EBV, CMV and HHV 6-8在线视频

Story 3 “Bubble boy”
故事3“气泡男孩”

This is a sad story.
这是一个悲伤的故事

David was born in 1971 with severe
大卫出生于1971年，他患有严重的

combined immunodeficiency (SCID),
联合免疫缺陷病（SCID）

one of the most severe types
最严重的原发性

of primary immunodeficiency syndrome.
免疫缺陷综合征之一

He lived in a special germ-free bubble
他从出生开始就生活在

from birth.
一个特殊的无菌气泡屋中

When he was 12 years old,
在12岁时

he received a bone marrow transplant
他接受了姐姐捐献的骨髓

from his sister hoping
进行移植

to restore his immune system.
希望以此能修复他的免疫系统

But he developed Burkitt's lymphoma
但他接受移植手术后

after the transplant and died because
患上了伯基特淋巴瘤

of the cancer.
并因此而死

Later, his sister'marrow was found
后来，科学家在他姐姐的骨髓里

to contain Epstein Barr virus.
发现了EB病毒

The virus seems to be latent
这种病毒在健康的人体内

in a healthy person,
表现为潜伏状态

but could induce lymphoma
却会在一个患有严重联合免疫缺陷症的病人

in a SCID patient.
体内诱发淋巴瘤

Now, let's get to know this virus.
现在，让我们来了解一下这种病毒

Epstein-Barr virus (EBV) is a member
EB病毒是

of the herpes virus family.
疱疹病毒家族的一员

It is one of the most common
它是最常见的

human viruses.
人类病毒之一

The target of EBV is B cells.
EBV的靶细胞是B淋巴细胞

EBV can cause infectious mononucleosis,
EBV可引起传染性单核细胞增多症

African Burkitt's lymphoma,
非洲伯基特淋巴瘤

Hodgkin disease,
霍奇金病

and nasopharyngeal carcinoma.
和鼻咽癌

Transmission:
传播途径

EBV spreads most commonly through
EBV一般通过

body fluids, primarily saliva.
体液，主要是唾液来传播

Infectious mononucleosis,
传染性单核细胞增多症

also known as kissing disease,
也被称为接吻病

is a very common condition caused
是一种非常常见的由

by this virus.
这种病毒感染导致的疾病

Most people get infected
大多数人在他们生命中的某个时候

with EBV some time during their lives.
都会被EBV感染

Children are usually asymptomatic
儿童通常没有症状

or have mild symptoms.
或有轻微的症状

Teenagers and adults are at risk
青少年和成年人都有

for infectious mononucleosis.
患传染性单核细胞增多症的风险

By adulthood,
到成年

90% -95% have been infected with EBV,
90% -95%的人都感染过EBV

most probably
并很有可能

when they were 5 to 25 years of age.
是在他们5到25岁的时候感染的

Infectious mononucleosis,
传染性单核细胞增多症

also called “I.M. or Mono”,
也被称为“I.M.或Mono”

is primarily acquired through saliva.
主要通过唾液传染

The initial symptoms of Mono
单核细胞增多症的最初症状

are a general lack of energy (malaise),
主要是乏力（不适）

loss of appetite, and chills.
食欲不振，和寒战

The most common signs are fever,
最常见的症状是发烧

a reddened throat and tonsils along
喉咙和扁桃体发红

with swollen lymph nodes in the neck.
并伴有颈部淋巴结肿大

Diagnostic tests:
实验室检查

The diagnosis is made mainly
诊断主要是基于

on clinical grounds,
临床症状

by history and examination.
病史和体格检查获得

Blood tests can show some typical changes
血液检查可以显示一些典型的变化

such as a moderately elevated white blood
例如白细胞计数，淋巴细胞中度升高

cell count with 50% lymphocytes and 10%
占50%

or more “atypical lymphocytes”
“非典型淋巴细胞”比例10%或更高

(the “mononuclear cells”).
(“单个核细胞”)

By the end of the 3rd week
到第三周末

the monospot blood test is positive
大约90%的病人中

in about 90% of patients.
传染性单核细胞增多测试（monospot）呈阳性

This is not too specific as chicken pox,
相较于对水痘的特异性诊断

lymphomas and influenza
淋巴瘤和流感

can lead to a falsely positive monospot
也会导致monospot

test as well.
结果呈阳性

The EBV antibody test is specific
EBV抗体检测可用于

for EBV infection.
特异性诊断EBV感染

Even after the monospot test
即使monospot检测

becomes negative,
显示为阴性

the EBV antibody test stays positive
EBV抗体阳性

for the rest of the individual’s life.
会持续终身

Mononucleosis-like syndromes can also
单核细胞增多症样综合征也可能

be caused by other viruses,
由其他病毒引起

such as CMV, HHV-6, and HIV.
如CMV,HHV-6,和HIV

Prevention and treatment:
预防和治疗

There is no vaccine
没有疫苗

to protect against EBV infection.

No kissing or sharing drinks, food,
预防措施：不和患有EBV感染的人接吻或

or personal items, like toothbrushes,
分享饮料、食物

with people who have EBV infection
或个人物品，如牙刷

can prevent the transmission.

There is no specific treatment for EBV.
EBV无特效治疗

Let's look at the story of David again.
我们再来看看关于大卫的故事

The EBV can be latent in B cells.
EBV可以潜伏在B淋巴细胞中

This DNA virus has the ability
这种DNA病毒有

to transform B cells.
转化B淋巴细胞的能力

This could explain why EBV is associated
这可以解释为什么EBV与

with malignant tumors,
恶性肿瘤有关

such as lymphoma, Hodgkin disease,
例如淋巴瘤、霍奇金病

and nasopharyngeal carcinoma.
和鼻咽癌

Immunosuppressant treatment after
骨髓移植后的

the bone marrow transplant also
免疫抑制剂治疗

put David at high risk
也使大卫处于易患

of developing malignancy.
恶性肿瘤的高危状态

So far, we have gone through HSV,
至今，我们讨论了HSV

VZV and EBV.
VZV和EBV

All of them are herpesviruses.
他们全都是疱疹病毒

Latent infection is the hallmark
潜伏感染是疱疹病毒

of herpesviruses.
的标志

HSV and VZV are latent in neurons,
HSV和VZV潜伏在神经元中

and EBV is latent in B cells.
EBV潜伏在B淋巴细胞中

Herpesviruses
疱疹病毒

are large enveloped DNA viruses.
是一组大包膜DNA病毒

The family name is Herpesviridae.
它们归类于疱疹病毒科

Members of this group
这一科的成员

have some features in common:
有一些共同的特征：

virion morphology,
相似的病毒体结构

basic mode of replication,
DNA复制模式

and capacity to establish latent
诱发潜伏感染

and recurrent infections.
和复发性感染的能力

The common properties of herpesviruses:
疱疹病毒的共同特性:

1.Similar structure.
1.类似的结构

The virion is spherical,
病毒体为球形

approximately 150 to 200 nm in diameter.
直径约150-200纳米

The genome is linear,
基因组是线性的

double-stranded DNA.
双链DNA

The core is surrounded
核心由一层

by an icosadeltahedral capsid.
十二面体的衣壳包围

This capsid is enclosed
这个衣壳又由

by a glycoprotein-containing envelope.
一层糖蛋白包膜包围

Attached to the capsid and
附着在衣壳上

in the space between the envelope
在衣壳和包膜之间的

and the capsid is the tegument,
是内膜（或称为皮质）

which are viral proteins and
内膜是病毒蛋白

enzymes that help initiate replication.
也是一种协助启动DNA复制的酶

Viral culture
病毒培养

Human herpesviruses replicate
人类疱疹病毒在

in human diploid cells.
人类二倍体细胞中复制

And inclusion bodies
会形成核内包涵体

or multinucleated cells can be formed,
或多核细胞

such as owl-eye inclusion body
比如猫头鹰眼包涵体

and Tzanck cells.
和Tzanck 细胞

Type of infection
感染类型

Types of the herpesvirus infection
疱疹病毒感染类型

include subclinical, apparent,
包括了亚临床、显性的

latent and congenital infections,
潜伏和先天性感染

and integration.
还有整合感染

As we have mentioned,
正如我们提到的

the hallmark of all herpesviruses
疱疹病毒感染的

is latent infection.
显著特点是潜伏感染

Human herpesviruses, HHV
人类疱疹病毒，HHV

The human herpesviruses are grouped
人类疱疹病毒根据

into three subfamilies on the basis
病毒特征

of differences in viral characteristics
疾病的发病机理

and the pathogenesis of the disease
和发病表现的差异

and manifestations.
被分为三个子家族

Official names of HSV-1, HSV-2, VZV, EBV
HSV-1、HSV-2、VZV、EBV、和CMV的名称

and CMV are HHV-1, 2, 3, 4, and HHV-5.
分别是人类疱疹病毒1，2，3，4，5型

HSV-1, HSV-2 and VZV are latent in neurons,
HSV-1、HSV-2和VZV潜伏在神经元中

and are members of the α-subfamily.
是α亚科的成员

EBV and HHV-8 are in γ-subfamily,
EBV和HHV-8属于γ亚科

and HHV-5, 6 and 7 are members
HHV-5，6和7属于β亚科

of the β-subfamily.

HHV-5 is also known
HHV-5也被称为

as cytomegalovirus (CMV).
巨细胞病毒(CMV)

CMV usually causes mild
巨细胞病毒通常在儿童和成人

or asymptomatic disease
中导致轻度

in children and adults,
或无症状的疾病

but can be a serious disorder
但对免疫功能受损

in an immunocompromised
或免疫缺陷的人

or immunodeficient person,
比如新生儿和艾滋病患者

such as a neonate or a patient with AIDS.
可能会造成严重的疾病

CMV is the most common virus
CMV是最常见的

causing congenital infection.
引起先天性感染的病毒

The cytomegalic inclusion disease
巨细胞包涵体疾病

is a congenital CMV-related problem.
是一种巨细胞病毒相关的先天性疾病

Can you recall “TORCH”? The “C” is CMV.
你能回忆起“TORCH”吗？“C”是指CMV

I'll leave you to review “TORCH”,
“TORCH”，导致先天性疾病的感染的病原体

pathogens causing congenital infection.
留给你们自己复习

CMV is particularly important
CMV，作为一种

as an opportunistic pathogen in
有可能影响艾滋病患者

the immunodeficient individual with AIDS.
的病原体，很重要

Although most CMV infections
虽然大多数年轻人的CMV感染

in young adults are asymptomatic,
是无症状的

patients may develop a heterophile-negative
但患者可能出现异嗜阴性

(monospot-negative)
（单核细胞增多症检测阴性）

infectious mononucleosis syndrome.
感染性单核细胞增多综合征

The symptoms are similar to those of EBV
症状与EBV感染

infection but with less severe pharyngeal
相似，但咽部受累

involvement and lymphadenopathy.
和淋巴结病不那么严重

The histological hallmark of CMV
CMV感染

infection is the cytomegalic cell,
的组织学标志

which is an enlarged cell containing
是含有“猫头鹰眼”形的

a “owl-eye,”
核内嗜碱性包涵体

basophilic intranuclear inclusion body.
的巨细胞

HHV-6 causes roseola (Roseola infantum)
人类疱疹病毒6型会导致玫瑰疹（婴儿玫瑰疹）

As the name suggests,
顾名思义

Roseola is a common disease
幼儿急疹是

of infants or young children,
一种常见婴幼儿发疹疾病

in whom several days of very high fever
它会导致持续几天的高热

is followed by a rash.
然后出皮疹

Five classical childhood exanthems (rash)
五类儿童期常见的皮疹（红疹）

are varicella, rubella, roseola,
包括水痘、风疹、幼儿急疹

measles and fifth disease.
麻疹和fifth disease

We have learned almost all
我们已经学了

of them except the fifth disease,
这些儿童期常见皮疹，除了fifth disease

which is caused by parvovirus B19.
fifth disease是由微小病毒 B19导致的

Back to the table.
回到这个表格

HHV-7 has been found
HHV-7

to cause some cases of roseola.
会导致幼儿急疹

HHV-8 is associated with Kaposi sarcoma.
HHV-8和卡波西肉瘤有关

We are done with herpesviruses,
现在我们完成了疱疹病毒——

a group of enveloped DNA viruses,
一群有包膜的DNA病毒的学习

with a hallmark of latent infection.
它们的显著特点是潜伏感染

Thank you for your attention.
感谢你的聆听

See you next time.
我们下次见