ups both in the treatment group and the control group (P < 0.01). The expression of IgA and IgM decreased after treatment in the two groups when compared with before treatment in the same group (P < 0.05, P < 0.01). IgG in the treatment group also obviously decreased after treatment, at week 4 and 12 of follow-ups (P < 0.05, P < 0.01), while it decreased only after treatment in the control group (P < 0.05). Activities of AST and ALT in the treatment group and the AST activity in the control group were markedly improved when compared with those before treatment (P < 0.05). Compared with the control group, the abnormal lymphocyte positive case number obviously decreased in the treatment group after treatment, at week 4 and 12 of follow-ups (P < 0.05). (4) After treatment, at week 4 and 12 of follow-ups, CD3+ and CD8+ significantly decreased; CD4+, CD4/CD8, and B cells significantly increased in the two groups, when compared with before treatment (P < 0.05). NK cells significantly increased more in the treatment group after treatment, at week 4 and 12 of follow-ups, higher than before treatment as well as the control group (P < 0.05). (5) EB viral DNA and EB viral CA-IgM negative conversion case numbers significantly increased in the two groups after treatment, at week 4 and 12 of follow-ups (P < 0.05). Compared with the control group, EB viral DNA and EB viral CA-IgM negative conversion case numbers significantly increased in the treatment group after treatment and at week 4 of follow-ups (P < 0.05)., Conclusions: Treatment of EB virus infection by Chinese medical treatment was effective. It could promote the recovery of EB viral infection, and reduce the risk of vicious disease after EB viral infection.

Epstein-barr virus (EBV)-associated lymphoproliferative disorders (EBV-LPD) include a series of diseases from chronic to aggressive EBV-positive T-cells, NK cells, T/NK cells or B-cell LPD. The occurrence and development of EBV-LPD are closely associated with the cytokine storm, the clinical manifestations are very complex. Studies found that the different types of EBV-LPD express different cytokine secretion patterns, which help to further understand the progression of diseases, thus the EBV-LPD can be diagnosed early and treated early. In this article, different cytokine secretion patterns and their roles in EBV-LPD progression are reviewed. The main problems discussed above are the classification of EBV-LPD, T/NK-LPD and cytokine, B-LPD and cytokine, HLH and cytokine, and so on.

Objective: To study the condition and clinical characteristics of Epstein Barr virus (EBV) infection in hospitalized children from Wuhan region., Methods: A total of 14 840 hospitalized children were classified into five age groups: less than 6 months old, 6 months to 1 year old, 1 to 3 years old, 3 to 7 years old and 7 to 15 years old. The antibodies IgM and IgG to EBV capsid antigen (VCA) were detected using ELISA., Results: In the 14 840 hospitalized children, 7 899 were positive for EBV antibodies, with an infection rate of 53.23%. The positive rate of VCA-IgM was 4.05% (601/14 840) and that of VCA-IgG was 49.18% (7 298/14 840). The lowest positive rate of VCA-IgM (0.11%) was found in the group of less than 6 months old and the highest positive rate of VCA-IgG (79.83%) was found in the group of 7 to 15 years old. Of the 601 children with positive VCA-IgM, 429 (71.4%) suffered from respiratory tract infection., Conclusions: EBV infection is very common in hospitalized children in Wuhan. Respiratory tract infection is a leading disease in children with positive EBV antibodies. The infection rate of EBV in different age groups is different.

Objective: Development of new methods, ELISA and immunostrip test, for the diagnosis of nasopharyngeal carcinoma., Methods: The engineering purified antigens coat plate or absorb on nitrocellulose filter. The plate and diagnostic strips carrying antigens were used for detection of IgG antibody in the sera from nasopharyngeal carcinoma patients and outpatients patients., Results: 127 cases sera from nasopharyngeal carcinoma patients were parallel detected TK/IgG antibody by ELISA and immunostrips. The TK/IgG antibody are all positive in the 127 cases of nasopharyngeal carcinoma patients. 55 cases show positive by ELISA, 58 cases positive by immunostrips in 247cases sera from outpatient. The antibody positive rate to early antigen p54 lower then to TK. Conclusion ELISA and imuunostrips are sensitive and specific means for detection of the IgG antibody to TK of EBV and the diagnosis of nasopharyngeal carcinoma.

Objective: There are two different types of chronic active Epstein-Barr virus (CAEBV) infection: chronic EBV (CEBV) having persistent infectious mononucleosis (IM)-like illness with relatively good prognosis, and severe CAEBV (SCAEBV)infection that has rather severe manifestations and generally poor prognosis with many life-threatening complications, such as EBV-associated malignant lymphoma and hemophagocytic syndrome (HPS). The purpose of this study was to clarify the clinical and prognostic characteristics in 12 cases with SCAEBV infection., Method: Data of 12 cases with SCAEBV infection were analyzed retrospectively, which included clinical and auxiliary examination, pathological data, especially EB virus (EBV)-antibodies and DNA in peripheral blood mononuclear cells (PBMC) and infected tissue, and follow-up information., Result: Of the 12 cases, 7 were male and 5 were female. The age at the onset of diseases ranged from 35 months to 14 years (median, 11 years). The major manifestations were fever (100%), splenomegaly (91.7%), hepatomegaly (83.3%), lymphadenopathy (75.0%), and others, including skin rash, development retardation, jaundice, ascites, pulmonary hypertension, oral ulcer, cholecystitis and pleural effusion. The abnormalities of auxiliary examination were as follows: elevated LDH level (91.7%), liver dysfunction (83.3%), anemia (75.0%), leukopenia (58.3%), neutropenia (50.0%), thrombocytopenia (25.0%) and abnormal chest X-ray findings. At the time of onset, 58.3% of the patients had an IM-like illness. In all of the 12 cases, EBV serologic tests revealed high IgG antibody levels against EB viral capsid antigen (VCA). The patients often had positive IgM and IgA antibodies against VCA (33.3% and 66.7%) as well. Elevated IgG antibody level to early antigen (EA) (100.0%), occasionally positive IgA antibody (40.0%) were also seen. The mean load of EBV-DNA detected by real-time polymerase chain reaction (PCR) in the PBMC was (8.12 x 10(6), median)copies/ml. Four of 12 cases presented a poor clinical course, two of whom died from EBV-associated HPS, 1 from severe multiple pathogens infection, and 1 from multiple organ failure. In addition, 1 case developed Hodgkin's T cell lymphoma and another case showed hepatopulmonary syndrome in 2 years after splenectomy., Conclusions: The clinical feature of SCAEBV infection varied exceedingly. EBV-DNA load in PBMC of SCAEBV infected patients was significantly increased. More attention should be paid to the disease because of its severe complications, poor prognosis and high mortality.

Objective: This study was aimed to investigate the clinical value of Epstein-Barr virus (EBV) Rta/IgG in the diagnosis of nasopharyngeal carcinoma (NPC)., Methods: Serum samples derived from 211 untreated patients with NPC, 413 subjects including 203 non-NPC ENT patients and 210 healthy volunteers as control were examined for the presence of antibodies directed against Rta/IgG by using enzyme-linked immnunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was applied to perform methodical evaluation of this tumor marker., Results: The rA value median of Rta/IgG in NPC group was significantly higher than one in control group (P < 0.001). The area under ROC was 0.933. The sensitivity and specificity of this marker were 90.5% and 90.1%, respectively, when the best cutoff value was defined., Conclusion: Rta/IgG detected with ELISA method is a new target of EBV, and may be one of important marker for NPC diagnosis.

Background and Objective: Nasopharyngeal carcinoma (NPC), with a remarkable geographic distribution, is consistently associated with Epstein-Barr virus (EBV) infection, and almost all NPC patients have sustained high levels of serum antibodies against EBV. This study was to compare the levels of six anti-EBV antibodies in healthy natives of Zhongshan (a high-incidence area of NPC) with those in provisional migrants from foreign provinces (low-incidence areas of NPC), and to illustrate the relationship between EBV infection and the geographic distribution of NPC., Methods: The serum levels of EBNA1-IgA, EBNA1-IgG, VCA-p18-IgA, VCA-p18-IgG, Zta-IgA and Zta-IgG in 303 healthy Zhongshan natives and 92 provisional migrants were tested using ELISA, and presented by values of adjusted relative absorbance (ArA). The serum levels and positive rates of the six antibodies were compared between the two groups., Results: The mean ArA values of both Zta-IgA and VCA-p18-IgA were significantly higher in Zhongshan natives than in provisional migrants (0.84+/-0.03 vs. 0.42+/-0.04, P <0.05; 0.96+/-0.05 vs. 0.40+/-0.05, P<0.05). In addition, the positive rates of Zta-IgA and VCA-p18-IgA in subjects aged of 30-49, or of 50 and above were significantly higher in Zhongshan natives than in provisional migrants (29.27% vs. 3.03% and 48.28% vs. 6.67% for Zta-IgA, P<0.05; 28.46% vs. 9.09% and 43.10% vs. 13.33% for VCA-p18-igA, P<0.05)., Conclusion: Zhongshan natives are likely to have an elevation of serum IgA antibodies against EBV lytic antigens (Zta and VCA-p18), which represents reactivation of EBV latency infection and implies that Zhongshan natives may have higher risk to develop NPC than provisional migrants.

Objective: To study the characteristics of the peripheral blood lymphocyte subsets in pediatric patients with chronic active EBV (CAEBV) infection., Method: Flow cytometry was used to detect the peripheral blood NK, B, T lymphocyte subsets and the functional, regulatory, naïve, memory and activatory subsets of T lymphocytes in 10 pediatric patients with CAEBV infection, 13 pediatric patients with acute Epstein-Barr virus infection (AEBV) and 12 healthy children in our hospital between March 2004 and April 2008., Result: Compared with AEBV group, the number of white blood cells [3325 x 10(6)/L (median, just the same as the following)], lymphocytes (1078 x 10(6)/L), NK cells (68 x 10(6)/L), B cells (84 x 10(6)/L), total T cells (684 x 10(6)/L), CD4+ T cells (406 x 10(6)/L) and CD8+ T cells (295 x 10(6)/L) in CAEBV patients were lower (P<0.05). The functional subset of the CD4+ T cells in CAEBV group (94.5%) was lower than those of the healthy control group (98.7%) (P<0.05), but was still higher than those of AEBV group (74.0%) (P<0.05). While the functional subset of the CD8+ T cells in CAEBV (40.7%) was not dramatically different from the healthy control group (48.3%), but was still higher than that of AEBV group (21.0%) (P<0.05). Although the regulatory subset in CAEBV group (5.0%) was higher than the health control group (4.6%) (P<0.05), but lower than AEBV group (5.8%) (P<0.05). In CAEBV, the proportion of CD4+/CD8+ naïve T cells (32.3%/37.5%) was lower than that of normal group (58.3%/56.6%) (P<0.05), but the proportion of CD4+/CD8+ effective memory T cells in CAEBV group (23.9%/15.1%) was lower than that in AEBV group (36.5%/69.8%) (P<0.05), while the proportion of CD8+ fake naïve T cells in CAEBV (17.5%) was higher than the other 2 groups (P<0.05). The CD8+ activatory subset in CAEBV group (84.4%/34.0%) was higher than that of the healthy control group (44.1%/16.7%) (P<0.05), but still lower than AEBV group (96%/95%) (P<0.05)., Conclusion: There is an imbalance in lymphocyte subsets and disturbance in cellular immunity in CAEBV patients, which may be associated with EBV chronic active infection. Detecting the peripheral haematologic parameters and lymphocyte subsets may be helpful in the diagnosis and the differential diagnosis of CAEBV.

Objective: To improve the existing serological early diagnosis method of nasopharyngeal carcinoma by improve the detection sensitivity., Methods: The samples of 294 serum specimen from the prevention and treatment of nasopharyngeal cancer model base, involving 106 serum specimen from the patients suffering from nasopharyngeal cancer and 188 from the healthy testers. IgA/VCA antibody and IgA/EA antibody of the serums are tested by Streptavidin-biotin-antibody immunoenzymatic test and normal traditional enzyme methods, SPSS statistical software is used to analyse the test results with chi2 test and t test., Results: Referring to 106 patients, the sera antibody positive rate tested by Streptavidin-biotin-antibody immunoenzymatic test method is obviously higher than that tested by traditional method; and the t test result of the GMT has significant difference in the two method., Conclusion: The modified method can improve the sensitivity of serology testing, ensure the specificity of test results, at the same time, improve the detection rate of nasopharyngeal carcinoma, so it can be applied to the early screen work of nasopharyngeal carcinoma.

Objective: To study the relation between the recent active infection with Epstein-Barr virus, cytomegalovirus,herpes simplex virus-1, coxsackievirus B I-IV and the relapse of relapsing-remitting multiple sclerosis (RR MS)., Methods: Using ELISA method, IgM antibodies to Epstein-Barr virus, cytomegalovirus, herpes simplex virus-1, coxsackievirus BI-IV in the plasma from 34 RR MS patients and 200 normal controls were detected. The rates of recent active infection with the above mentioned viruses of the patients and controls were compared.For patients group,comparison was also made between the clinical data of recent active infected patients and patients without recent active infection., Results: There was no statistically significant difference in positive rates of positive rates of IgM antibodies against Epstein-Barr virus, cytomegalovirus, herpes simplex virus-1 and coxsackievirus BI, II, III or VI between the two groups. While there was statistically significant difference in positive rates of IgM antibodies to coxsackievirus B VI and V in the RR MS patients and those in the controls (being 3/34 and 0/200 P < 0.05; 2/34 and 0/200 P < 0.05, respectively). In the patient group, when patients who had active infection with any of the viruses were compared with those who had no active infection, no significant difference between them was found in terms of age, course, frequency, body temperature on admission, differential leukocyte count (neutrophilic granulocyte, lymphocyte and monocytes), use of glucocorticoids, and EDSS point value., Conclusions: There is a high rate of recent active infection with coxsackievirus B VI and V in RR MS patients at relapsing stage. While the recent virus active infection is unrelated to the severity of the symptoms.

Objective: To observe whether dendritic cells (DCs) transfected with recombinant adenovirus Ad5F35-LMP2 induces LMP2 specific immunity mediated by cytotoxic T lymphocytes in vitro., Methods: Dendritic cells have been generated in vitro, and cocultured with autologous T cell after the DCs were infected with Ad5F35-LMP2, then the proliferation of the induced T cells and their cytotoxic activity against CNE-2 tumor cells which express EBV-LMP2 protein on membrane were assessed by MTT method., Results: The dendritic cells could be transfected with Ad5F35-LMP2 and the CTL activated by Ad5F35-LMP2-DC could effectively suppress the proliferation of CNE-2 cells compared with control groups., Conclusion: The dendritic cells transfected with recombinant adenovirus Ad5F35-LMP2 showed cytotoxicity effect by activating T lymphocytes.

The aim of this study was to analyze characteristics of chronic active Epstein-Barr virus (CAEBV) infection associated hematological disorders in children. Clinical characteristics were summarized; the morphology of hematopoietic cells in bone marrow was observed by microscopy; the lymphocyte subpopulations were analyzed by flow cytometry; the immunophenotype of liver biopsies was assayed by immunohistochemistry; EBV-related antibodies were measured by ELISA; serum EBV-DNA loads were detected by real-time quantitative PCR; EBV-encoded small RNA 1-positive cells in peripheral blood mononuclear cells were identified by in situ hybridization. The results indicated that the clinical manifestations in patients included persistent or recurrent fever, hepatosplenomegaly, liver dysfunction, anemia, thrombocytopenia, systemic inflammatory reaction. Bone marrow presented as hypocellularity, dysmaturation, myelodysplasia and hemophagocytosis. CD8(+) cell high counts were demonstrated in all 4 patients, one of them developed into a T cell lymphoma. Serum EBV-DNA load was 3.26 x 10(3) copies/ml in one patient, EBER1(+) cells were detected at a frequency of 1.7% in PBMNCs from another patient; the titers of IgG to EBV-VCA were >or= 1:5120 in the rest 2 patients. All 4 patients described above were diagnosed as CAEBV infection. In conclusion, the immune-related cytopenia, macrophage activation syndrome and lymphoproliferative disorders are characteristics of CAEBV infection associated hematological disorders in these 4 children patients.

The latent membrane protein 2 (LMP2) is a kind of protein expressed by EBV-infected cells. This study was aimed to investigate whether the stimulation of peripheral blood mononuclear cells with peptides induces EBV-specific cytotoxic T lymphocytes (CTL). The peptides were mixture of LMP2 protein and available for people with different HLA types. Peripheral blood sample was collected from a patient with EBV-associated hemophagocytic syndrome. The mononuclear cells were isolated and cultured to obtain dendritic cells (DCs). Immature DCs were pulsed with MIX-LMP2 and added with different maturation-promoting factors. The auto-T lymphocytes were stimulated weekly with the harvested mature DCs loaded with MIX-LMP2, and totally for two times. Part of isolated lymphocytes was cultured without any stimulation as control. T-cell receptor (TCR) beta spectratyping was used to analyze the distribution of different T cell subgroups before and after culture. The phenotype of T lymphocytes was determined by flow cytometry. The IFN-gamma assay was used to estimate specific cytoxic activity of the cultured T cells. The results showed that the distribution of TCRbeta was changed according to analysis of TCR spectratypes. From the distribution of gene families of TCRbeta, the T lymphocytes were oligoclonal before culture, but shifted to a polyclonal after culture in vitro like the normalization of TCR diversity, suggesting the subgroups of lymphocyte could return to normal. The percentage of CD3+, CD3+CD8+ CD3+ CD45RA- CD45 RO+ on T lymphocytes from freshly isolated mononuclear cells were 70.73%, 42.99%, 27.56% respectively. After being stimulated twice with DC loaded with MIX-LMP2, they further increased to 95.17%, 52.54% and 81.41%. The percentages of CD3-CD56+ NK cells and CD4+CD35+ FOXP3+ regulation T cells seldom changed, from 2.12%, 0.03% to 2.35%, 0.02% respectively. The increase of CD3+CD45RA-CD45RO+ cells obviously indicated that most naive T cells could be activated. ELISA for IFN-gamma showed that when DCs loaded with LMP2 peptide were used as target cells, IFN-gamma level secreted by the T cells stimulated with LMP2 peptide-pulsed DCs was 805+/-16 pg/ml and 1729+/-49 pg/ml, the IFN-gamma level secreted by T cells stimulated twice with LMP2 peptide-pulsed DCs was 956+/-23 pg/ml and 2325+/-58 pg/ml respectively at effector-target ratios of 10:1 and 10:2. They were both significantly higher than that secreted by T cells without any stimulation (441+/-27 pg/m and 557+/-19 pg/ml) (p<0.05). But DCs unpulsed with LMP2 peptide were used as target cells, there were no significant differences between the T cells stimulated with LMP2 peptide-pulsed DCs and the T cells without stimulation (p>0.05). It is concluded that the antigen specific T cells recognizing EBV epitopes can be obtained by using DCs pulsed with MIX-LMP2 peptide in vitro, meanwhile the distribution of T cell subgroups can be changed and normalized.

Objective: To understand the prevalence of Epstein-Barr virus (EBV) infection in urban and rural areas of Beijing using the serological method., Methods: Totally 589 serum samples were collected from children in Beijing urban and rural areas who were 0--14 years old and tested with Viron-Seron ELISA classic EBV virus capsid antigen IgG antibody (EBV VCA IgG) kit. Optical density of serum samples was obtained at the wavelength of 405 nanometers. Sero-positive or negative samples were determined according to standard curve and cut-off attached in ELISA classic EBV VCA IgG kits. The activity of EBV VCA IgG was calculated by using special formula. The percentage and activity of EBV VCA IgG from Beijing children were compared with SPSS 13.0 between the urban and rural areas., Results: The percentage of EBV VCA IgG seropositive samples was 83.6%, and 80.8% in those from urban and 86.2% in those from rural areas. The peak value of EBV infection was 71% seen among children under the age of 3 years, and in urban area the rate was 67.7%, which was lower than that in the rural area (75.3%), and was 82.5% by the age of 6, which was lower than the data (up to 90%) reported 30 years ago. There was a significant difference in EBV infection rate and VCA IgG activities in children at different ages between urban and rural areas (P < 0.05)., Conclusion: The rate of EBV infection in children living in urban area was lower by the age of 6 years. The primary infection of EBV occurred late in part of children lived in urban area.

Objective: To explore the relationship of Epstein-Barr virus (EBV) specific antibodies detection and the diagnoses of infectious mononucleosis (IM) caused by EBV., Methods: Single serum samples were collected from 220 inpatients with the diagnosis of IM between January 2005 and December 2006 in Beijing Children's hospital. The samples were detected for EBV-CA-IgM, EBV-CA-IgG, EBV-EA-IgG, EBV-NA-IgG and the avidity of EBV-CA-IgG by indirect immunofluorescent assay., Results: The positive rate of EBV-CA-IgG, EBV-CA-IgM, EBV-EA-IgG and EBV-NA-IgG were 100%, 95.9%, 79.5% and 4.1% respectively. Low-avidity EBV-CA-IgG was detected in 204 patients (92.7%) with positive EBV-CA-IgM and EBV-CA-IgG,negative EBV-NA-IgG, low-avidity EBV-CA-IgG were the main pattern of EBV antibody in IM patients (84.6%)., Conclusion: The existence of EBV specific antibody (CA-IgG, CA-IgM, EA-IgG, NA-IgG and avidity of CA-IgG) could add more information to identify the stage of EBV infection so as to provide more reliable serological evidence for the diagnosis of IM.

Objective: To explore the role of CD(8)(+)CD(28)(-) T regulatory cells (Tr) in the immunological pathogenesis of acute infection with Epstein-Barr virus in children., Methods: The present study enrolled 25 children with infectious mononucleosis (IM) and 25 age-matched healthy children. Flow cytometric analysis was performed to detect the percentage of CD(3)(+), CD(3)(+)CD(4)(+), CD(3)(+)CD(8)(+), CD(8)(+)CD(28)(+) by determining the ratio of positive cells in lymphocytes. Reverse transcriptase-polymerase chain reaction (RT-PCR) and real-time PCR were used to analyze IL-6, IL-10, IFN-gamma expression in CD(8)(+)CD(28)(-) Tr cells and ILT-3, ILT-4 expression in monocytes/macrophages., Results: The proportions of CD(8)(+)CD(28)(-)T cells in children with acute-phase IM was significantly higher than those in the controls (P < 0.01). The expression level of IL-6, IL-10, IFN-gamma, ILT-3, ILT-4 mRNA significantly increased compared to those of the controls (P < 0.01)., Conclusion: The CD(28) expressed on CD(8)(+) T cells in vivo is gradually lost with age and CD(8)(+)CD(28)(-) cells increase up 50% to adult. EBV can directly infect B cells, trigger CD(8)(+) CTL response and destroy the target cells to cause serious immunopathological lesion. Therefore we speculate that the expansion of CD(8)(+)CD(28)(-) Tr cells in children with IM may be an adaptive immune response to avoid serious inflammation and autoimmune reactions.

Nasopharyngeal carcinoma (NPC) is a complex disease caused by an interaction of EBV chronic infection, environment and host genes, in a multi-step process of carcinogenesis. However, which genetic factors play an important role in the development of chronic EBV infection and NPC remain elusive. The objective of this study is to identify genetic variations associated with two key clinical stages of NPC development: persistent Epstein-Barr virus (EBV) infection of nasopharyngeal epithelia and progression to NPC. We inspected a NPC-associated region on the short arm of chromosome 4 previously implicated by a genome-wide linkage analysis of familial NPC. We determined genotypes for 319 alleles in 34 microsatellite markers spanning an 18 Mb region in 350 NPC cases, 288 individuals with IgA antibodies to EBV capsid antigen (IgA/VCA+) and 346 controls seronegative for IgA antibodies to EBV capsid antigen (IgA/VCA-). The cases and controls were Han Chinese from Wuzhou city and Cangwu County, Guangxi province where the incidence of NPC is as high as 25-50 per 100,000 individuals. Comparing NPC cases to IgA/VCA+ subjects, we found 9 alleles marginally associated with developing NPC from IgA+ status, 5 for risk (OR=1.51-5.36, P=0.01-0.03) and 4 for restrictive (OR=0.3-0.71, P=0.02-0.045). Comparing IgA/VCA+ subjects and IgA/VCA- controls, and comparing all IgA seropositives with and without NPC to IgA seronegatives revealed 12 significant and 3 highly significant (P<0.01) alleles associated with IgA+ serostatus in the two comparing groups. Alleles D4S3241-136 (P=0.004, OR=1.91, 95% CI=1.2-3.0) and D4S3347-213 (P=0.001, OR=1.6, 95% CI=1.2-2.1) were for risk. Allele D4S174-202 (P=0.001, OR=0.5, 95%CI=0.3-0.7) was restrictive. However, statistical significance was lost for all when corrected for multiple comparisons test. Our study could not affirm the genetic association within this region with NPC as did another pedigree study, but provide an opportunity for further gene discovery in this highly endemic NPC population and suggest that this region warrants further study.

Objective: To investigate the expression of CD25(+) lymphocytes in nasopharyngeal carcinoma (NPC) tissue and the influence of Epstein-Barr virus (EBV) infection on CD25 expression., Methods: Immunohistochemistry was used to detect CD25 expression in the NPC tissues and in situ hybridization employed to detect EBV infection with chronic nasopharyngitis tissue as the control sample., Results: Significant difference was noted in the expression of CD25(+) lymphocytes between NPC and chronic inflammatory tissues. The expression was higher in undifferentiated NPC than in keratinizing squamous cell carcinoma and non-keratinizing carcinomas. The NPC tissue was all EBV-positive except for one sample, which was identified as keratinizing carcinoma, but the control samples were all negative for EBV infection, which was correlated with CD25 expression., Conclusion: The expression of CD25(+) lymphocytes is higher in NPC tissues and correlated to EBV infection.

Objective: To investigate the clinicopathological features, immunophenotypes and EB virus infection of 25 cases of primary central nervous system lymphoma (PCNSL)., Methods: Immunohistochemical staining was performed using monoclonal antibodies, L26 (CD20), kappa,lambda for B lymphocytes, UCHL-1 (CD45RO) for T lymphocytes, CS1-4 for latent membrane protein-1 (LMP-1) and GFAP for gliocytes. In situ hybridization was used for detection of EB virus encoded small nuclear RNAs (EBER1/2)., Results: All of the 25 PCNSL were of B lymphocyte origin with high-grade malignancy. Only 2/25 (8%) cases showed positive signal in EBER1/2 in situ hybridization., Conclusion: This group of PCNSL were all B-cell lymphomas, and the role of EB virus in this group of PCNSL was uncertain.

Objective: To study the subclinical EBV infection and related factors among heroin addicts., Methods: Three hundred and twelve heroin addicts were tested for serum EBV-VCA-IgA antibody by immunoenzyme technique population, four hundred and twenty one serum specimens from general were selected as control., Results: Ninty nine heroin addicts (31.51%) were found to be EBV positive. Three people from control group (0.7%) were found to be EBV positive. EBV prevalence rates were significantly different among heroin addict groups according to a group (P = 0.05), duration of addiction. However the dose and sex difference of heroin addicts was not associated with EBV infection rate., Conclusion: The high infection rate of EBV in heroin addicts might be connected with different kinds of factors, hence worthy of supervising the subclinical EBV infection of heroin addicts.

Objective: Study on the relationship between the infection of Epstein-Barr virus (EBV) and the pathogenesis of rheumatoid arthritis (RA)., Methods: The IgA and IgG antibodies against EBV capsid antigen (IgA/VCA and IgG/VCA respectively), and anti-Z protein IgG antibodies (IgG/Z) in the sera from the patients with RA, systemic lupus erythematosus (SLE), and normal controls were detected by using indirect immunofluoresence and immunobloting techniques., Results: The positive rate of IgA/VCA antibody in the serum of RA patients which was significantly higher than that in SLE patients and normal subjects. The anti IgG/Z antibodies were only found in RA patients with IgA/VCA antibody., Conclusions: The results suggested that activated EB virus may play a role in the pathogenesis of RA. It is a useful laboratory method for the clinical diagnosis of RA.

The viral capsid antigen of Epstein-Barr virus was purified from sf9 cells infected with recombinant Baculoviruses and the purified protein was used to establish ELISA and immuno-strip method for detection of VCA/IgG and VCA/IgA antibodies in human sera. A sensitive, specific and cost-effective method has been developed for serological mass survey.

Epstein-Barr virus is believed to be controlled in normal host by virus specific cytotoxic T lymphocytes (CTL). Although unable to eliminate EBV from the body, CTL seems to be essential in control of latently infected cells. Infusion of autologous EBV specific CTL, which can be produced in laboratory by separating lymphocytes from patients and stimulating them with EBV antigen, will provide an effective method of preventing and treating EBV-related diseases. We inserted the LMP gene of EB virus into an AAV vector pACP and packed it in Ad2 infected 293 cells by co-transfecting with plasmid Ad8, which produced the recombinant virus rAAV-LMP. The recombinant virus was used to infect stimulating cells and LMP antigen was expressed on the surface of these cells. Then the stimulating cells were irradiated and co-cultured with T lymphocytes. The EBV specific CTLs were obtained. The target cells were autologous LCLs from EBV-transformed B lymphocytes. The CTL activity was assayed by BLT activity method. The result indicated that all the four CTL strains could recognize and kill their target cells. This study has laid the technical basis for us to prevent and treat nasopharyngeal carcinoma in China with molecular biological methods.