IntroductionKaposi sarcoma-associated herpesvirus (KSHV)/human herpesvirus-8 (HHV-8) is the first human ␥-herpesvirus identified since the 1964 discovery of Epstein-Barr virus (EBV). 1,2 HHV-8 has been causally implicated in the pathogenesis of 3 proliferative disorders that occur with increased frequency in the immunocompromised host: Kaposi sarcoma (KS), primary effusion lymphoma (PEL), and the plasmablastic variant of multicentric Castleman disease (MCD). [1][2][3][4] Although KS is uncommon, it is the most common malignancy associated with human immunodeficiency virus infection. KS lesions may spontaneously resolve following immune reconstitution or may wax and wane with an individual's state of T-cell competence. 5,6 This remarkable feature, shared by EBVassociated B-cell lymphoproliferative disease, suggests that a latent reservoir of HHV-8 infection in vivo gives rise to KS.Many HHV-8-encoded proteins, which contribute to the pathogenesis of KS, PEL, and MCD, are homologs of cellular genes involved in inflammation, cell cycle regulation, and angiogenesis. 7 Two such proteins are those encoded by open-reading frame (ORF)-74 and ORF72. The respective proteins are expressed in distinct phases of the virus life cycle. 7 ORF74 encodes a lytic viral G protein-coupled receptor (vGPCR), which is homologous to human interleukin-8 receptors. 7,8 When injected into mice, vGPCRtransfected rodent fibroblasts cause spindle cell tumors with prominent vasculature. 7,9 ORF72 encodes a latent viral cyclin that can activate kinases that inactivate retinoblastoma protein (pRB), a checkpoint protein that inhibits entry into S phase. 7,10 In the complex lesions of KS, viral gene products are expressed in endothelial cells, in spindle cells of probable endothelial origin, in monocytes, and possibly in some infiltrating lymphocytes. The endothelial cells primarily harbor virus as circular episomes and synthesize latency-associated gene products, whereas the smaller monocyte subpopulation is productively infected. 11,12 Normal primary endothelial cells can be infected with HHV-8 in vitro. However, the efficiency and outcome of infections have been variable despite diverse efforts to optimize in vitro culture. [13][14][15][16][17] In contrast, herpesvirus infection of relevant primary cells, whether productive or causing immortalization, is usually robust. Thus, the recent studies of endothelial cell infection raise several questions concerning whether a more physiologic target cell remains to be identified, whether variable transmission in vitro is caused by technical difficulties, whether in vitro infection is blocked at a particular phase of the virus life cycle, or whether indeed HHV-8 infection is inefficient when compared with infection by other members of the human herpesvirus family. To gain a better understanding of the viral and cellular events that occur upon initiation of infection, early in vitro transmission of HHV-8 to primary vascular endothelial cell populations was investigated.
Materials and methods
CellsBCBL-1 ...