EPSTEIN-BARR-VIRUS IN HODGKINS-DISEASE - MORE THAN JUST AN INNOCENT BYSTANDER

Several lines of evidence suggest that the Epstein-Barr virus (EBV) is an important factor in the pathogenesis of Hodgkin's disease (HD). Th is Editorial focuses on two pathogenic mechanisms probably influenced by the presence of EBV in the Hodgkin and Reed-Sternberg (H-RS) cells: resistance of the H-RS cells to apoptosis; and escape of H-RS cells f rom a cytotoxic T lymphocyte (CTL) mediated immune response. In additi on, data are summarized implicating the latent membrane protein 1 (LMP 1) as the most likely EBV-encoded protein responsible for this putativ e EBV-mediated pathogenic effect. It is known that, using conventional therapy regimens, the presence of EBV bears little influence on clini cal presentation and treatment outcome of HD. However, the differences in regulation of both apoptosis and immune escape mechanisms between EBV+ and EBV- cases may be important determinants of the success of im munotherapy to treat Hodgkin's disease. Thus, clarification of these m echanisms will be essential to the development of successful immunothe rapeutic strategies in Hodgkin's disease. (C) 1997 by John Wiley & Son s, Ltd.