Genotypic analysis on the ORF-K1 gene of human herpesvirus 8 from patients with Kaposi's sarcoma in Xinjiang,China

Human herpesvirus 8 （HHV-8） is thought to be essential for the development of all forms of Kaposi＇s sarcoma （KS）. HHV-8 DNA is present virtually in all KS tumor biopsy samples. Genes at both ends of the HHV-8 genome have been shown to vary considerably. Seven major molecular subtypes of HHV-8 were defined based on the amino acid sequence of the open reading frame K1 （ORF-K1）, generally known as A, B, C, D, E, F, and Z. Most strains collected worldwide were clustered into two subtypes （A and C）. Here, the K1/VRI region of HHV-8 was amplified by nested PCR in 22 （81.48%） of 27 cases from Xinjiang Uygur Autonomous Region, a province in northwestern China. Phylogenetic analysis on the basis of the K1/VR1 amino acid sequence indicated that the majority of these KS patients were infected by subtype C HHV-8 （n = 18, including 15 belonging to the C2 group）, and several by subtype A （n = 4, including 3 being the A1 group）. This is the first report of subtype A HHV-8 in China. Furthermore, the correlations between different forms and lesions of KS and different subtypes of HHV-8 were analyzed. The findings showed that subtype A HHV-8 resulted in significantly more frequent mucosal KS lesions than subtype C. However, there was no obvious correlation between different forms of KS and different subtypes of HHV-8.

Human herpesvirus-8 positive iatrogenic Kaposi's sarcoma in the setting of refractory ulcerative colitis

Although Kaposi sarcoma(KS) has been more traditionally considered an AIDS-defining illness,it may also be seen in individuals on immunosuppresive therapy.We report a case of a patient who presented to the hospital in the setting of increasingly refractory ulcerative colitis.Computed tomography scan of the abdomen was consistent with sigmoid diverticulititis and blood cultures were positive for Klebsiella.After a course of antibiotics with resolution of infection,a colonoscopy was performed to evaluate his diverticulitis and incidentally revealed a new rectal tumor.Immunohistochemistry showed the tumor was consistent with KS,with cells staining strongly positive for human herpesvirus-8.This case not only illustrates a rare case of KS found in an HIV-negative individual,but it also highlights the importance of considering an alternative diagnosis in a patient refractory to medical treatment.We discuss the management and care of an ulcerative colitis patient diagnosed with KS on immunosuppressive therapy.

Reactivation of Latent Infection of Human Herpesvirus 8 in BC-3 Cells from Primary Effusion Lymphoma by Recombinant CytokinesSimilar to that Produced by HIV-1-infected T Cells

Objective: To study and confirm that recombinant cytokines similar to those produced by HIV-1 infected T cells induced lytic cycle replication of human herpesvirus 8 (HHV-8) in BC-3 cells, another cell line from primary effusion lymphama(PEL). Methods: The persistent stimulation of BC-3 was conducted by several cytokines known to be produced by HIV-1-infected T cells and important in growth and proliferation of Kaposi's sarcoma(KS)cells in vitro, such as the interferon-γ (IFN-γ) , tlie hepatocyte growth factor/scatter factor (HGF / SF) , the Oncostain M(OSM) , and the tumor necrosis factor-α (TNF-α)which is not produced by HIV-1-infected T cells. Treated and untreated BC-3 cells were collected at the 3rd and 7th day of persistent stimulation, respectively. Immuno-histochemical (IHC) staining, Northern blot, quantitative PCR (real- time PCR ) and electron microscopy (EM) were carried out to detect the expression of immunogenic protein ORF59, messenger RNA (mRNA) of minor capsid protein ORF26, and the presence of viral particles of HHV-8 from treated and untreated BC-3 cells. Results: It showed that IFN-γ, HGF/SF, OSM, and TNF-α were found to induce an increase in mRNA expression of ORF26 when added individually to BC-3 cells. Particularly, ORF26 expression stimulated with IFN-γ and TNF-α respectively, increased 6. 1 and 2. 5-fold(from real-time PCR results)at the 7th day when compared with untreated BC-3 cells. Meanwhile, about 20% of IFN-γ stimulated BC-3 cells expressed ORF59 at the 7th day as compared with 1. 5% of untreated BC-3 cells when IHC staining was employed. In addition, viral particles of HHV-8 were readily identified in BC-3 cells stimulated with IFN-γ at the 7th day with EM analysis. Conclusion;TNF-α and recombinant cytokines being similar to those produced by HIV- 1 infected T Cells could really induce HHV- 8 lytic cycle replication in BC-3 cells, another cell line of PEL.

Prevalence of human herpesvirus 8 infection in patients undergoing hemodialysis using nested-PCR

Objective:To study the prevalence of HHV-8 infection in patients undergoing hemodialysis.Methods:In this study,blood samples of 89 patients undergoing hemodialysis were collected.DNA was extracted from peripheral blood mononuclear cells and HHV-8 DNA was evaluated by nested-PCR.Results:Of total 89 patients,51(57.3%)were males and 38(42.7%)were females.The patients'age ranged from 24 to 90 years and the mean age was(57.5±1.4)years.HHV-8 DNA was found in 9 of 89(10.1%)peripheral blood mononuclear cell samples,8/51(15.7%)in males and 1/38(2.6%)in females(P=0.07).All patients who were positive for HHV8-DNA were more than 50 years old.Conclusions:This study shows high prevalence of HHV-8.Since hemodialysis patients are candidates for kidney transplantation and due to the possibility of HHV8-reactivation and its serious complications in immunocompromised patients,routine screening for detection of the virus should be implemented for all hemodialysis patients.

The Role of Human Herpesvirus 8 Molecular Characterization in the Management of HIV Infected Patients Diagnosed with Malignancies Associated with Its Infection

Despite the progress has been reached with Human herpesvirus 8 (HHV-8) research, there are gaps in the knowledge of viral induced oncogenesis. The aim of the present study was to identify possible associations between HHV-8 subtypes, HHV-8 loads and clinical manifestations of HIV infected patients diagnosed with different malignancies associated with HHV-8 infection. Forty six HIV-1 infected individuals diagnosed with different HHV-8 associated diseases were studied [37 epidemic Kaposi’s sarcoma (KS), 3 pleural effusion lymphoma (PEL);5 peripheral lymphadenopathies (PL);1 Hodgkin’s lymphoma (HL);1 non Hodgkin’s lymphoma (NHL)]. HHV-8 loads were determined by quantitative real time PCR (qRT-PCR) whilst HHV-8 subtypes were determined by open-reading frame (ORF)-K1 gen genotyping. HHV-8 subtypes B, A, C, A5 and E were exhibited by 31.8%, 23.4%, 19.1%, 17% and 8.5% of the studied patients, respectively. The median HHV-8 viral load did not differ between subtypes (p > 0.05) but HHV-8 viral loads were significantly higher in PEL than in epidemic KS lesion or lymph nodes (p = 0.04). Subtype B was detected in 60% of patients with B cell lymphoma (NHL, PEL and HL) whereas subtype E was only detected in patients with epidemic KS diagnosis. Our data suggest that HHV-8 DNA quantification instead of subtype identification could be used as a surrogate marker for monitoring its infection, not only in epidemic KS patients but also in HIV infected individuals with lymphoproliferative disorders.

细胞周期蛋白激酶抑制调控蛋白p21在HHV-8病毒裂解复制周期的作用

目的研究细胞周期蛋白激酶抑制调控蛋白p21对人类疱疹病毒8型(human herpesvirus 8,HHV-8)病毒裂解复制周期的影响。方法组蛋白去乙酰化酶(histone deacetylase,HDAC)抑制剂SAHA预处理后,倒置荧光显微镜观察红色荧光蛋白(RFP)阳性的iSLK.219细胞数,实时定量PCR检测TREx-K-Rta BCBL-1细胞中HHV-8病毒相关基因的mRNA水平。脂质体转染p21-siRNA后,免疫印迹法检测iSLK.219和TREx-K-Rta BCBL-1细胞中p21蛋白表达,计算RFP阳性iSLK.219细胞百分率,检测TREx-K-Rta BCBL-1细胞中ORF50和PAN的mRNA水平,CCK-8法和台盼蓝染色观察细胞存活情况。结果SAHA显著增强iSLK.219细胞RFP阳性率、TREx-K-Rta BCBL-1细胞中HHV-8裂解复制周期相关基因ORF50、PAN及K8.1的mRNA水平和p21蛋白表达,差异有统计学意义(P<0.05)。siRNA沉默p21后,iSLK.219细胞RFP阳性率、TREx-K-Rta BCBL-1细胞中HHV-8裂解复制周期相关基因ORF50和PAN mRNA水平显著下降,差异有统计学意义(P<0.05),且保护SAHA介导的TREx-K-Rta BCBL-1细胞死亡。结论抑制HDAC活性通过调控p21促进HHV-8病毒裂解复制。

Diagnostic value of endothelial markers and HHV-8 staining in gastrointestinal Kaposi sarcoma and its difference in endoscopic tumor staging

AIM: To clarify the diagnostic values of hematoxylin and eosin (HE), D2-40, CD31, CD34, and HHV-8 immunohistochemical (IHC) staining in gastrointestinal Kaposi's sarcoma (GI-KS) in relation to endoscopic tumor staging. METHODS: Biopsy samples (n = 133) from 41 human immunodeficiency virus-infected patients were reviewed. GI-KS was defined as histologically negative for other GI diseases and as a positive clinical response to KS therapy. The receiver operating characteristic area under the curve (ROC-AUC) was compared in relation to lesion size, GI location, and macroscopic appearances on endoscopy. RESULTS: GI-KS was confirmed in 84 lesions (81.6%). Other endoscopic findings were polyps (n = 9), inflammation (n = 4), malignant lymphoma (n = 4), and condyloma (n = 2), which mimicked GI-KS on endoscopy. ROC-AUC of HE, D2-40, blood vessel markers, and HHV-8 showed results of 0.83, 0.89, 0.80, and 0.82, respectively. For IHC staining, the ROC-AUC of D2-40 was significantly higher (P < 0.05) than that of HE staining only. In the analysis of endoscopic appearance, the ROC-AUC of HE and IHC showed a tendency toward an increase in tumor staging (e.g. , small to large, patches, and polypoid to SMT appearance). D2-40 was significantly (P < 0.05) advantageous in the upper GI tract and for polypoid appearance compared with HE staining. CONCLUSION: The diagnostic value of endothelial markers and HHV-8 staining was found to be high, and its accuracy tended to increase with endoscopic tumor staging. D2-40 will be useful for complementing HE staining in the diagnosis of GI-KS, especially in the upper GI tract and for polypoid appearance.

新疆Kaposi肉瘤组织内EBV、HHV-8双重感染的调查

应用PCR方法，对20例新疆Kaposi肉瘤病理组织进行了EBV和HHV－8双重感染的调查。结果：20例Kaposi肉瘤病理组织中14例检出HHV－8DNA（70％），EBV均为阴性。正常皮肤对照：10例这两种疱疹类病毒均为阴性。作者认为新疆Kaposi肉瘤的发生与EBV的相关性很小，但明显与HHV－8感染有关，但是否HHV－8感染就是新疆Kaposi肉瘤发生的决定因素，仍需进一步研究。

人类疱疹病毒8型k12/T0.7基因亚型与Kaposi肉瘤的相关性研究

目的:了解Kaposi肉瘤患者所感染的疱疹病毒8型(HHV-8)k12/T0.7基因亚型分类,初步探索k12/T0.7基因亚型与Kaposi肉瘤不同临床分型的相关性。方法:对30例病理诊断明确的Kaposi肉瘤石蜡包埋组织进行HHV-8 DNA提取、k12/T0.7基因扩增、双向测序。使用DNAMAN软件、ClustalW软件和PHYLIP软件包对测序结果进行系统发生学分析,确定HHV-8 k12/T0.7基因亚型。最后用Fisher确切概率法对结果进行统计学分析。结果:30例Kaposi肉瘤中有22例HHV-8阳性,阳性率为73.33%,其中7例艾滋病相关型患者HHV-8均阳性。30例HHV-8阳性患者中,10例为HHV-8 k12 A亚型,12例为A/C亚型。Kaposi肉瘤患者不同亚型间有无黏膜损害及临床分型的分布差异均无统计学意义(P>0.05)。结论:Kaposi肉瘤患者感染HHV-8 k12亚型以A亚型和A/C亚型为主,不同亚型与临床分型无关。

VEGF在头颈部Kaposi肉瘤中的表达及其与HHV-8病毒相关性研究

目的:研究血管内皮生长因子(vascular endothelial growth factor,VEGF)在头颈部Kaposi肉瘤(Kaposi’ssarcoma,KS)中的表达,并分析人类8型疱疹病毒(Human Herpesivirus-8,HHV-8)感染对其表达的影响,探讨VEGF与头颈部KS发生发展的关系。方法:应用逆转录聚合酶链反应(RT-PCR)检测3例头颈部KS和3例正常对照组织中VEGF mRNA表达,免疫组化S-P法检测9例头颈部KS和正常对照组织中VEGF蛋白的表达,并用Western blotting检测感染有HHV-8病毒的BCBL-1细胞和未感染HHV-8病毒的BJAB细胞中VEGF蛋白的表达水平。结果:VEGF在头颈部KS中的mRNA和蛋白表达水平均高于正常对照组织(P<0.05),且VEGF蛋白在BCBL-1细胞中的表达较BJAB细胞高,差异有显著性(P<0.01)。结论:VEGF在头颈部Kaposi肉瘤中高表达,并且其高表达与感染HHV-8密切相关。

Kaposi肉瘤组织内人疱疹病毒8型的K14.1基因型研究

目的:确定人疱疹病毒8型K14.1基因等位基因型在Kaposi肉瘤中的分布,及与Kaposi肉瘤临床分型的关系。方法:使用酚-氯仿-异戊醇法对32例Kaposi肉瘤石蜡包埋组织进行病毒DNA提取,使用PCR法扩增K14.1基因片段,然后确定其等位基因型。结果:32例中有27例人疱疹病毒8型感染为阳性,阳性率为84.38%,其中5例艾滋病相关型KS患者HHV-8感染均为阳性,感染率100%;在分析的27例HHV-8病毒株中,24例为P等位基因型(包括5例艾滋病相关型KS患者皮损),3例为M等位基因型(均来自经典型KS)。结论:本研究中,Kaposi肉瘤感染的人疱疹病毒8型的K14.1等位基因型以P等位基因型为主。

人疱疹病毒8型KS330基因片段的检出与Kaposi肉瘤的关系

HHV-8 sequences were recently identified in 100% of the amplifiable samples from AIDS patients with Kaposi’s sarcoma(KS)and in 15% of the non-KS tissue samples from AIDS patients, so there is a strong correlation of Kaposi’s sarcoma with HHV-8. Serum and DNA samples from a clinically diagnosed Kaposi’s sarcoma Chinese patient were tested. HHV-8 antibody was tested positive by IFA and HIV-I antibody was negative by Western blot. The KS330 PCR product was found both in peripheral blood mononuclear cells and in KS tumor cells from this Chinese patient. This supports the hypothesis that Kaposi’s sarcoma results from infection of HHV-8.

Identification of human herpesvirus-8 in Kaposi＆#39;s sarcoma with bullous pemphigoid

Kaposi＆#39;s sarcoma （KS） is a rare,malignant vascular.tumor of the skin,mucosa,and viscera with an increased incidence in human immunodeficiency virus （HIV）-positive patients.According to the clinical characteristics and the affected population,four clinical types of KS have been described successively：classic,endemic to Africa,acquired immunodeficiency syndrome （AIDS）-associated,and immunosuppression associated type.Bullous pemphigoid （BP） is an acquired autoimmune bullous skin disease that frequently occurs in the elderly and is characterized by intraepidermal blisters and immunoglobulin G （IgG） deposits on the basement membrane.A few cases of KS have occurred in immunosuppressed patients with BP.Here,we report a Chinese female patient diagnosed with immunosuppression associated KS that was induced by the short-term use of immunosuppressive agents for BP.We also present a review of the literature on immunosuppressed KS with BP and discuss the potential role of human herpesvirus-8 （HHV-8） in the pathogenic mechanism.

新疆Kaposi肉瘤患者感染的人类疱疹病毒8型ORF75基因多态性研究

目的通过对人类疱疹病毒8型(HHV-8)ORF75基因多态性研究,初步探讨其与新疆Kaposi肉瘤的相关性。方法对25例新疆Kaposi肉瘤患者石蜡包埋组织进行HHV-8 DNA抽提、扩增及双向测序,使用CLUSTALW软件和PHYLIP软件包对ORF75基因进行核苷酸多态性分析。结果①25例新疆Kaposi肉瘤患者有21例HHV-8感染阳性,阳性率为84%,其中7例艾滋病相关型Kaposi肉瘤(AIDS-KS)患者HHV-8感染均为阳性。②新疆Kaposi肉瘤患者HHV-8 ORF75基因核苷酸具有多态性,存在462、618、647三个主要突变位点。结论人类疱疹病毒8型ORF75基因多态性与新疆Kaposi肉瘤具有相关性。

Kaposi肉瘤患者血清人类疱疹病毒8型的检测

目的了解干扰素治疗Kaposi肉瘤近期疗效及其对血清HHV-8DNA检测的影响。方法主要应用干扰素治疗4例无明显内脏损害的新疆经典型Kaposi肉瘤患者,同时在治疗前后采用PCR法检测血清HHV-8DNA特异性片段。结果4例患者经干扰素治疗45d后,均有不同程度的近期疗效,主要表现在皮损色泽变暗、结节和斑块变软、变平,部分小结节消退,且均无新皮损发生。但淋巴水肿无明显改观。血清HHV-8DNA特异性片段经PCR检测,治疗后全部转阴。结论干扰素治疗可有效地清除Kaposi肉瘤患者血清中HHV-8感染,能缓解病情,防止Kaposi肉瘤多灶病状的发生。

Splenic Kaposi’s sarcoma in a human immunodeficiency virusnegative patient:A case report

BACKGROUND Kaposi’s sarcoma(KS)is a malignancy that usually affects the skin of the lower extremities,and may involve internal organs.It originates from the vascular endothelium.It is well known that the development of KS is associated with human herpes virus 8(i.e.HHV8)infections.Sporadic KS cases have mainly been found in Africa.Isolated splenic KS in Asia has rarely been reported.We present here a case of KS primarily involving the spleen in a human immunodeficiency virus(HIV)-negative Chinese patient.CASE SUMMARY A 50-year-old male patient was admitted to hospital due to abdominal distension and discomfort,reduced food intake and weight loss.Medical examination revealed that the patient had moderate anemia,a low platelet count,slight fatty liver and a huge mass in the spleen.Spleen lymphoma was considered.An anti-HIV test was negative.The whole spleen was surgically excised.The final pathological diagnosis was nodular stage spleen KS,and the patient underwent total splenectomy.He recovered well and was discharged from hospital 12 d after surgery.Two weeks later,the patient developed liver metastasis and died within 1 mo after surgery.CONCLUSION KS is difficult to diagnose and pathological examination is necessary.KS has a poor prognosis and should be diagnosed and treated early to improve survival.

Establishment of method for seroepidermiological detection of human herpes virus 8 infection by using the fusion protein in the prokaryotic expression system as antigen for testing

To establish a sensitive and specific method for seroepidermiological detection of human her- pes virus 8(HHV-8)infection,three potent antigenic proteins encoded by open reading frames(ORFs) K8.1,65 and 73C in genome of HHV-8 were produced as glutathione S-transferase fusion protein in the prokaryotic expression system and was used as antigen for testing.The recombinant fusion protein ex- pressed in the prokaryotic expression vector E.coli BL21 was purified by glutathione Sepharose 4B affin- ity chromatography and was quantitated with SDS-PAGE.All these 3 fusion proteins produced in the pro- karyotic expression system showed good immunogenicity as demonstrated by Western blotting and could be recognized by mixed sera of patients with Kaposi′s sarcoma(KS).The immuno-reactivities of the single or compound fusion protein were determined by means of ELISA and compared with the traditional immu- nofluorescence assay(IFA)to determine their sensitivity and specificity of the test.It was demonstrated that the sensitivity of mixed-antigen ELISA method was significantly higher than that of IFA(81.8% vs 34.4%),while the specificity of the former was demonstrated to be 97.9%.The coincidence of the de- tection rate between these two methods was considerably high,approaching up to 90.0%.These results suggest that the mixed antigen ELISA assay appears to be a sensitive and specific method for sero-epide- miological detection of human herpesvirus 8 infection.

中国东北地区健康献血员中人类疱疹病毒8的检测

目的 了解中国东北地区健康献血员中人类疱疹病毒 8(HHV 8)DNA和IgG抗体检出情况 ,及不同性别、年龄段、种族和血型间的检出率差别。方法 用巢式PCR法检测外周血单一核细胞 (PBMCs)中HHV 8DNA ,ELISA法检测血清中抗HHV 8ORF6 5和ORFK8.1寡核苷多肽的IgG抗体。 结果 2 30份献血员PBMCs中HHV 8DNA检出率为 7.8%,10 9份血清中抗HHV 8IgG抗体检出率为 7.3%。HHV 8DNA检出率有随献血员年龄增加而增高的趋势 ,但男女、汉族和蒙族、以及A、B、AB、O血型献血员间HHV 8DNA或IgG抗体的检出率差异均无显著性。 结论 中国东北地区健康献血员中HHV 8DNA和IgG抗体的检出并不罕见 ,但HHV 8检出率没有性别、种族或血型差异。HHV 8有经血液传播的可能。

济南地区献血者中人疱疹病毒8型(HHV-8)IgG抗体的检测及相关危险因素分析

目的:了解人疱疹病毒8型(HHV-8)在济南地区不同献血者中的感染情况,并对其与年龄、性别、HBV、HCV、梅毒螺旋体的相关性进行统计学分析。方法:以HHV-8 ORF K8.1合成多肽为抗原,采用ELISA方法检测献血者血清中相应IgG水平。结果:520份血清中抗HHV-8 ORFK8.1抗体的总体检出率为5.962%(31/520),有随年龄增加而增高的趋势,但与性别、HBV、HCV、梅毒螺旋体的相关性无统计学意义。结论:济南地区献血者中有一定比率的HHV-8感染。采取措施,防止HHV-8经输血传播具有一定的现实意义。

Detection of human herpesvirus 8 DNA in acute leukemia patients

Objective To determine the prevalence of human herpesvirus 8 (HHV-8) DNA in acute leukemia (AL) patients. Methods The presence of HHV-8 DNA sequences in peripheral blood mononuclear cells (PBMC) and bone marrow mononuclear cells (BMMC) from 50 AL patients was examined using polymerase chain reaction (PCR). Nine human hematopoietic cell lines and PBMC from 30 normal donors were also included. Results HHV-8 DNA sequences were detected in one case of acute myelogenous leukemia (AML). The specimens from the bone marrow aspirate, peripheral blood and serum of this patient were all positive. None of the normal donors and human hematopoietic cell lines showed evidence of HHV-8 DNA. Conclusion The results suggest that the prevalence of HHV-8 is low in AL in China.