Infectious Agents and Cancer

unofficial impact factor 2.33

Open Access Research article

Elevated anti-Zta IgG levels and EBV viral load are associated with site of tumor presentation in endemic Burkitt's lymphoma patients: a case control study

Amolo S Asito1,2, Erwan Piriou3, Peter S Odada2, Nancy Fiore3, Jaap M Middeldorp4, Carole Long5, Sheetij Dutta6, David E Lanar6, Walter GZO Jura1, Collins Ouma1, Juliana A Otieno7, Ann M Moormann8 and Rosemary Rochford3*

Author Affiliations

1 Maseno University, Maseno, Kenya

2 Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3 SUNY Upstate Medical University, Syracuse, NY, USA

4 VU University Medical Center, Amsterdam, The Netherlands

5 National Institutes of Health, Bethesda, MD, USA

6 Walter Reed Army Institute of Research, Silver Springs, MD, USA

7 Kenya Ministry of Health, Kisumu, Kenya

8 University of Massachusetts, Worcester, MA, USA

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Infectious Agents and Cancer 2010, 5:13 doi:10.1186/1750-9378-5-13

Published: 28 July 2010

Abstract

Background

Endemic Burkitt's lymphoma (BL) is an extranodal tumor appearing predominantly in the jaw in younger children while abdominal tumors predominate with increasing age. Previous studies have identified elevated levels of antibodies to Plasmodium falciparum schizont extracts and Epstein-Barr virus (EBV) viral capsid antigens (VCA) in endemic BL relative to malaria exposed controls. However, these studies have neither determined if there were any differences based on the site of clinical presentation of the tumor nor examined a broader panel of EBV and P. falciparum antigens.

Methods

We used a suspension bead Luminex assay to measure the IgG levels against EBV antigens, VCA, EAd, EBNA-1 and Zta as well as P. falciparum MSP-1, LSA-1, and AMA-1 antigens in children with BL (n = 32) and in population-based age-and sex-matched controls (n = 25) from a malaria endemic region in Western Kenya with high incidence of BL. EBV viral load in plasma was determined by quantitative PCR.

Results

Relative to healthy controls, BL patients had significantly increased anti-Zta (p = 0.0017) and VCA IgG levels (p < 0.0001) and plasma EBV viral loads (p < 0.0001). In contrast, comparable IgG levels to all P. falciparum antigens tested were observed in BL patients compared to controls. Interestingly, when we grouped BL patients into those presenting with abdominal tumors or with jaw tumors, we observed significantly higher levels of anti-Zta IgG levels (p < 0.0065) and plasma EBV viral loads (p < 0.033) in patients with abdominal tumors compared to patients with jaw tumors.

Conclusion

Elevated antibodies to Zta and elevated plasma EBV viral load could be relevant biomarkers for BL and could also be used to confirm BL presenting in the abdominal region.