Infectious agents as causes of non-Hodgkin lymphoma
Infectious agents as causes of non-Hodgkin lymphoma
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DOI：
10.1158/1055-9965.epi-06-1056
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发表时间：
2007-03-01
影响因子：
3.8
通讯作者：
Engels, Eric A.
中科院分区：
文献类型：
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作者：
Engels, Eric A.
在目前被视为非霍奇金淋巴瘤(NHL)可能的致病因素的暴露中，感染几乎被认为是确定的原因。根据发病机制，引起非霍奇金淋巴瘤的感染性病原体可分为三大类。首先，一些病毒可以直接转化淋巴细胞。淋巴细胞转化病毒包括Epstein Barr病毒(与Burkitt淋巴瘤、免疫抑制患者的NHL和结外自然杀伤细胞/T细胞NHL有关)、人类疱疹病毒8(原发渗出性淋巴瘤)和人类T淋巴细胞嗜性病毒I型(成人T细胞白血病/淋巴瘤)。其次，人类免疫缺陷病毒是独一无二的，会导致CD4(+)T淋巴细胞的严重枯竭，导致获得性免疫缺陷综合征和一些NHL亚型的相关高风险。第三，最近的证据表明，一些感染通过慢性免疫刺激增加了非霍奇金淋巴瘤的风险。这些感染包括丙型肝炎病毒以及某些引起慢性部位特异性炎症的细菌，似乎增加了局部粘膜相关淋巴组织NHL的风险。确定非霍奇金淋巴瘤是由一种感染性病原体引起的，取决于证明这种病原体存在于非霍奇金淋巴瘤患者身上，以及阐明相关机制的实验室实验。只有流行病学研究才能提供证据，证明感染实际上是一个危险因素，因为感染在NHL病例中比在对照组中更常见。鉴于感染可能导致非霍奇金淋巴瘤的一系列机制，以及我们对这种恶性肿瘤的分子理解日益加深，这一研究领域值得继续关注。
Among exposures presently viewed as possible etiologic factors in non-Hodgkin lymphoma (NHL), infections are close to being regarded as established causes. Infectious agents causing NHL can be classified, according to mechanism, into three broad groups. First, some viruses can directly transform lymphocytes. Lymphocyte-transforming viruses include Epstein Barr virus (linked to Burkitt's lymphoma, NHLs in immunosuppressed individuals, and extranodal natural killer/T-cell NHL), human herpesvirus 8 (primary effusion lymphoma), and human T lymphotropic virus type I (adult T-cell leukemia/lymphoma). Second, human immunodeficiency virus is unique in causing profound depletion of CD4(+) T lymphocytes, leading to acquired immunodeficiency syndrome and an associated high risk for some NHL subtypes. Third, recent evidence suggests that some infections increase NHL risk through chronic immune stimulation. These infections include hepatitis C virus as well as certain bacteria that cause chronic site-specific inflammation and seem to increase risk for localized mucosa-associated lymphoid tissue NHLs. Establishing that an infectious agent causes NHL depends on showing that the agent is present in persons with NHL as well as laboratory experiments elucidating the mechanisms involved. Only epidemiologic studies can provide evidence that infection is actually a risk factor by showing that infection is more frequent in NHL cases than in controls. Given the range of mechanisms by which infections could plausibly cause NHL and our growing molecular understanding of this malignancy, this field of research deserves continued attention.