Is Hodgkin's disease an infectious disease?
Several lines of evidence question the concept of Hodgkin's disease (HD) starting as a true malignant disorder of the lymphatic system: (i) In early stages HD exerts pronounced clinical and biological features of an atypic immune response. (ii) Despite extensive investigations, the Hodgkin/Reed-Sternberg (H/RS) cells have not been unequivocally determined as the definite malignant cell population in HD. (iii) The epidemiological pattern of HD strongly resembles that of an infectious disease. (iv) About 50% of HD cases can be linked to infection with Epstein-Barr virus. Hodgkin's disease in early stages might thus be understood as the unsuccessful attempt of the organism to eliminate a cell expressing a putative (cellular or viral) target antigen. A stepwise transformation of this antigen-carrying cell, possibly triggered by an inherent genetic instability, might then lead to outgrowth of a malignant cell clone in late stages of the disease.
Wolf
J
J
Department of Internal Medicine I, University of Cologne, Germany.
Diehl
V
V
D000917:Antibody Formation; D002472:Cell Transformation, Viral / Q000502:physiology; D006566:Herpesviridae Infections; D004854:Herpesvirus 4, Human / Q000502:physiology; D006689:Hodgkin Disease / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D016539:Reed-Sternberg Cells / Q000473:pathology; D014412:Tumor Virus Infections