摘要
EB病毒是人类疱疹病毒4型(EBV), 其感染可导致不常见的并发症. 本文报道的患者气道中出现了与EBV感染相关的炎症性肉芽肿, 入院后紧急接受了气管内肿物切除术. 他的气道组织经宏基因组下一代测序(mNGS)测试后, 被确认为EB病毒感染. 在术后第30天, 患者接受支气管镜复查时发现声门下方气管壁上出现多个结节性粘膜隆起, 且其病理学检查结果发现炎性肉芽组织. 因此, 推测患者气道内出现的肉芽肿组织可能是由于EB病毒慢性感染导致的. 虽然类似的肉芽肿在其他组织中的产生已有报道, 但在气道内却是第一次. EB病毒最常通过呼吸道传播, 从而入侵上呼吸道的网状内皮细胞, 这可能是产生炎性肉芽肿的原因. 此外, EB病毒感染后的炎性肉芽肿易复发, 需要对患者进行进一步严格的随访.
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References
Chung HJ, Chi HS, Jang S, et al., 2010. Epstein-Barr virus infection associated with bone marrow fibrin-ring granuloma. Am J Clin Pathol, 133(2):300–304. https://doi.org/10.1309/AJCPB7SX7QXASPSK
Cohen JI, 2000. Epstein-Barr virus infection. N Engl J Med, 343(7):481–492. https://doi.org/10.1056/nejm200008173430707
Fiala M, Colodro I, Talbert W, et al., 1987. Bone marrow granulomas in mononucleosis. Postgrad Med J, 63(738):277–279. https://doi.org/10.1136/pgmj.63.738.277
Fiorentino DF, Zlotnik A, Vieira P, et al., 1991. IL-10 acts on the antigen-presenting cell to inhibit cytokine production by TH1 cells. J Immunol, 146(10):3444–3451. https://doi.org/10.4049/jimmunol.146.10.3444
Glaser R, Litsky ML, Padgett DA, et al., 2006. EBV-encoded dUTPase induces immune dysregulation: implications for the pathophysiology of EBV-associated disease. Virology, 346(1):205–218. https://doi.org/10.1016/j.virol.2005.10.034
Houen G, Trier NH, 2021. Epstein-Barr virus and systemic autoimmune diseases. Front Immunol, 11:587380. https://doi.org/10.3389/fimmu.2020.587380
Jiang S, Zhang WY, Lu YQ, 2022. Development and validation of novel inflammatory response-related gene signature for sepsis prognosis. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 23(12):1028–1041. https://doi.org/10.1631/jzus.B2200285
Kerr JR, 2019. Epstein-Barr virus (EBV) reactivation and therapeutic inhibitors. J Clin Pathol, 72(10):651–658. https://doi.org/10.1136/jclinpath-2019-205822
Lu X, Yang YM, Lu YQ, 2022. Immunosenescence: a critical factor associated with organ injury after sepsis. Front Immunol, 13:917293. https://doi.org/10.3389/fimmu.2022.917293
Makino K, Takeichi O, Hatori K, et al., 2015. Epstein-Barr virus infection in chronically inflamed periapical granulomas. PLoS ONE, 10(4):e0121548. https://doi.org/10.1371/journal.pone.0121548
Melani C, Jaffe ES, Wilson WH, 2020. Pathobiology and treatment of lymphomatoid granulomatosis, a rare EBV-driven disorder. Blood, 135(16):1344–1352. https://doi.org/10.1182/blood.2019000933
Nakai H, Kawamura Y, Sugata K, et al., 2012. Host factors associated with the kinetics of Epstein-Barr virus DNA load in patients with primary Epstein-Barr virus infection. Microbiol Immunol, 56(2):93–98. https://doi.org/10.1111/j.1348-0421.2011.00410.x
Nowalk A, Green M, 2016. Epstein-Barr virus. Microbiol Spectr, 4(3):4.3.47. https://doi.org/10.1128/microbiolspec.DMIH2-0011-2015
Shannon-Lowe C, Rickinson AB, Bell AI, 2017. Epstein-Barr virus-associated lymphomas. Phil Trans Roy Soc B Biol Sci, 372(1732):20160271. https://doi.org/10.1098/rstb.2016.0271
Sin SH, Dittmer DP, 2012. Cytokine homologs of human gammaherpesviruses. J Interferon Cytokine Res, 32(2):53–59. https://doi.org/10.1089/jir.2011.0083
Smets F, Bodeus M, Goubau P, et al., 2000. Characteristics of Epstein-Barr virus primary infection in pediatric liver transplant recipients. J Hepatol, 32(1):100–104. https://doi.org/10.1016/s0168-8278(00)80195-6
Tsao SW, Tsang CM, Lo KW, 2017. Epstein-Barr virus infection and nasopharyngeal carcinoma. Phil Trans Roy Soc B Biol Sci, 372(1732):20160270. https://doi.org/10.1098/rstb.2016.0270
Volaric AK, Singh K, Gru AA, 2021. Rare EBV-associated B cell neoplasms of the gastrointestinal tract. Semin Diagn Pathol, 38(4):38–45. https://doi.org/10.1053/j.semdp.2021.04.004
Zhang W, Kazeem BB, Yang HT, et al., 2021. Aeromonas sobria regulates proinflammatory immune response in mouse macrophages via activating the MAPK, AKT, and NF-κB pathways. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 22(9):782–790. https://doi.org/10.1631/jzus.B2100456
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This research was supported by the Key Research and Development Program of Zhejiang Province (No. 2019C03076), China.
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Zhaodi WANG performed the research and wrote the manuscript. Xuan LU and Yunmei YANG edited the manuscript. Yuanqiang LU contributed to the study design and editing of the manuscript. All authors have read and approved the final manuscript, and therefore, have full access to all the data in the study and take responsibility for the integrity and security of the data.
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Zhaodi WANG, Xuan LU, Yunmei YANG, and Yuanqiang LU declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013. Informed consent was obtained from all patients for being included in the study. This study protocol was approved by the Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine (Study ID: 20230163).
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Wang, Z., Lu, X., Yang, Y. et al. Inflammatory granuloma of the trachea: a rare case with Epstin-Barr virus infection. J. Zhejiang Univ. Sci. B 24, 539–542 (2023). https://doi.org/10.1631/jzus.B2300024
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DOI: https://doi.org/10.1631/jzus.B2300024