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Biomedical subjects

W Henle

Publications and source records attributed to W Henle.

At least 73 records · Page 4Linked to original sources

Central-nervous-system lymphoma related to Epstein-Barr virus.

We have studied five cases suggesting a relation between Epstein-Barr virus infection and primary lymphoma of the central nervous system. A 48-year-old man had primary lymphoma of the central nervous system in the absence of systemic lymphoma or immunosuppression. Development of the tumor was associated with serologic evidence suggesting a recent primary infection with Epstein-Barr virus. DNA preparations from tumor tissue, but not from adjacent normal brain tissue, contained Epstein-Barr virus genomes when hybridized with a probe consisting of the BamHI K fragment of Epstein-Barr virus strain FF41. Evaluation of serum samples from four additional patients with central-nervous-system lymphoma revealed patterns of Epstein-Barr virus-specific antibody that were suggestive of an ongoing infection with EBV. Our results suggest induction of the lymphoma by Epstein-Barr virus.

Antibodies, Viral↗

Association of herpesvirus infections with T-lymphocyte-subset alterations, glomerulopathy, and opportunistic infections after renal transplantation.

We studied the interrelation among herpes-virus infections, T-lymphocyte subsets, opportunistic infections, and renal histopathology in 28 recipients of renal allografts. All primary or reactivated herpesvirus infections occurring in the first three months after transplantation in recipients of cadaveric grafts accompanied persistent inversions in the ratio of OKT4 (helper/inducer) to OKT8 (cytotoxic/suppressor) lymphocytes. In the less heavily immunosuppressed recipients of organs of living related donors, these inversions were seen only in association with clinically apparent cytomegalovirus infections. Five of seven opportunistic infections occurred in patients with OKT4/OKT8 ratios of less than 1.0. Biopsy specimens from patients with renal dysfunction occurring in association with a low OKT4/OKT8 ratio frequently revealed glomerular damage rather than acute cellular rejection. Monitoring of T-lymphocyte subsets provides early evidence of herpesvirus infections and identifies patients at increased risk for opportunistic infection after renal transplantation.

Biopsy↗

Application of Epstein-Barr virus (EBV) serology to the diagnosis of North American nasopharyngeal carcinoma.

A cooperative study was established among a number of institutions in the USA to determine the clinical value of Epstein-Barr virus (EBV) serology for the diagnosis of different histopathological types of North American nasopharyngeal carcinoma (NPC) including occult primary tumors. One hundred-twenty-four patients with confirmed NPC have now been entered into the study. For each patient, anti-EBV antibody titers were determined at diagnosis and related to the histopathology as classified according to the World Health Organization (WHO). The results suggest that certain anti-EBV antibodies are of potential value for the diagnosis of undifferentiated types of NPC but not for the well-differentiated cancer. The IgA anti-VCA antibody response is the most specific for this disease and of the greatest diagnostic value when used alone or in combination with the anti-EA test. These tests have also been used successfully for the detection of occult NPC. These results indicate that these tests can be useful aids to the clinician for the diagnosis of certain histopathologic types of this disease.

Antigens, Viral↗

Elevated antibody titers to Epstein-Barr virus and low natural killer cell activity in patients with Chediak-Higashi syndrome.

Four Venezuelan patients with the autosomal recessive Chediak-Higashi syndrome (CHS) were studied. The results confirm the severe reduction in natural killer (NK) cell activity, as previously described and showed also a decline in the activity of cells involved in antibody-dependent cellular cytotoxicity (ADCC). No defect was found in the production of immunoglobulins and of specific antibodies to measles, varicella, herpes simplex, and cytomegalo viruses. Two of the patients had extremely high antibody titers to the Epstein-Barr virus (EBV) specific viral capsid antigen (VCA), to the restricted (R) component of the EBV-induced early antigen complex, and to the EBV-associated nuclear antigen (EBNA). These two patients had enlarged livers, spleens, and lymph nodes indicative of the lymphoproliferative phase. The other two patients were initially negative for all EBV-associated antibodies but seroconverted subsequently and, in the course of a year, also developed high antibody titers to VCA and R. In one of these patients the primary infection was accompanied by moderate signs of infectious mononucleosis (IM) followed after more than 6 months by persistent hepatosplenomegaly. The other patient also developed signs of a lymphoproliferative syndrome with hepatosplenomegaly and jaundice and died 8 months later. Such high anti-R titers are seen frequently in Burkitt's lymphoma, but rarely in other conditions. It is likely that the high antibody titers reflect an increased production of VCA and R due to defective NK and ADCC cell activities so that productively infected B lymphocytes are no longer eliminated before they have synthesized maximal amounts of antigens. The high anti-EBNA titers suggest normal T lymphocyte function. The possibility that the accelerated, lymphoma-like phase of the CHS involves EBV-transformed cells is discussed.

Adult↗

Infectious mononucleosis in patients aged 40 to 72 years: report of 27 cases, including 3 without heterophil-antibody responses.

Epstein-Barr-virus (EBV)-induced infectious mononucleosis usually occurs in young adults between the ages of 15 and 30. When it occurs in older individuals, it frequently presents diagnostic problems. This report describes data from 27 such patients aged 40 to 72, all of whom had definitive evidence of a current EBV primary infection. Protracted fever, jaundice, pleural effusion, anemia, or the Guillain-Barré syndrome were dominant clinical findings among these patients. Fourteen patients were hospitalized and numerous diagnostic procedures were performed, including bone-marrow aspirations (8 patients), abdominal CAT scan procedures (4 patients), and liver (2 patients) or lymph-node biopsies (1 patient). Overall, the laboratory data in these patients were similar to those seen in young adults, with the exception of more marked hepatic dysfunction and more prominent antibody responses to the restricted (R) component of the early antigen complex. Particularly difficult were the diagnostic problems encountered in three patients in this study (3/27) who failed to develop heterophil antibodies.

Adult↗

Application of Epstein-Barr virus serology to the diagnosis and staging of North American patients with nasopharyngeal carcinoma.

From 1978 to 1981, 151 patients with nasopharyngeal carcinoma (NPC) were enrolled in a prospective, collaborative study of North American patients, most of them white. Thirty-seven had World Health Organization (WHO) type 1 tumors, and 114 had WHO types 2 and 3 tumors. The anti-Epstein-Barr virus (EBV) profile of elevated antibody titers directed against viral capsid antigen and early antigen was seen in 85% of the patients with WHO types 2 and 3 tumors but in only 16% of the patients with WHO type 1 tumors. Geometric mean titers tended to be higher in higher stages of the disease in several staging systems. Low antibody-dependent cellular cytotoxicity at diagnosis appears to reflect a poorer prognosis, and the determination of antibody titers by this assay may prove to be useful for identifying persons in whom recurrent disease is likely to develop after conventional therapy. Anti-EBV titers can aid in diagnosis and treatment planning in patients with NPC, particularly those with occult primary NPC.

Adolescent↗

An unusually high-titer human anti-Epstein Barr virus (EBV) serum and its use in the study of EBV-specific proteins synthesized in vitro and in vivo.

Sera from a patient with a chronic Epstein Barr virus (EBV) infection contained unusually high anti-EBV antibody titers (1:2560 to 1:10,240 for EA(D) and 1:5,120 to 1:40,960 for VCA). One of these serum samples was shown by immunoprecipitation to recognize at least 11 EBV-specific proteins from virus producer cells labeled in vivo and 10 EBV-specific proteins from in vitro translations of producer cell mRNA. Six of the in vivo labeled proteins (135,000, 89,000, 50,000 to 55,000 doublet, 46,000, and 34,000 daltons) are "early" by their resistance to phosphonoacetic acid, and five (350,000, 220,000, 160,000, 140,000, and 85,000 daltons) are "late" membrane and capsid proteins. The EBV-specific proteins immunoprecipitated from in vitro translations had molecular masses of 150,000, 140,000, 115,000, 52,000, 50,000, 45,000, 34,000, 29,000, 17,000, and 15,000. Subcellular fractionation studies of cells labeled in vivo revealed that the 135,000-dalton protein and part of the 50,000 to 55,000 dalton protein doublet were found in both the nuclear and the cytoplasmic fractions, and thus are good candidates to be components of the EA(D) diffuse-type immunofluorescence observed with many EA-positive sera.

Adult↗

Epstein-Barr virus-specific leukocyte migration inhibition reaction with tumor biopsy extracts: correlation with the presence of viral DNA.

The Epstein-Barr virus (EBV)-specific leukocyte migration inhibition (LMI) reaction was used to detect EBV antigens in human tumor biopsies in parallel with nuclei acid hybridization for EBV DNA. None of six EBV DNA-negative tumors gave any significant LMI reaction. Fourteen of 17 EBV DNA-positive tumors gave a significant difference between the migration of leukocytes from EBV-seropositive versus -seronegative donors. One tumor gave a borderline reaction. The two-LMI-negatives in this group had only a marginal EBV DNA content. It is suggested that the EBV-specific LMI test may be useful for detecting EBV genomes in tissue and tumor extracts.

Animals↗

Transient immunodeficiency during asymptomatic Epstein-Barr virus infection.

In vivo and in vitro humoral and cellular immune responses were studied in a 2 1/2-year-old girl immediately before, during, and after an asymptomatic infection with Epstein-Barr virus. During the acute EBV infection, the patient's peripheral blood mononuclear cells were deficient in immunoglobulin synthesis and suppressed the in vitro immunoglobulin synthesis of normal allogeneic cells. In vitro mitogen transformation of lymphocytes was reduced. In vivo antibody responses to the T cell-dependent antigens bacteriophage phi X 174 and Keyhole limpet hemocyanin were markedly depressed. These studies suggest that suppressor cells induced during acute EBV infection not only suppress immunoglobulin synthesis in vitro, but also interfere with in vivo antibody synthesis.

Antibodies, Viral↗

Serum anti-EBV IgA is inversely related to tumor infiltration by surface IgA positive lymphocytes in nasopharyngeal carcinoma.

The mean number of tumor-infiltrating lymphoid cells with surface IgA was moderately higher in primary nasopharyngeal carcinoma (NPC) than in their neck gland metastases or in other head and neck tumors. Within the group of primary NPC, patients with large numbers of IgA positive infiltrating cells had a significantly lower mean IgA antibody titer to Epstein-Barr viral capsid antigen. It is unlikely therefore that the unique, frequent elevation of this antibody titer in NPC is due to stimulation of infiltrating IgA positive lymphoid cells among the virus-containing epithelial tumor cells.

Antibodies, Viral↗

Antibody responses to Epstein-Barr virus-specific DNase in relation to the prognosis of juvenile patients with nasopharyngeal carcinoma.

We have examined serial sera from 17 juvenile patients with nasopharyngeal carcinoma (NPC) for their capacity to neutralize the activity of Epstein-Barr virus (EBV)-specific DNase. The results revealed that NPC patients who became long-term survivors (LTS) without evidence of the disease either never possessed significant levels of antibodies to the enzyme or showed a gradual decline in the number of EBV DNase units neutralized from an elevated level at diagnosis to an insignificant figure several years later. All the 10 LTS neutralized less than 4, and some neutralized less than 2 units of the enzyme 3 or more years after the initial diagnosis. In contrast, serial sera from juvenile patients who died of NPC neutralized over 10 and as many as 25 units of EBV DNase either persistently until death occurred or with transient declines during unmaintained remissions. Rises and declines in the neutralizing activity were, with few exceptions, accompanied by corresponding changes in the titers of IgA and IgG antibodies to EB viral capsid antigen and to the diffuse component of the early antigens. Although the number of juvenile NPC cases available for study was small, the observations suggest that the EBV DNase neutralization test may serve to provide information on the prognosis of the patients.

Adolescent↗

Nasopharyngeal carcinoma in American Children: Epstein-Barr virus-specific antibody titers and prognosis.

Seven American juvenile patients with undifferentiated or nonkeratinizing nasopharyngeal carcinoma (NPC) were examined serially for Epstein-Barr virus (EBV)-specific antibody spectra and titers in sera. At diagnosis, all showed antibody patterns characteristic of NPC: i.e., high titers of IgG antibodies to viral capsid antigen (VCA) and to the diffuse (D) component of the early antigen complex. Six patients had IgA antibodies to VCA, and four to the D component. In the patients who responded to therapy with complete and maintained remissions, the IgG antibodies to D and the IgA antibodies to VCA and D decreased to undetectable levels within 12 to 30 months. By contrast, of the four patients who responded only transiently to therapy, three showed substantial increases and one continuously high titers of IgG anti-D and IgA anti-VCA. The increases in antibody titers preceded clinical recognition of recurrent tumors by 1 to 6 months. Three of these patients have died and the fourth is alive with disease. These data indicate that American juvenile NPC does not differ from the adult disease observed anywhere in the World. They reaffirm the potential usefulness of EBV-specific serology in the diagnosis and prognosis of NPC and the monitoring of patients following therapy.

Adolescent↗

A non-x-linked syndrome with susceptibility to severe Epstein-Barr virus infections.

Three siblings developed severe (two) or fatal (one) infectious mononucleosis. This family differed from previously described kindreds with a susceptibility to overwhelming Epstein-Barr virus infections in that: (1) both males and females were affected; (2) they had a history of the recurrent bacterial infections; (3) they produced the full spectrum of antibodies to EBV in the expected range of titers; and (4) survivors recovered completely. Two of these youths, but not their parents or an unaffected sibling with mild IM, had a deficiency of natural killer activity that did not respond to preincubation of their peripheral blood mononuclear cells with interferon. NK activity may have an important role in controlling infections with EBV.

Adolescent↗

Epstein-Barr virus in nasopharyngeal and salivary gland carcinomas of Greenland Eskimoes.

Biopsy specimens from nasopharyngeal carcinomas (NPC) or salivary-gland carcinomas (SGC) in Greenland Eskimoes were examined for the presence of Epstein-Barr virus (EBV) DNA and sera from the patients were tested for EBV-specific antibody titres. Six out of 7 NPCs and one from an undifferentiated SGG were positive for EBV DNA. The EBV-specific antibody spectra and titres of the patients with NPC or undifferentiated SGG conformed to the results of earlier studies in other high-incidence areas.

Adult↗

Spurious rapid infections mononucleosis test results in non-infectious mononucleosis sera. The role of high-titer horse agglutinins.

The present report-describes serologic data from five individuals without infectious mononucleosis (IM) who had very high levels of horse red blood cell agglutinins (1:896-1:7168) that were unusual in that they were minimally absorbed by either guinea pig kidney or beef red blood cell suspensions. Agglutination of sheep red blood cells was negative, and Epstein-Barr virus (EBV)-specific serodiagnostic tests revealed evidence for long past primary infections. In one of the five cases, serologic findings suggested a more than usually active EBV carrier state, as evident from persistently high anti-VCA (IgG) levels of 1:1280 and the continual presence of anti-R at 1:40. Sera from all cases predictably interfered with several commercially available IM-specific rapid slide agglutination tests. The incidence of such findings was estimated to be no more than one per one thousand non-IM cases. In three patients adequately studied, the poorly absorbable horse agglutinins persisted in serum samples over periods of five to nine years. The significance of these findings is discussed.

Adult↗

Detection of antibodies to Epstein-Barr virus capsid antigen by immune adherence hemagglutination.

The immune adherence hemagglutination assay was found to be as sensitive and specific as the indirect immunofluorescence technique for titration of antibodies to Epstein-Barr virus capsid antigen. Satisfactory virus capsid antigen-specific and negative control antigens for the immune adherence hemagglutination assay were prepared from cell extracts of the Epstein-Barr virus producer P3HR-1 and the Epstein-Barr virus genome-negative BJAB lymphoblastoid cell lines, respectively. As the immune adherence hemagglutination assay can be used to titrate antibodies to both the heterophil antigen of the Paul-Bunnell type and to virus capsid antigen, it offers a promising alternative to the immunofluorescence methods in the serodiagnosis of Epstein-Barr virus infections which can be performed by most diagnostic laboratories.

Antibodies, Viral↗