PRELIMINARY EVIDENCE FOR AN ASSOCIATION OF EPSTEIN-BARR-VIRUS WITH PREULCERATIVE ORAL LESIONS IN PATIENTS WITH RECURRENT APHTHOUS ULCERS ORBEHCETS-DISEASE

In this study we used the polymerase chain reaction (PCR), slat blot a nd Southern blot hybridization, direct sequencing and in situ hybridiz ation (ISH) to show the possible presence of EBV-DNA In pre-ulcerative oral aphthous lesions of patients with recurrent aphthous ulcers (RAU ) or Behcet's disease (BD). For this purpose, formalin-fixed biopsy sp ecimens were obtained from 13 pre-ulcerative oral aphthous lesions of nine RAU and four ED patients. Five specimens of normal oral mucosa IN OM) from five normal control subjects and 10 specimens of oral erosive or ulcerative lesions from ID patients with erosive lichen planus (EL P) were also included. EBV-DNA was detected by PCR in 5 of the 13 (38. 5%) pre-ulcerative oral aphthous lesions, two from RAU patients and th ree from ED patients, However. no EBV-DNA was demonstrated in live NOM specimens from normal control subjects and in 10 specimens of oral le sions from ELF patients. EBV-DNA was also demonstrated in patients' pe ripheral blood lymphocytes and/ or plasma, suggesting that the lymphoc ytes may be the reservoir of latent EBV infection and there is EBV she dding in the plasma. EBV-DNA Ras detected by ISH in only one PCR-posit ive case: the reaction product was found to deposit on the nuclei of s ome of the epithelial cells and lymphocytes. By immunohistochemistry, expression of Epstein-Barr nuclear antigen and EBV/C(3)d receptors was also noted in some of the epithelial cells and lymphocytes in this IS M-positive case. Therefore, we suggest that the epithelial cells of pr e-ulcerative oral aphthous lesions may be infected by EBV through EBV- infected lymphocytes; also, the cytotoxic T lymphocyte-induced lysis o f the EBV-infected epithelial cells, but not the virus-induced cytolys is, may be the main mechanism causing oral ulcer formation. Our data p rovide preliminary evidence for an association of EBV with pre-ulcerat ive oral aphthous lesions in RAU and BD patients.