This approach prevents EBV-associated malignancies by inhibiting the Epstein-Barr virus (EBV) lytic phase malignancies. EBV is a ubiquitous oncogenic herpesvirus, causing an estimated 300,000 new cancers and 200,000 deaths each year. EBV commonly causes infectious mononucleosis in adolescents but also contributes to multiple sclerosis, and drives several life-threatening malignancies, including post-transplant lymphoproliferative disorder (PTLD), lymphomas, nasopharyngeal cell carcinoma, and gastric cancer. Like all herpesviruses, EBV has both latent/dormant and lytic phases. In the host B cell, EBV is primarily in its latent state, from which such malignancies can arise. In the setting of immunosuppression, such as after organ transplantation, infection by donor-derived EBV or lytically reactivated EBV not only dysregulates host gene expression but also spreads the infection to new B cells, ultimately leading to the development of PTLD and lymphoma. EBV-specific vaccines or antivirals have yet to be developed, and conventional management of PTLD relies on frequent EBV load monitoring and reactive treatment with broad B cell-depleting drugs like rituximab. These approaches are limited by delayed intervention, indiscriminate immune suppression, and increased vulnerability to infection and long-term immunodeficiency.
Studies have revealed the lytic cycle of EBV is triggered by activation of the host cell inflammasome either by cell stress, damage, or activation of surface IgG, also known as the B cell receptor. With the inflammasome and B cell receptor signaling linked, researchers at the University of Florida have discovered EBV reactivation is preventable by using inhibitors of the Bruton’s tyrosine kinase (BTK) – a key enzyme in signaling between the B cell receptor and the inflammasome. BTK inhibitor therapy provides a targeted, early, and sustained method to blocking EBV reactivation, thereby protecting against EBV-associated malignancies without compromising overall immune function. With an adaptive dosing regime, BTK therapy can also be adjusted based on patient risk and clinical context.
BTK inhibitors to prevent EBV reactivation and reduce the incidence of EBV-driven lymphoproliferative diseases
This advanced EBV reactivation prevention system uses Bruton's Tyrosine Kinase (BTK) inhibitors to precisely block the viral switch from latency to lytic phase in B cells. BTK is a critical enzyme in B cell receptor signaling and inflammasome activation, both are pathways exploited by EBV to initiate viral replication and drive lymphoproliferative disease. The technology features both irreversible and reversible BTK inhibitor compounds, disrupting BTK-mediated phosphorylation events and downstream signaling cascades. This interruption prevents the activation of the EBV lytic cycle, showcased by reduced expression of key viral proteins (ZEBRA and EA-D) and decreased cleavage of procaspase 1, a marker of inflammasome activation and programmed cell death. By inhibiting BTK, the system prevents EBV-driven activation and proliferation of EBV-cancer cells with high specificity. This technology’s ability to target the molecular machinery required for EBV reactivation makes it an invaluable tool for precise prevention of EBV-driven malignancies while preserving healthy immune function, avoiding indiscriminate B cell destruction that is often used to prevent EBV-cancers.
