EBV-associated neoplasms: alternative pathogenetic pathways

Med Hypotheses. 2004;62(3):387-91. doi: 10.1016/j.mehy.2003.11.001.

Abstract

We propose that there are two main classes of Epstein-Barr virus (EBV) associated lymphomas: primarily malignant Burkitt's Lymphoma (BL) and Hodgkin's Disease (HD), on one hand, and primarily benign lymphoproliferations, e.g., post-transplant lymphoproliferative disease (PTLD) on the other hand. PTLD may start as a benign lymphoproliferation which becomes malignant if out of T cell control for too long. Our discovery of a binding site for the oncoprotein c-Myc at a central position of the EBV genome favours a distinction of pathogenetic pathways or scenarios for the proposed lymphoma classes. In the first scenario nuclear maintenance of the EBV genome and activation of viral anti-apoptotic functions with the help of c-Myc are indispensable for the origin of malignant tumours (BL, HD) from the germinal centre B-cell. In the second scenario expression of the main viral transforming protein EBNA2 is essential for immortalisation and non-malignant morphological transformation of any (germinal centre derived or non-germinal centre) B-cell in the absence of T cell control. Although EBNA2 expression is permissible, under specific circumstances, in malignant B-cells, it is not required for oncogenesis.

MeSH terms

  • Burkitt Lymphoma / etiology
  • Burkitt Lymphoma / virology*
  • DNA / metabolism
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / pathogenicity*
  • Herpesvirus 4, Human / physiology
  • Hodgkin Disease / etiology
  • Hodgkin Disease / virology*
  • Humans
  • Proto-Oncogene Proteins c-myc / metabolism
  • Virus Latency / physiology

Substances

  • Proto-Oncogene Proteins c-myc
  • DNA