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The infection from Epstein-Barr virus (EBV) or virus of infectious mononucleosis, together with other herpes viruses’ infections, represents a prototype of persistent viral infections characterized by the property of the latency. Although the reactivations of the latent infection are associated with the resumption of the viral replication and event...
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... markedly limiting viral gene expression during latency, EBV reduces the number of viral proteins that permit the recognition of infected cells by cytotoxic T cells. Our knowledge of the functions of the latent proteins is extensive but incomplete (Table 1): the main functions so far explored are represented by the maintenance of latency, the immortalization of B cells in vitro and the oncogenetic activity. ...
Citations
... Дилема клінічних форм хронічної ЕБВІ далека від вирішення [23]. У клінічній практиці рідко запідозрюють реактивацію ВЕБ в імунокомпетентних осіб. ...
Висвітлено особливості хронічної Епштейна-Барр вірусної інфекції (ЕБВІ) у дітей дошкільного віку та їх інфікованість цитомегаловірусом (ЦМВ) і вірусом герпесу людини 6 типу (ГВЛ 6). Мета – вивчити особливості клінічних проявів хронічної реактивованої ЕБВІ в дітей дошкільного віку та частоту коінфекції з ЦМВ і ГВЛ 6. Пацієнти і методи. До основної групи увійшли 40 дітей віком 3-6 років, інфіковані ВЕБ, з частими гострими респіраторними захворюваннями (ГРЗ), рекурентними тонзилітами, з одним або кількома проявами: лімфаденопатією, періодичним підвищенням температури тіла, утрудненням носового дихання, гіпертрофією піднебінних мигдаликів. До контрольної групи увійшли 20 здорових дітей віком 3-6 років, інфікованих ВЕБ. Методом ІФА виявляли anti-VCA IgM та anti-EBNA IgG, IgM та IgG до ЦМВ. ДНК ВЕБ, ЦМВ та ГВЛ 6 виявляли методом ПЛР у крові та ротоглотці. Результати. При обстеженні дітей реплікацію вірусу в крові виявлено у 25 % випадків. У таких пацієнтів частіше виявляли підвищення температури тіла, збільшення задньошийних і передньошийних лімфовузлів до 2,0-2,5 см, гіпертрофію піднебінних мигдаликів, гіпертрофію носоглоткового мигдалика, гепатомегалію, післявірусний синдром стомлюваності. Значна лімфаденопатія, гіпертрофія носового мигдалика, частота ГРЗ 8-10 на рік корелюють з реплікацією ВЕБ у крові. У дітей основної групи в ротоглоткових зішкрібах у 67,5 % випадках виявлено ДНК ВЕБ, у 15,0 % – ДНК ЦМВ, у 37,5 % – ДНК ГВЛ 6. Висновки. У дітей з хронічною ЕБВІ виявлено реплікацію вірусу у крові у 25,0 % випадків, на мигдаликах – у 67,5 %. У дітей з вірусемією виявлено субфебрилітет, шийну лімфаденопатію, гіпертрофію піднебінних мигдаликів 2-3-го ступеня та аденоїди 2-3-го ступеня, частота ГРЗ – 8-10 разів на рік, тонзилітів – 4-6 на рік. У дітей без вірусемії лімфаденопатія та гіпертрофія мигдаликів менш значні, нижча частота ГРЗ і тонзилітів. Частота ЕБВІ, асоційованої з ЦМВ, – 90,0 %, а з ГВЛ 6 – 95,9 %.
... 6,9,12,[15][16][17][18][19] Many viruses have been thought to be associated with post-acute infection syndromes, most commonly Coxsackie viruses, but also Influenza, Varicella, Epstein-Barr, Ebola, and tick-borne encephalitis viruses. 6,9,12,17,20,21 Similarly, SARS-CoV-2 infection may be followed by a comparable post-acute, long-lasting multi-organ syndrome. 13 The most commonly reported symptoms of Long/post COVID conditions include fatigue, headache, attention disorder, hair loss, cough, chest pain and dyspnea [22][23][24] ; however, with a lower prevalence in children to young adults as compared to adults. ...
... The underlying pathophysiological mechanisms of post-viral conditions are still unclear, and multiple mechanisms have been proposed: the chronic activation of the immune system, 17 and the neuro-immunoendocrinological pillars may be the critical points to understanding the complexity of the disease. 9,18,20 Viral persistence has also been postulated 8,9,11,13,19,21,[64][65][66][67] ; however, in most cases, no changes in viral antibody titers can be found, not surprisingly, as the symptoms usually appear long after the initial infection. 6 For Long COVID, the possible mechanisms for prolonged symptoms are similar and include the hypothesis of viral persistence in "sanctuary" organs (i.e., brain), direct organ damage, and an increased tendency to blood clotting. ...
Background: Post Coronavirus disease (COVID) and other post-viral infection syndromes present an overlap of pathogenesis, onset, progression, and symptom profile. We aimed to systematically describe studies on post-viral conditions and determine the entity of post COVID compared to other post-viral conditions in children.
Methods: We conducted a systematic search of the Embase, MEDLINE, Cochrane Library, and GoogleScholar databases (January 1946–3 November 2023), according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The main outcomes were differences in condition duration, symptom type, and development of chronic symptoms. This systematic review was registered on PROSPERO (CRD42023401789).
Findings: 35/5051 studies were included, with 42,934 children, adolescents and young adults (0–20 years old) overall. Twenty-eight studies focused on post COVID symptoms, followed by five papers on Respiratory Syncytial Virus (RSV) and Rhinovirus, one study on Epstein–Barr Virus (EBV), and one on gastrointestinal viruses. Studies on post COVID mainly reported data on older children/adolescents, describing long-lasting symptoms, including fatigue, neurologic,
cardiorespiratory, musculoskeletal, mental health, and gastrointestinal symptoms. The maximum described symptoms duration was eighteen months, with an average follow-up of seven months. The development of chronic symptoms was reported by 30 studies (93.8%) for 10,473/28,474 patients (36.8%). Recovery was achieved
in 18,001/28,474 cases (63.2%). The study on EBV reported persistent fatigue in adolescents for a similar duration (6 months, 46% chronic). Studies on RSV and Rhinovirus were mainly done in children under three years, with development of recurrent wheezing (up to 3 years).
Interpretation Post-viral fatigue was a shared feature between post COVID and post EBV conditions. A better understanding of post COVID as a unique condition, sharing features with other post-viral syndromes, is needed. The healthcare burden and socio-economic consequences for children and their families warrant further investigation and development of appropriate healthcare management plans. The foremost requirement is the establishment of consistent and shareable definitions, as well as a consensus on outcomes, to effectively evaluate follow-up and
quantify the burden of different viral infections.
... In this regard, the Herpesviridae family study is of great interest in the etio-and immunopathogenesis of some infectious and non-infectious diseases, tending to a chronic progressive course and characterized by torpidity to ongoing standard therapy, the clinical picture of which is often atypical, polysymptomatic and polysyndromic. Possessing pronounced neuroand immunotropism, herpes family viruses are able to persist for a long time in neuroglial cells, neurons, cells of the immune system, causing the development of chronic systemic and neuroimmune inflammation, clinically accompanied by the meningoencephalitis (ME) symptoms, post-viral chronic fatigue syndrome and immune dysfunction, including signs of amnestic mild cognitive impairment (aMCI) [2,7,11,12,14,15]. It is known that one of the aMCI causes is neuroinflammation induced by a viral process of a predominantly integrative type [5,6,8,10]. ...
According to modern ideas, changes in the functioning of the immune system affect the immune processes in the nervous system, contributing to the development of neuro-immuno-inflammation and thereby indirectly affect the rate of progression of neurodegenerative processes. The aim of our study was to investigate the prevalence of post-viral chronic fatigue syndrome and cognitive impairment (aMCI) among patients with atypical, chronic active herpesvirus infections (ACA-HVI).
Under our supervision were 126 patients of both sexes aged 18 to 60 years with ACA-HVI.
It was established that mono-EBV infection affects 27.7%; mixed EBV infection is observed in 72.3% of patients. When assessing cognitive functioning using CGI, MMSE scales, the incidence of aMCI was found to be 68.3%: with mixed HVI — 87.4%, with mono HVI — 38.8%. During the study, significant limitations were identified in the use of standard scales due to the impossibility of conducting a comprehensive assessment of clinical status parameters and cognitive dysfunctions, as well as correlation of these parameters and assessment of dynamics of the immunocorrection. To achieve this goal the Scale of assessment of the criterion clinical symptoms of patients with ACA-HVI with CFS was used. It was shown that in mixed-HVI, the severity of symptoms exceeded the severity of symptoms of patients with mono-HVI and was 52.7 (43.1-62.2) and 38.0 (31.9-42.8) points, respectively (p > 0.05). Thus, it was found that patients suffering from mixed HVI have more pronounced, severe manifestations of CFS and aMCI, which are 1.5 times higher than similar manifestations in patients with mono-HVI, significantly reducing the quality of life of these patients, worsening their social adaptation.
Prolonged persistence of herpes viruses in immune-compromised people creates conditions for constant antigenic stimulation and immune imbalance with the onset of secondary immunodeficiency or clinical manifestation of existing primary disorders in the immune system, which creates the prerequisites for the development of neuro-immuno-inflammatory changes in nervous system, followed by the formation of clinical manifestations of ME/CFS with different cognitive impairments that may be classified as aMCI.
... Did this patient have asymptomatic HLH that was triggered by EBV and CMV and become symptomatic a few weeks before his admission? Can Cannabis be a trigger for HLH? Has the reactivation of EBV been triggered by HLH, or has HLH been induced by the reactivation of EBV? Returning to our case report, we discovered that CMV IgG and EBV IgG were both positive, indicating a chronic infection (29), implying that the patient had previously been infected with these viruses. In this case, we can either stick to the epidemiological evidence and the causative role of EBV and CMV in HLH as described in the review and adopt the viral etiology theory. ...
Haemophagocytic lymphocytosis (HLH) is a rare life-threatening syndrome caused by the uncontrolled activity of cytokines, natural killers, and macrophages, which can alter the activity of the organism, resulting in multiple organ dysfunction and mortality. Fever, splenomegaly, coagulopathies, dyspnea, changes in mental status, or irritability may be associated with HLH diseases. Depending on the underlying causes, such as bacterial or viral infections, HLH may be primary, hereditary, or secondary. The early diagnosis and treatment of patients are directly related to their prognosis and clinical outcome. On the other hand, HLH can present a number of obstacles, particularly for children and newborns, as well as hematological defects which might cause other autoimmune disorders.
Case presentation: We present a case of a 28-year-old male patient admitted to the hospital with a history of persistent high grade fever for two weeks, right lower limb swelling three weeks prior to admission, and right side weakness for one month. Aside from being addicted to cannabis for three years, the patient has no prior medical history. On admission, the patient was awake, conscious, oriented, and hemodynamically stable. A complete blood count, ultrasound examinations, and a whole-body CT scan revealed that the results were favorable for multiple enlarged lymph nodes and hepatosplenomegaly. The patient was given acyclovir, Vfend, Colistin, Targocid, Tinam, Septrin, and anticoagulant during the follow-up. The patient's clinical condition was rapidly deteriorating; a bone marrow biopsy was performed, which revealed haemophagocytosis; and dexamethasone was started. The patient's clinical condition deteriorated during his hospital stay until he went into cardiac arrest and had to be resuscitated for 30 minutes with pulseless electrical activity.
Background and Aim: This case suggests that we should be vigilant to the patient who is admitted to the hospital with symptoms for unknown reasons, in order to diagnose HLH as soon as possible and clarify its cause, and it also puts several theories regarding the pathogenicity of this disease in our hands, which will be described in this case, making this case a subject for discussion and research in the medical field.
Conclusion: Haemophagocytic lymphocytosis (HLH) is a severe inflammatory disease that improperly controls the body's immune response. Viruses and bacterial infections are just two examples of the various etiological causes that can cause it. Lab results and symptom presentations that are particular to the primary infection can indicate it. Diagnosis and treatment must be provided as soon as possible in order to reduce morbidity and mortality.
... Epstein-Barr virus (EBV), a member of the Herpesviridae family, is associated with various lymphoproliferative diseases involving one or more types of lymphoid cells [1]. Most EBV-infected healthy individuals are asymptomatic; however, immune regulation may be disrupted, and evoked proliferation of EBV-infected lymphocytes can be observed in immunocompromised patients [2]. ...
... [7] CAEBV is characterized by persistent or recurrent mononucleosislike symptoms with elevated EBV antibodies, presence of EBV-DNA, or of EBV-positive lymphocytes in histological findings; diagnosis also requires the absence of other EBV-related diseases that nevertheless can occur over time. [8][9][10] Many etiopathogenetic hypotheses have been made for CAEBV, like a particularly virulent strain of EBV, a deficit in the production of EBV-related CTLs, a clonal expansion of CAEBV-lymphocytes, or a genetic predisposition, but this disease has probably a multifactorial pathogenesis. [11,12] Depending on disease severity, different therapeutic strategies have been described, but none of them can obtain a lasting resolution of the disease; only hematopoietic stem cell transplantation (HSTC) has been resolutive in the most severe cases. ...
... 52 This is reminiscent of persistent fatigue after Epstein-Barr virus (EBV) infection. 83 Here, the most accepted hypothesis suggests a multifactorial pathogenesis including latent EBV infection, immune and/or neuroendocrine dysfunction as well as behavioral factors. It may be speculated if a similar etiopathogenesis could explain such persistent symptoms also with SARS-CoV-2. ...
To optimize diagnostic workup of the current severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic, we systematically reviewed neurological and neuroradiological manifestations of SARS‐CoV‐2 and all other known human coronavirus species (HCoV). Which lessons can we learn? We identified relevant publications (until 26 July 2020) using systematic searches in PubMed, Web of Science, and Ovid EMBASE with predefined search strings. A total of 4571 unique publications were retrieved, out of which 378 publications were selected for in‐depth analysis by two raters, including a total of 17549 (out of which were 14418 SARS‐CoV‐2) patients. Neurological complications and associated neuroradiological manifestations are prevalent for all HCoVs (HCoV‐229E, HKU1, NL63, OC43, Middle East respiratory syndrome (MERS)‐CoV, SARS‐CoV‐1, and SARS‐CoV‐2). Moreover there are similarities in symptomatology across different HCoVs, particularly between SARS‐CoV‐1 and SARS‐CoV‐2. Common neurological manifestations include fatigue, headache, and smell/taste disorders. Additionally, clinicians need to be attentive for at least five classes of neurological complications: (1) Cerebrovascular disorders including ischemic stroke and macro/micro‐hemorrhages, (2) encephalopathies, (3) para‐/postinfectious immune‐mediated complications such as Guillain‐Barré syndrome and acute disseminated encephalomyelitis, (4) (meningo‐)encephalitis, potentially with concomitant seizures, and (5) neuropsychiatric complications such as psychosis and mood disorders. Our systematic review highlights the need for vigilance regarding neurological complications in patients infected by SARS‐CoV‐2 and other HCoVs, especially since some complications may result in chronic disability. Neuroimaging protocols should be designed to specifically screen for these complications. Therefore, we propose practical imaging guidelines to facilitate the diagnostic workup and monitoring of patients infected with HCoVs.
... It has a tropism for the nervous and epithelial cells and, in addition, they infect cells of the immune system -the cells of the thymus, monocytes / macrophages, neutrophils, B-lymphocytes, and are found in T-lymphocytes. The peculiarity of EBV is its ability to cause not only cytolysis, but also the proliferation of infected B-lymphocytes [6,7]. It has an affinity for the CD21 receptor of B-lymphocytes, which contributes to its specific binding to it and penetration into the cell, where it is actively reproduced, exploiting the various mechanisms of the cell itself [8][9][10]. ...
The annual steady increase of the herpesviral infections number in the human population is one of the most important interdisciplinary problems of modern medicine. Clinicians and laboratory diagnostics physicians face difficulties in clinical symptoms assessing, inadequate laboratory diagnostics and difficulties in interpretation of the obtained results. This is connected with a low awareness of atypical chronic active infection symptoms caused in particular by the Epstein-Barr virus (EBV), of the ability to fully diagnose, and of serious consequencescaused by prolonged activity of herpesviruses in the human body. Studies were carried out to determinethe functioning features of the antiviral defense system, as well as defects and disorders in the interferon system in patients suffering from various mono-, mixed herpesvirus infections and bacterial co-infections. The main clinical syndromes associated with these herpetic infections, as well as prevailing nosological forms of concomitant diseases, have been identified. Among the group of patients suffering from mono-herpesvirus infections, the leading position takes the allergic syndrome (55%), while the syndrome of chronic fatigue syndrome (85%) and the infectious syndrome (68%) prevail in the incidence of patients with mixed herpesvirus infections. Extended testing of the antiviral protection main mechanisms state made it possible to identify the most frequent defects in the functioning of antiviral immunity: disturbances in induced production of IFNα and IFNγ, deficiency of cytotoxic T lymphocytes, deficiency of natural killer cells, including EKT, and / or inadequate absence of their activation, neutropenia. The revealed clinical syndromes and functioning features of the antiviral defense system will allow us to further develop the concept of complex, individualized, etio- and immunopathogenetic therapy.
... EBV infection subsequently inhibits the activation of EBV-specific CD4 + lymphocytes (29). Thus, the effector cell response does not eliminate EBV infection, which results in latent infection (30). ...
Background/aim:
Chronic viral infection is an important risk factor in the development of cancer. Failure of immune response to clear the oncogenic infection can facilitate cancer progression. The aim of the present study was to analyze early and late activation of T-lymphocytes related to Epstein-Barr virus (EBV) infection by the expression of markers of activation (CD69, CD25) on the surface of T-lymphocytes (CD3+, CD4+, CD8+) in patients bearing laryngeal cancer according to absence/presence immunoglobulin G antibodies to EBV nuclear antigen (EBNA1).
Materials and methods:
Thirty-three patients with laryngeal squamous cell carcinoma (LC) and 20 volunteers without cancer (control group) were enrolled in the study. Peripheral blood samples were collected from every individual. The markers of activation of T-lymphocytes were determined by flow cytometry, whereas commercial immunoenzymatic assay kits were used for detection of anti-viral capsid antigen (VCA) IgM, anti-VCA IgG, and anti-EBNA1 IgG.
Results:
Increased early activation of CD8+ and CD4+ T-lymphocytes was found in patients with LC. There was a significantly higher proportion of CD4+ and CD8+T-lymphocytes expressing CD69 antigen in patients with LC compared to the control group. The proportion of CD4+ CD25+ T-lymphocytes in patients with LC positive for anti-EBNA1 IgG and anti-VCA IgM was lower compared to patients without antibodies to VCA IgM.
Conclusion:
The dysfunction of immune response in larynx cancer patients could be associated with EBV infection.
... 2,4 This reactivation can manifest as infectious mononucleosis or as other rarer complications including, but not limited to, hematologic derangements (hemolytic anemia, thrombocytopenia, aplastic anemia, etc.), neurologic complications (Guillain-Barré syndrome, facial nerve palsy, aseptic meningitis, transverse myelitis, etc.), splenic rupture, and upper airway obstruction. 3,5 However, only a few case reports have described hemorrhagic EBV colitis. ...
Epstein-Barr virus (EBV) is a member of the herpesvirus family that is associated with various disease manifestations, including EBV-associated colitis. There are few case reports describing hemorrhage associated with EBV colitis. We report a 61-year-old woman with acute gastrointestinal bleeding due to EBV colitis after initiation of methylprednisolone and enoxaparin for spinal cord infarction. To our knowledge, there are only a few case reports of hemorrhagic EBV colitis. Perhaps we need to have a higher suspicion for EBV in cases of colitis associated with hemorrhage even in relatively immunocompetent patients.
