KISEP Head and Neck Korean J Otolaryngol 2001;44: 만성편도염에서의 Epstein-Barr Virus 의검출률과유전자형분포 최영철 1 이숙경 2 권용순 2 강진한 3 박용수 1 전은주 1 Detection Rates of

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1 KISEP Head and Neck Korean J Otolaryngol 2001;44: 만성편도염에서의 Epstein-Barr Virus 의검출률과유전자형분포 최영철 1 이숙경 2 권용순 2 강진한 3 박용수 1 전은주 1 Detection Rates of Epstein-Barr Virus from the Chronic Tonsillitis and Its Typing Young-Chul Choi, MD 1, Suk Kyeong Lee, PhD 2, Yong Soon Kwon 2, Jin-Han Kang, MD 3, Yong-Soo Park, MD 1 and Eun-Ju Jeon, MD 1 1 Department of Otolaryngology-Head and Neck Surgery, 2 Research Institute of Immunobiology, Catholic Research Institutes of Medical Science, and 3 Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea ABSTRACT Background and ObjectivesEpstein-Barr virus EBV is a DNA virus and a type of Herpes virus. Two different types of EBV exist based on the DNA sequence divergence of the EBV genome, and several differences exist between the two types. There are no reports about EBV detection rates and typings associated in chronic tonsillitis, despite the known fact that tonsil is one of the most common sites EBV resides. The aims of this study were to investigate the prevalence of EBV infection in tonsils of children and adults as well as to compare the detection rates and the distribution of types of EBV in tonsillitis patients with normal controls. Materials and MethodsPalatine tonsil tissues were obtained from seventy adults 20 normal controls and 50 chronic tonsillitis and one hundred children. Using polymerase chain reaction PCR, EBV genome was detected and typing was performed. We confirmed EBV by Southern blot hybridization and in situ hybridization. ResultsThe detection rates of EBV in chronic tonsillitis of adults were higher than those in children with idiopathic tonsillar hypertrophyith and normal controls. The detection rates of type 1 EBV showed no differences among the four groups. The detection rates of type 2 EBV in ITH and chronic tonsillitis of adults and children were higher than those in the normal controls. Conclusion Our results suggest that tonsillitis is caused by EBV and that the type 2 EBV plays a more important role in tonsillitis. Korean J Otolaryngol 2001;44: KEY WORDSEpstein-Barr virus Palatine tonsil Typing. 1171

2 DNA의추출 1172 Tabel 1. Primer sequences for EBV detection Sequences 1st sense 5 -AAGGAGGGTGGTTTGGAAAG-3 1st antisense 5 -AGACAATGGACTCCCTTAG-3 2nd sense 5 -ATCGTGGTCAAGGAGGTTCCA-3 2nd antisense 5 -ACTCAATGGTGTAAGACGAC-3 EBV 검출을위한중합효소연쇄반응 (PCR) 중합효소연쇄반응 (PCR) 을통한 EBV의감염형의분류 Korean J Otolaryngol 2001;44:1171-6

3 Southern hybridization In situ hybridization 통계처리 Table 2. Detection rate of EBV Group Detection rate Cases *ITH 50 25/50 Chronic tonsillitis in children 62 31/50 Chronic tonsillitis in adults 72 36/50 Healthy adults 45 9/20 ITHIdiopathic Tonsillar Hypertrophy, p0.05 P M N Fig. 1. EBV detection by nested PCR. PCR products of palatine tonsil DNA was reamplified with nested primer sets and separated on 2 agarose gel. A band of 208 bp indicates the presence of EBV DNA. P-globin, Nnegative control distilled water, Mmarker. 1173

4 Table 3. Typing of EBV from palatine tonsils of healthy adults and tonsillitis patients Group Detection rate Cases Type 1 Type 2 Type 1 2 *ITH 24 12/50 8 4/ /50 Chronic tonsillitis in children 22 11/50 8 4/ /50 Chronic tonsillitis in adults 30 15/50 6 3/ /50 Healthy adults 35 7/20 0 0/ /20 ITHIdiopathic Tonsillar Hypertrophy Fig. 3. In Situ Hybridization. Positive signal black arrow of Not 1, Pst 1 probe hybridization was seen on the hypernuclear, large lymphocyte of lymphoproliferative paracortical area P2 P1 N Fig. 2. Southern blot hybridization. For EBV detection we used a 3 end-labelled oligonucleotide probe specific to EBNA-3C sequence. P1positive control of type 1 Namalwa cell, P2positive control of type 2 SNU-99 cell, Nnegative control distilled water Korean J Otolaryngol 2001;44:1171-6

5 1175

6 REFERENCES 1) Zimber U, Adldinger HK, Lenoir GM, Michele VL, Magnus V, Knebel D, et al. Geographical prevalence of two types of Epstein- Barr virus. Virology 1986;154: ) Rickinson AB, Moss DJ. Human cytotoxic T lymphocyte response to Epstein-Barr virus infection. Annu Rev Immunol 1997;15: ) Young LS, Yao QY, Rooney CM, Sculley TB, Moss DJ, Rupani H, et al. New type B isolates of Epstein-Barr virus from Burkitt s lymphoma and from normal individuals in endemic areas. J Gen Virol 1987;68: ) Sixbey JW, Shirley P, Chesney PJ, Buntin DM, Resnick L. Det- ection of a second widespread strain of Epstein-Barr virus. Lancet 1989;30: ) Egeli E, Inalkac E. Body growth in relation to tonsillar enlargement. Auris Naris Larynx 1997;24: ) Smitheringale AJ. Acquired diseases of the oral cavity and pharynx. In: Wetmore RF, Muntz HR, McGill TJ editors. Pediatric otolaryngology: Principles and practice pathways. New York: Thieme; p ) Epstein MA, Achong BG, Barr YM. Viral particles in cultured lymphoblasts from Burkitt's lymphoma. Lancet 1964;1: ) Bram DK, Dominguez G, Pellett PE. Human herpes virus 6. Clin Microbiol Rev 1997;10: ) Miller G, Nierderman JC, Andrews LL. Prolonged oropharyngeal excretion of Epstein-Barr virus by healthy subjects and patients with infectious mononucleosis. N Engl J Med 1973;288: ) Tosato G. The Epstein-Barr virus and the immune system. Adv Cancer Res 1987;49: ) Niedobitek G, Herbst H, Young LS, Brooks L, Masucci MG, Crocker J, et al. Patterns of Epstein-Barr virus infection in non-neoplastic lymphoid tissue. Blood 1992;79: ) Ichiro A, Kioshi M. Detection of Epstein-Barr virus in formalin fixed, paraffin-embeded tissue of nasopharyngeal carcinoma using polymerase chain reaction and in situ hybridization. Laryngoscope 1990;101: ) Jeng KC, Hsu CY, Liu MT, Chung TT, Liu ST. Prevalence of Taiwan varient of Epstein-Barr virus in throat washing from patients with head & neck tumors in Twain. J Clin Microbiol 1994; 32: ) Hording U, Albeck H, Katholm M, Kristensen HS. Epstein-Barr virus in exfoliated cells from the post nasal space. APMIS 1994; 102: ) Kunimoto M, Tamura S, Tabata T, Yoshie O. One-step typing of Epstein-Barr virus by polymerase chain reaction: predominance of type 1 virus in Japan. J Gen Virol 1992;73: ) Munch M. Epstein-Barr virus strain characterization. APMIS 1998;106: ) Gratama JW, Oasterveer MAP, Weimer W, Sintnicoals K, Sizoo W, Bollnuis RLH, et al. Detection of multiple Ebnotypes in individual Epstein-Barr carriers following lymphocyte transformation by virus derived from peripheral blood and oropharynx. J Gen Virol 1994;75: ) Kyaw MT, Hurren L, Evens L, Moss DJ, Cooper DA, Benson E, et al. Expression of B-type Epstein-Barr virus in HIV-infected patients and cardiac transplant recipients. AIDS Res 1992;8: ) Rickinson AB, Young LS, Rowe M. Influence of the Epstein-Barr virus nuclear antigen EBNA 2 on the growth phenotype of virustransformed B cells. J Virol 1987;61: ) Kang JH, Hur JK, Kim JH, Lee AH. Typing of Epstein-Barr virus in healthy Korean children and adults. J Korean Ped Society 2000; 43: Korean J Otolaryngol 2001;44:1171-6

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