The Immune Response to Epstein Barr Virus and Implications for Posttransplant Lymphoproliferative Disorder.
The Immune Response to Epstein Barr Virus and Implications for Posttransplant Lymphoproliferative Disorder.
复制标题
对爱泼斯坦Barr病毒的免疫反应及其对移植后淋巴增生性疾病的影响。
DOI：
10.1097/tp.0000000000001767
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发表时间：
2017-09
期刊：
影响因子：
6.2
通讯作者：
Krams SM
中科院分区：
文献类型：
--
作者：
Martinez OM;Krams SM
移植后淋巴细胞增生性疾病（PTLD）是器官移植受者的一种严重并发症，通常与eb病毒（EBV）有关。EBV是一种常见的伽玛疱疹病毒，对B淋巴细胞具有亲和性，在免疫能力强的个体中感染通常是无症状和良性的。然而，免疫功能低下或免疫抑制个体的感染可导致恶性B细胞淋巴增生，如PTLD。EBV+ PTLD可在原发性EBV感染后发生，或由于先前感染的再激活，并且是移植人群中的主要恶性肿瘤。EBV+ PTLD的发生率取决于移植器官和接受者是否预先存在EBV免疫，但可高达20%。人们普遍认为，免疫抑制导致的免疫功能受损是EBV+ PTLD的主要原因。在这篇综述中，我们回顾了EBV的生命周期，并讨论了我们目前对健康、免疫功能正常的个体、移植受体和PTLD患者对EBV的免疫反应的理解。我们回顾了EBV用来破坏和逃避宿主免疫的策略，并讨论了EBV+ PTLD发展的意义。
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication in organ transplant recipients and is most often associated with the Epstein Barr virus (EBV). EBV is a common gammaherpes virus with tropism for B lymphocytes and infection in immunocompetent individuals is typically asymptomatic and benign. However, infection in immunocompromised or immunosuppressed individuals can result in malignant B cell lymphoproliferations such as PTLD. EBV+ PTLD can arise following primary EBV infection, or because of reactivation of a prior infection, and represents a leading malignancy in the transplant population. The incidence of EBV+ PTLD is variable depending on the organ transplanted and whether the recipient has preexisting immunity to EBV but can be as high as 20%. It is generally accepted that impaired immune function due to immunosuppression is a primary cause of EBV+ PTLD. In this overview, we review the EBV life cycle and discuss our current understanding of the immune response to EBV in healthy, immunocompetent individuals, in transplant recipients, and in PTLD patients. We review the strategies that EBV utilizes to subvert and evade host immunity and discuss the implications for the development of EBV+ PTLD.