Epstein-Barr virus (EBV) uses nasal mucosa-associated lymphoid tissue (NALT) as a portal of entry toEpstein-Barr virus (EBV) is a ubiquitous human gammaherpesvirus that is transmitted via saliva and infects more than 90% of the world's population (21). Much of EBV's medical importance relates to its association with B-cell malignancies, including Burkitt's lymphoma, Hodgkin's lymphoma, and posttransplant lymphoproliferative disease (21). The oncogenic potential of EBV is clearly illustrated by its unique capability to transform B cells in vitro (21).In the current paradigm, EBV infects naïve B cells in tonsils in vivo (32). EBV is present mainly as a latent virus; upon infection, EBV expresses distinct patterns of its latency genes depending upon distinct B-cell differentiation stages, varying from expression of all 10 known EBV latency genes in naïve B cells to the complete absence of EBV mRNA expression in resting memory B cells. This has led to the model that EBV, by virtue of expression of its latency genes, provides cell survival signals in naïve B cells (32). In particular, recent data suggest that EBV expedites the antigen-driven somatic hypermutation and selection of B cells taking place in germinal centers (GC) (26). Chaganti et al. challenged the current paradigm by showing for patients with primary EBV infection that EBV avoids GC transit and directly infects memory B cells (6). This report is consistent with in vitro experiments showing that EBV is able to infect memory B cells (9, 10), in addition to the well-accepted susceptibility of naïve and GC B cells to EBV.Irrespective of which B-cell subset is the primary target of EBV, its propagation within the host is linked to proliferation of infected B cells, which deliver latent EBV to daughter cells, or, more rarely, to switching of EBV to lytic infection (21). The latter process can eventually be triggered by the differentiation of infected memory B cells into plasma cells and results in the release of virions that may subsequently infect new B cells (17). Importantly, transmission of EBV to naïve hosts is thought to occur via droplets loaded with virions (21). Thus, lytic replication of EBV takes place best in nasal mucosa-associated lymphoid tissue (NALT), which will release EBV into the saliva, generating infectious droplets. Therefore, the NALT is the point of EBV transmission, i.e., the portal of entry of EBV as well as a shedding organ for further transmission (21).The attachment of EBV to B cells is mediated by the direct interaction of EBV glycoprotein gp350/220 with cellular CD21, initiating receptor-mediated endocytosis. After binding to CD21, EBV gp42 can interact with host HLA class II molecules, leading to a conformational change in the viral glycoproteins and triggering fusion with the host cell membrane (12,28). Nevertheless, experimental data suggest that CD21 and HLA class II molecules are dispensable for the infection of B cells (14). Notably, in polarized oropharyngeal epithelial cells, which lack CD21, interactions between ␤1 int...

Toll-like receptor 9 (TLR9) triggering is a promising novel strategy to combat cancer as it induces innate and adaptive immunity responses. B-cell lymphoma is unique in this context as tumor cells express TLR9 and may harbor latent Epstein-Barr virus (EBV), a gamma-herpesvirus with remarkable oncogenic potential when latent. Latent EBV may be promoted by TLR9 triggering via suppression of lytic EBV. Here, we elaborated an initial assessment of the impact of TLR9 triggering on EBV-positive and EBV-negative B-cell lymphoma using Burkitt's lymphoma (BL) cell lines as an in vitro model. We show that, independent of the presence of EBV, the TLR9 ligand oligodeoxynucleotide (ODN) CpG-2006 may or may not induce caspase-dependent cell death in BL cells. Moreover, ODN CpG-2006-induced cell death responses of BL cells were associated with TLR9 single-nucleotide polymorphisms (SNPs) rs5743836 or rs352140, which we detected in primary BL tumors and in peripheral blood from healthy individuals at similar frequencies. Thus, our findings suggest that the effect of TLR9 agonists on BL cells should be tested in vitro before installment of therapy and TLR9 SNPs in BL patients should be determined as potential biological markers for the therapeutic response to treatment targeting innate immunity.

Lymphoproliferative diseases (LPDs) associated with Epstein-Barr virus (EBV) infection cause significant morbidity and mortality in bone marrow and solid organ transplant recipients. To gain insight into LPD pathogenesis and to identify potential effective therapeutic approaches, we investigated early molecular events leading to B-cell transformation by gene expression profiling of EBV-infected B-cells from tonsils by Affymetrix microarray 72 hr postinfection when the B-cells hyperproliferation phase starts. Cell cycle and apoptosis were the most significantly affected pathways and enriched gene sets. In particular, we found significantly increased expression of cyclin-dependent kinase (CDK)1 and CCNB1 (cyclin B1) and of one of their downstream targets BIRC5 (survivin). Importantly, the strong upregulation of the antiapoptotic protein survivin was confirmed in lymphoblastoid cell lines (LCLs) and 71% of EBV-positive post-transplant EBV-LPD lesions scored positive for survivin. The validity of early transforming events for the identification of therapeutic targets for EBV-LPD was confirmed by the marked antiproliferative effect of the CDK inhibitor flavopiridol on LCLs and by the strong induction of apoptosis by survivin inhibition with YM155 or terameprocol. Our results suggest that targeting of CDKs and/or survivin in post-transplant EBV-LPD by specific inhibitors might be an important approach to control and eliminate EBV-transformed B-cells that should be further considered.Lymphoproliferative disease (LPD) associated with the B-cell tropic Epstein-Barr virus (EBV) causes significant morbidity and mortality in solid organ transplant (SOT) 1 or bone marrow transplant (BMT) 2 recipients. The risk to develop EBV-LPD is greatest in EBV-seronegative transplant recipients, i.e., upon primary EBV infection, and in patients with extensive iatrogenic immunosuppression. 3 EBV-associated B-cell lymphoma in the setting of post-transplant LPD (PTLD) is

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