Many cells latently infected with EpsteinBarr virus (EBV),
IntroductionEpstein-Barr virus (EBV) is a class I carcinogen according to the World Health Organization and is associated with several B-cell lymphomas including Hodgkin lymphoma, Burkitt lymphoma, posttransplantation lymphomas, and certain carcinomas. 1 In lymphomas, EBV is found associated with almost all cases of posttransplantation lymphomas and endemic Burkitt lymphoma, whereas approximately 40% and up to 30% of tumor biopsies of Hodgkin lymphoma and sporadic Burkitt lymphoma, respectively, are EBV positive. EBV is also tightly linked to nasopharyngeal carcinoma in Southeast Asia; in contrast, only approximately 20% of all cases of gastric adenocarcinomas are EBV positive. 2 These malignancies appear to be relatively rare because more than 95% of the human population is infected with EBV. In these individuals, EBV establishes a benign, latent infection in a small fraction of B cells for a lifetime. In vitro, EBV very efficiently infects all human B lymphocytes in a latent mode, and growth transforms them into lymphoblastoid cell lines (LCLs). Therefore, transformation of primary B cells by EBV is a hallmark of this virus and constitutes a relevant model system for viral transformation. 3 In all virus-infected cells, EBV adopts a latent state in which viral gene expression is restricted and de novo viral synthesis is abrogated. In LCLs and cases of posttransplantation lymphomas, 11 so-called latent genes are consistently expressed. These are the EBV nuclear antigens EBNA1, EBNA2, EBNA-LP, EBNA3A, EBNA3B, EBNA3C, and the latent membrane proteins LMP1, LMP2A, and LMP2B, and 2 small, noncoding RNAs. 3 Besides these noncoding RNAs, which are expressed in all latently EBV-infected cells, latent viral genes are found in typical combinations in the different EBV-associated tumors. Briefly, in Burkitt lymphoma almost exclusive and invariant expression of EBNA1 is well documented, but recently, LMP2A has also been detected in fresh biopsies of this tumor. 2,4 In nasopharyngeal carcinomas and EBV-positive Hodgkin lymphomas, LMP1 is often expressed in conjunction with EBNA1 and LMP2A, and a similar expression profile might also be prevalent in EBV-positive gastric carcinomas. 2 Although studies clearly show that EBNA1 and LMP1 definitely contribute to cellular transformation, 5,6 the role of LMP2A remains controversial because it has been reported to be dispensable for B-cell transformation in vitro (Speck et al 7 and references therein) but has transforming characteristics in epithelial cells. 8 LMP2A can constitutively induce several signaling cascades. Its amino-terminal cytoplasmic domain is reminiscent of the signaling domain of the BCR complex because LMP2A as well as the signaling domains of the Ig␣ (CD79A) and Ig (CD79B) chains of the BCR carry an immunoreceptor tyrosine-based activation motif (ITAM). 9 Both LMP2A and BCR signal through Syk, Lyn, Btk, BLNK, AKT, PI3K, and other signaling mediators, and LMP2A can deliver signals similar to those of an a...