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Abstract(s)
O vĂrus Epstein-Barr (EBV) Ă© um vĂrus de DNA, pertencente Ă famĂlia gammaherpesvirus, causador de 2% dos tumores a nĂvel mundial. Trata-se de um vĂrus com
tropismo para células B e células epiteliais, associando-se a patologias benignas, mais
frequentemente a mononucleose infeciosa (MI), a patologias malignas, como o linfoma de
Burkitt (LB), o linfoma de Hodgkin (LH), o linfoma extranodal de células NK-T (LENKT)-
tipo nasal, o linfoma difuso de grandes cĂ©lulas B (LDGCB), o carcinoma nasofarĂngeo (CN)
e a doenças autoimunes como a esclerose mĂșltipla (EM).
A sua descoberta deu-se em 1964, num linfoma de Burkitt de uma criança originåria
da Ăfrica Subsariana e sabe-se que atualmente aproximadamente 90% dos adultos
saudĂĄveis sĂŁo portadores deste mesmo vĂrus. Os programas encontrados nestes indivĂduos
sĂŁo os mesmos que os encontrados nos indivĂduos que desenvolveram tumores associados.
A transmissĂŁo do vĂrus Ă© mais frequentemente realizada atravĂ©s da saliva embora possa
ocorrer atravĂ©s de outras vias, como transplantes e transfusĂ”es sanguĂneas. A infeção
primĂĄria por EBV possui dois picos de incidĂȘncia, um durante a infĂąncia e outro durante a
adolescĂȘncia/inĂcio da idade adulta, sendo que no primeiro Ă© habitualmente assintomĂĄtica
e no segundo, manifesta-se maioritariamente pelo quadro de MI. A MI é uma doença
benigna que habitualmente necessita apenas de tratamento sintomĂĄtico, baseado no alĂvio
da febre e dor, da hidratação e repouso. O diagnĂłstico da infeção primĂĄria por EBV efetuase habitualmente pelo âteste monospotâ. No entanto, em alguns casos Ă© necessĂĄrio recorrer
ao teste dos anticorpos especĂficos contra o EBV devido a forte suspeita de infeção por EBV,
apesar de um monospot ser negativo. A patologia autoimune mais associada ao EBV Ă© a EM,
e sabe-se que os indivĂduos que no curso da infeção primĂĄria desenvolvem MI tĂȘm um risco
2-3 vezes superior de desenvolver EM.
A presente dissertação pretende efetuar uma revisão da literatura existente, no
Ăąmbito de melhor caracterizar a epidemiologia, sintomatologia, fisiopatologia e
mecanismos de ação do vĂrus EBV nas doenças benignas e malignas a ele mais
frequentemente associadas, assim como as estratĂ©gias terapĂȘuticas e/ou preventivas
baseadas no mecanismo pelo qual o vĂrus se associa a cada patologia.
The Epstein-Barr virus (EBV) is a DNA virus belonging to the gamma-herpes family, which causes 2% of tumors worldwide. It is a virus with tropism for B cells and epithelial cells, associated with benign pathologies, more often infectious mononucleosis (IM), malignant pathologies, such as Burkitt's lymphoma (BL), or Hodgkin's lymphoma (HL), extranodal NK-T cell lymphoma (LENKT) - nasal type, diffuse large B cell lymphoma (DLBCL), nasopharyngeal carcinoma (NC) and autoimmune diseases such as multiple sclerosis (MS). Its discovery occurred in 1964, in the Burkitt's lymphoma of a child from SubSaharan Africa and it is known that approximately 90% of healthy adults carry this virus. The programs found in these individuals are the same as those found in individuals who have developed associated tumors. The transmission of the virus is most often carried out through saliva although it can occur through other routes, such as transplants and blood transfusions. Primary EBV infection has two peaks of incidence, one during childhood and the other during adolescence/early adulthood, with the former usually being asymptomatic and the latter mostly manifested by IM. IM is a benign disease that usually requires only symptomatic treatment, based on the relief of fever and pain, hydration and rest. The diagnosis of primary EBV infection is usually performed by the âmonospot testâ. However, in some cases testing specific antibodies against EBV is necessary due to the strong suspicion of EBV infection despite a negative monospot test. The autoimmune pathology most associated with EBV is MS and it is known that individuals who develop IM during the course of primary infection have a 2-3 times higher risk of developing MS. This dissertation intends to revise the existing literature, in order to better characterize the epidemiology, symptoms, pathophysiology and mechanisms of action of the EBV in the most frequently associated benign and malignant diseases, as well as the therapeutic and/or preventive strategies based on the mechanism by which the virus is associated with each pathology.
The Epstein-Barr virus (EBV) is a DNA virus belonging to the gamma-herpes family, which causes 2% of tumors worldwide. It is a virus with tropism for B cells and epithelial cells, associated with benign pathologies, more often infectious mononucleosis (IM), malignant pathologies, such as Burkitt's lymphoma (BL), or Hodgkin's lymphoma (HL), extranodal NK-T cell lymphoma (LENKT) - nasal type, diffuse large B cell lymphoma (DLBCL), nasopharyngeal carcinoma (NC) and autoimmune diseases such as multiple sclerosis (MS). Its discovery occurred in 1964, in the Burkitt's lymphoma of a child from SubSaharan Africa and it is known that approximately 90% of healthy adults carry this virus. The programs found in these individuals are the same as those found in individuals who have developed associated tumors. The transmission of the virus is most often carried out through saliva although it can occur through other routes, such as transplants and blood transfusions. Primary EBV infection has two peaks of incidence, one during childhood and the other during adolescence/early adulthood, with the former usually being asymptomatic and the latter mostly manifested by IM. IM is a benign disease that usually requires only symptomatic treatment, based on the relief of fever and pain, hydration and rest. The diagnosis of primary EBV infection is usually performed by the âmonospot testâ. However, in some cases testing specific antibodies against EBV is necessary due to the strong suspicion of EBV infection despite a negative monospot test. The autoimmune pathology most associated with EBV is MS and it is known that individuals who develop IM during the course of primary infection have a 2-3 times higher risk of developing MS. This dissertation intends to revise the existing literature, in order to better characterize the epidemiology, symptoms, pathophysiology and mechanisms of action of the EBV in the most frequently associated benign and malignant diseases, as well as the therapeutic and/or preventive strategies based on the mechanism by which the virus is associated with each pathology.
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Keywords
Epidemiologia Fisiopatologia Mononucleose Infeciosa Neoplasias VĂrus Epstein-Barr