Cancer gone viral: The kissing disease virus can cause cancer?
Cancer EBV epstein-barr virus

Cancer gone viral: The kissing disease virus can cause cancer?

Dr. Talia Henkle
Dr. Talia Henkle

In 10 seconds? The Epstein-Barr virus (EBV) causes about 1.5% of all human cancers. Almost everyone is infected with EBV, but due to a wide range of interplaying environmental and genetic factors, only a small percentage develop EBV-related cancers.

What’s the story? EBV is a member of the herpesvirus family that is most commonly known for causing mononucleosis–the ‘kissing disease’–that spreads around college campuses. Interestingly, most people get infected as young children and never experience any symptoms (you only get sick from EBV infection if you don’t catch it until you’re older). About 90% of adults in the US are infected but they are unaware. And like all herpesviruses, once you get it, you’re stuck with it for life–which gives it the decades needed to form cancer.

So, what kind of cancers does it cause? EBV mostly causes B cell cancers (B cells are the immune cells that produce antibodies), but also can cause T cell and Natural Killer cell cancers (other types of immune cells), as well as gastric (stomach) and nasopharyngeal (upper respiratory) cancers.

EBV causes several types of lymphomas--or cancers formed from white blood cells. Source:
EBV causes several types of lymphomas--or cancers formed from white blood cells. Source:

What puts people at risk for EBV-related cancer? That’s the key question, isn’t it? For other cancer-causing viruses such as the Hepatitis C virus, Human Papillomavirus, and Human Immunodeficiency Virus (HIV), testing for infection among vulnerable populations can catch the disease before it causes problems–which is the key to slashing cancer rates caused by those viruses. But with EBV, with no vaccine or cure available (yet), and since most people are infected with EBV and never experience any health issues, researchers are challenged to prevent these cancers from occurring.

Well, what progress have they made? Researchers have been able to tie the increased risk of EBV cancers to multiple variables ranging from genetic and environmental factors. For instance, researchers linked the increased risk of Burkitt’s lymphoma (a B-cell cancer frequently caused by EBV) to concurrent malaria infection, which essentially distracts the immune system in such a way that makes EBV more dangerous. And this isn’t the only case where infectious agents conspire together to increase EBV cancer risk.

Don’t leave me hanging… what are the other cases? Well, if you’ve been following our Cancer Gone Viral series, you might even be able to guess! Infection with HIV damages the immune system and makes those infected more vulnerable to other viral cancers. To that point, about 45% of Burkitt’s Lymphoma cases among patients who have Acquired Immunodeficiency Syndrome (AIDS) are due to concurrent HIV and EBV infection. What’s more, EBV’s herpesvirus cousin, KSHV, is thought to conspire with EBV to cause a rare B cell cancer called “primary effusion lymphoma”. On a similar note, patients who are immunosuppressed due to organ transplantation are also at an increased risk for EBV-associated cancers (as well as pretty much every other viral cancer!).

Anything else we should know about EBV? Weirdly, as I mentioned, EBV can also cause cancers in completely distinct bodily sites. For example, EBV causes about 10% of gastric (stomach) cancers. Additionally, EBV is known to cause nearly all cases of upper respiratory tract cancer called nasopharyngeal carcinoma, which is particularly common in parts of the world like Hong Kong and Malaysia. You would ask: why there? More work still needs to be done to concisely figure out why some populations are more vulnerable than others (virus genetic factors, human genetic factors, and environment likely play a role).

So, are EBV-caused cancers curable? Well, there are no antiviral medications for EBV (like there are for HIV), but these cancers can be treated by many different approaches ranging from chemotherapy to immunotherapy. But alas, that’s it while the search continues to develop effective vaccines and better treatments to combat EBV infections and EBV-associated cancers.

EBV’s ‘immortal’ contribution to science

EBV’s ability to turn B cells cancerous has helped revolutionize scientific research and medicine.

You see, certain types of B cells produce antibodies. Scientists have now figured out how to use B cells, that have been turned cancerous by EBV (aka immortalized), to create pure populations of antibodies (AKA monoclonal antibodies).

Monoclonal antibodies can be used to create immunotherapies like checkpoint blockade inhibitors (for cancer), or even tools for scientific research (to perform scientific experiments like western blots, flow cytometry, immunoprecipitation, and more!).

While nowadays, multiple methods, beyond EBV immortalized B cells are in use to create monoclonal antibodies...we still have EBV to thank for kickstarting this important scientific discovery!

Dr. Talia Henkle has distilled 2 research papers saving you 7 hours of reading time.

The Science Integrity Check of this 3-min Science Digest was performed by Flávia Oliveira Geraldes.

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