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Journal of Virology, November 2005, p. 13984-13992, Vol. 79, No. 22
0022-538X/05/$08.00+0 doi:10.1128/JVI.79.22.13984-13992.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Epstein-Barr Virus Lytic Infection Is Required for Efficient Production of the Angiogenesis Factor Vascular Endothelial Growth Factor in Lymphoblastoid Cell Lines
Gregory K. Hong,1,2
Pawan Kumar,3
Ling Wang,1,2
Blossom Damania,1,2
Margaret L. Gulley,4
Henri-Jacques Delecluse,5
Peter J. Polverini,3 and
Shannon C. Kenney1,2,6*
Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina 27599,1
Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina 27599,2
Department of Oral Medicine/Pathology/Oncology, 5205 School of Dentistry, 1011 N. University Ave., University of Michigan School Of Dentistry, Ann Arbor, Michigan 48108,3
Department of Pathology, 913 Brinkhous-Bullit, CB #7525, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina 27599,4
German Cancer Research Center, Applied Tumour Virology F-100, Im Neuenheimer Feld 242, D-69120, Heidelberg, Germany,5
Department of Medicine, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina 275996
Received 10 May 2005/
Accepted 15 August 2005

ABSTRACT
Although Epstein-Barr virus (EBV)-associated malignancies are
primarily composed of cells with one of the latent forms of
EBV infection, a small subset of tumor cells containing the
lytic form of infection is often observed. Whether the rare
lytically infected tumor cells contribute to the growth of the
latently infected tumor cells is unclear. Here we have investigated
whether the lytically infected subset of early-passage lymphoblastoid
cell lines (LCLs) could potentially contribute to tumor growth
through the production of angiogenesis factors. We demonstrate
that supernatants from early-passage LCLs infected with BZLF1-deleted
virus (Z-KO LCLs) are highly impaired in promoting endothelial
cell tube formation in vitro compared to wild-type (WT) LCL
supernatants. Furthermore, expression of the BZLF1 gene product
in
trans in Z-KO LCLs restored angiogenic capacity. The supernatants
of Z-KO LCLs, as well as supernatants from LCLs derived with
a BRLF1-deleted virus (R-KO LCLs), contained much less vascular
endothelial growth factor (VEGF) in comparison to WT LCLs. BZLF1
gene expression in Z-KO LCLs restored the VEGF level in the
supernatant. However, the cellular level of VEGF mRNA was similar
in Z-KO, R-KO, and WT LCLs, suggesting that lytic infection
may enhance VEGF translation or secretion. Interestingly, a
portion of the vasculature in LCL tumors in SCID mice was derived
from the human LCLs. These results suggest that lytically infected
cells may contribute to the growth of EBV-associated malignancies
by enhancing angiogenesis. In addition, as VEGF is a pleiotropic
factor with effects other than angiogenesis, lytically induced
VEGF secretion may potentially contribute to viral pathogenesis.

INTRODUCTION
Epstein-Barr virus (EBV), a ubiquitous human herpes virus, can
exist in either a latent or lytic state with regard to viral
gene expression. In the latent forms of infection, a limited
subset of viral genes is expressed, and the virus is replicated
using the host cell DNA polymerase (
53). The EBV proteins known
to be important for cellular transformation are expressed during
the type II and type III forms of latent infection (
28,
33,
58,
63). In lytic infection, widespread viral gene expression
occurs, resulting in replication of the virus by viral DNA polymerase,
release of infectious virus, and death of the host cell (
53).
Entry into lytic cycle is triggered by expression of the two
immediate-early genes of EBV, BZLF1 and BRLF1. The BZLF1 and
BRLF1 gene products function as transcription factors with the
capacity to activate both viral and cellular promoters (
9,
37,
39,
53).
EBV is associated with numerous malignancies of both B-cell and epithelial cell origin. EBV-associated malignancies are primarily infected with one of the latent forms of EBV, although a small subset of lytically infected cells is commonly detected in biopsies of EBV-positive malignancies (11, 42, 70). BZLF1-deleted (Z-KO) and BRLF1-deleted (R-KO) viruses are unable to replicate lytically but can immortalize primary B cells in vitro with similar efficiency as the wild-type (WT) virus (17). However, a potential role for lytically infected cells in promoting tumor growth in vivo was suggested by our recent finding that early-passage lymphoblastoid cell lines (LCLs) derived with either Z-KO or R-KO EBV (Z-KO or R-KO LCLs, respectively) were impaired for growth in SCID mice in comparison to LCLs infected with WT EBV (WT LCLs) (26). Restoration of the capacity of Z-KO LCLs to enter the lytic cycle (accomplished by introducing a BZLF1 expression vector in trans) resulted in enhanced growth of Z-KO LCLs in SCID mice. Furthermore, LCLs derived from the Z-KO and R-KO viruses expressed significantly less interleukin-6 (IL-6), cellular IL-10, and viral IL-10 in vitro in comparison to WT LCLs, suggesting that the in vivo tumorigenesis defect may be due at least partly to decreased secretion of paracrine B-cell growth factors.
Angiogenesis, or the formation of new blood vessels, is a critical event for the efficient growth of both B-cell and epithelial cell malignancies, as all cells must be located within
100 µm of a capillary in order to survive (8). In addition, angiogenesis provides tumor cells with access to the host vasculature, thereby allowing dissemination and metastasis. Angiogenesis is a tightly regulated process in which the relative balance between proangiogenic factors and antiangiogenic factors determines whether new vessels are formed. Tumors induce angiogenesis by disrupting this balance, often by upregulating secretion of proangiogenic factors such as vascular endothelial growth factor (VEGF) (8).
Virus-induced upregulation of angiogenesis factors in virally mediated malignancies may play a significant role in tumor progression. In the case of Kaposi's sarcoma-associated herpes virus, a close relative of EBV, multiple viral lytic proteins are capable of inducing upregulation of VEGF (3, 6, 66). The capacity of VEGF to induce angiogenesis is thought to contribute to the development of Kaposi's sarcoma (6), a highly vascularized lesion, while the ability of VEGF to increase vascular permeability may play a role in the pathogenesis of Kaposi's sarcoma-associated herpes virus-associated primary effusion lymphoma (4, 5). Angiogenesis is also thought to be critically important for the growth of the EBV-associated malignancies nasopharyngeal carcinoma (NPC) and Burkitt's lymphoma (BL), as angiogenesis inhibitors are able to inhibit tumor growth in mouse models of either malignancy (48, 50, 71). The viral latent protein LMP1, which is expressed in some cases of NPC, may play a role by inducing expression of angiogenic factors such as VEGF, IL-8, and IL-6 in latently infected tumor cells (15, 16, 43, 72). The contribution of EBV lytic proteins to the regulation of tumor angiogenesis is largely unknown.
In this paper we have examined whether lytic-defective Z-KO LCLs are impaired in mediating angiogenesis in comparison to WT LCLs. Somewhat surprisingly, especially considering that only a few percent of WT LCLs have the lytic form of viral infection, the supernatant of Z-KO LCLs from two separate donors had significantly lower angiogenic activity than the supernatant from WT LCLs. Furthermore, BZLF1 expression in trans restored angiogenic activity in the Z-KO LCL supernatants. In comparison to WT LCLs, Z-KO and R-KO LCLs secreted much lower amounts of the angiogenic factor VEGF in vitro, and reintroduction of BZLF1 expression in the Z-KO LCLs resulted in increased secretion of VEGF. The difference in VEGF secretion in the lytic-defective versus WT LCLs was not due to differences in transcription of VEGF, since the WT and Z-KO LCLs expressed similar levels of VEGF mRNA. Instead, one or more lytic EBV proteins presumably increase translation and/or secretion of VEGF. These results suggest that in early-passage LCLs, angiogenic factors are primarily derived from a small number of lytically infected cells. The decreased secretion of angiogenesis factors in early-passage lytic-defective LCLs, coupled with their known defect in forming tumors in vivo, suggests that lytic induction of angiogenesis factors such as VEGF may play a significant role in growth of some EBV-associated tumors.

MATERIALS AND METHODS
EBV wild-type, Z-KO, and R-KO viruses and cell lines.
293 cells infected with the R-KO virus, Z-KO virus, and WT virus
have been described previously (
17). In the R-KO virus, nucleotides
103638 to 105083 (strain B95.8 coordinates, accession number
V01555) within the BRLF1 gene were removed via insertion of
a tetracycline resistance cassette. In the Z-KO virus, nucleotides
102389 to 103388 (B95.8 coordinates) within the BZLF1 gene were
removed via insertion of a kanamycin resistance cassette. The
R-KO, Z-KO, and WT viruses also encode enhanced green fluorescent
protein and a hygromycin B resistance gene (both cloned into
the B95.8 deletion of EBV where the second copy of oriLyt normally
resides). LCLs containing the WT, Z-KO, and R-KO viruses were
generated as described previously (
25), using the supernatant
of BZLF1- or BRLF1-transfected 293 cells infected with Z-KO
or R-KO virus, respectively, as a source of virus and peripheral
blood leukocytes derived from several different anonymous donors
(obtained from the American Red Cross). LCLs were maintained
in RPMI medium supplemented with 10% fetal bovine serum and
antibiotics. Z-KO and R-KO LCLs were verified to be BZLF1
and BRLF1
via PCR with BZLF1- and BRLF1-specific primers.
Generation of Z-KO LCLs expressing BZLF1.
pREP9-Zp-Z (which contains the BZLF1 gene driven by its own promoter) was generated by cloning the 1.8-kb BamHI Z EBV fragment (B95.8 genome) into the BamHI site of a modified pREP9 vector (Invitrogen) in which the Rous sarcoma virus promoter had been removed and a blasticidin resistance cassette was inserted. The pREP9 plasmid contains the EBV oriP element and hence can be stably maintained as an episome in EBNA-1-expressing LCLs. Stable Z-KO LCL lines containing either the vector control (Z-KO-vector LCLs) or the pREP9-ZpZ expression vector were generated using a nucleoporator (Amaxa) as previously described (26).
Matrigel in vitro HDMEC tube formation assay.
Human dermal microvascular endothelial cells (HDMECs) were maintained in EGM-2 medium supplemented with 5% fetal bovine serum. Matrigel (125 µl; growth factor reduced), after being thawed on ice, was plated in eight-well chamber slides. These slides were then incubated at 37°C for 30 min to allow the Matrigel to polymerize. HDMECs (400 µl; 4 x 104 cells/ml in EBM-2 medium without serum) were added to each well and treated with 40 µl of culture supernatant from LCLs (1 x 106 cells cultured in 1 ml of serum-free medium for 24 h). VEGF (50 ng/ml) was used as positive control, and medium alone was used as a negative control. The chamber slides were then incubated for 16 to 18 h at 37°C in a 5% CO2 humidified atmosphere. At the end of incubation, the culture medium was very carefully aspirated off the Matrigel surface, and the cells were fixed with methanol and stained with Diff-Quick solution II. Each chamber was photographed using an inverted microscope with a digital camera (Leica DMIRB, Germany) and total tube area in each chamber was quantified using Metamorph software (Universal Imaging Corporation, Downingtown, PA) and expressed as an angiogenic score. P values were calculated using an Excel t test.
In vivo angiogenesis studies.
LCL tumors generated in SCID mice injected subcutaneously with 5 x 106 WT or Z-KO LCLs from the same donor (26) were harvested once they reached
4 mm in diameter, fixed overnight in 10% neutral buffered formalin, and embedded in paraffin. Hematoxylin- and eosin-stained sections were examined under high power, and the number of vessels per five high-powered fields was counted and averaged. For identification of human-derived CD31+ cells, tumor sections were deparaffinized and rehydrated. Following epitope retrieval, slides were stained using a human specific CD31 antibody (clone JC/70A; Ventana) on a BenchMark instrument (Ventana Medical Systems, Inc).
Immunoblotting.
Supernatants of LCLs growing for 2 days in serum-free medium were concentrated
50-fold using ultrafiltration with Centricon columns (Millipore, Billerica, MA). Equal amounts (micrograms) of concentrated supernatants were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotted using standard procedures with the following primary antibodies: polyclonal rabbit anti-VEGF-A (1:500; Santa Cruz Biotechnology) and polyclonal rabbit anti-basic fibroblast growth factor (bFGF) (1:500; Santa Cruz Biotechnology). Protein extracts from the cellular pellets collected at the same time as the supernatants were also immunoblotted as described above using the anti-VEGF-A antibody.
Reverse-transcription PCR (RT-PCR) analysis.
LCLs were grown in serum-free medium for 24 h, and total RNA was harvested using a QIAGEN RNeasy Kit according to the manufacturer's instructions. One microgram of RNA was reverse transcribed using a Promega Reverse Transcription system according to the manufacturer's instructions. PCR was then performed using primers specific for VEGF (7) and B2-microglobulin (41) using different dilutions of cDNA.

RESULTS
Z-KO LCL supernatants are less angiogenic than WT LCL supernatants in vitro.
To determine whether lytic infection contributes to tumor angiogenesis,
we utilized early-passage Z-KO LCLs, which we recently discovered
have a tumorigenesis defect in SCID mice (
26). Z-KO LCLs are
infected with a recombinant EBV in which the BZLF1 immediate-early
gene has been deleted via insertional mutagenesis (
17). The
Z-KO virus cannot replicate lytically unless BZLF1 is supplied
in
trans (
17) and, hence, represents a lytic-defective virus.
Supernatants from early-passage Z-KO or WT LCLs growing in vitro
(derived from the same donor) were tested for their ability
to induce endothelial tube formation in a Matrigel in vitro
angiogenesis assay (Fig.
1). WT LCL supernatants, as well as
the known angiogenic factor VEGF, were able to induce significant
endothelial tube formation. In sharp contrast, Z-KO LCL supernatants
induced minimal tube formation. Quantification of tube formation
revealed that WT LCL supernatants contained approximately threefold
more angiogenic activity than Z-KO LCL supernatants (Fig.
1,
right panel) (
P < 0.0001).
Given that the donor origin of LCLs can influence their behavior
both in vitro and in vivo (
14,
30,
47), we next determined if
Z-KO LCLs derived from a second donor were also defective in
their capacity to secrete angiogenesis factors in comparison
to the corresponding WT LCLs. Z-KO LCLs from the second donor
also secreted lower levels of angiogenesis factors in comparison
to the corresponding WT LCLs (Fig.
1), indicating that the angiogenesis
defect of Z-KO LCLs is not donor specific. The decreased angiogenic
activity of Z-KO supernatants surprisingly suggests that the
majority of secreted angiogenesis factors in early-passage LCLs
is derived from the rare, lytically infected cells.
Restoring expression of BZLF1 in trans increases the angiogenic capacity of Z-KO LCLs.
Previous studies have demonstrated that Z-KO LCLs have a similar viral latency profile to WT LCLs (17, 26). To further verify that the difference between WT and Z-KO LCLs with regard to angiogenesis was solely due to a lack of lytic gene expression, we created Z-KO LCLs stably carrying either an oriP-replicated episomal control vector (Z-KO-vector LCLs) or the same vector containing the BZLF1 gene driven by the endogenous BZLF1 promoter (Z-KO-ZpZ LCLs). Z-KO-ZpZ LCLs behaved similarly to WT LCLs in their capacity to be induced into the lytic cycle in vitro (data not shown); furthermore, tumors formed in SCID mice by Z-KO-ZpZ LCLs expressed viral lytic proteins in a few percent of cells at a comparable level to WT LCL tumors (26). As depicted in Fig. 2a, the supernatants from Z-KO-ZpZ LCLs possessed approximately twofold higher angiogenic activity than the Z-KO-vector supernatants, and this difference was statistically significant (P < 0.0001) (Fig. 2b). The increased angiogenic capacity of Z-KO-ZpZ supernatants indicates that restoration of BZLF1 expression increases secretion of angiogenic factors.
Examination of angiogenesis in vivo.
In order to determine whether the in vitro angiogenesis defect
in the Z-KO LCLs could also be demonstrated in vivo, we analyzed
tumors arising in SCID mice following injection with either
Z-KO or WT LCLs. The degree of angiogenesis was not significantly
different between WT and Z-KO LCL tumors as determined by vessel
counts of hematoxylin- and eosin-stained tumor sections. The
lack of an in vivo angiogenesis difference may simply reflect
the possibility that the tumors were harvested at a point where
an angiogenesis difference was minimized or no longer apparent
(see Discussion).
A recent report suggests that the vasculature within human posttransplant lymphoproliferative disease (PTLD) is, unexpectedly, partially derived from lymphoma cells (61). The LCL tumor vasculature in SCID mice can be stained with an antibody specific to the mouse form of CD31 (a marker routinely used for detection of endothelial cells), and therefore at least a portion of the vasculature in this animal model for PTLD is derived from murine endothelial cells (69). To determine if the vasculature within LCL tumors in SCID mice is also partially derived from the LCLs themselves, we stained the tumors using an antibody specific for the human form of CD31 (Fig. 3). Notably, some tumor vessels (Fig. 3a, arrow) as well as individual LCLs (Fig. 3b, arrow) were strongly positive for human CD31. While CD31 can be detected in lymphomas and in some normal B-cell subsets (59), the human origin of the tumor vasculature suggests that LCLs may directly contribute to the formation of tumor vessels in SCID mice. However, we did not detect a consistent difference in the degree of human CD31 staining in either LCLs or the tumor vasculature between WT- and Z-KO LCL-derived tumors, suggesting that lytic infection is not required for the ability of LCLs to become endothelial cells.
Lytic-defective LCLs secrete less VEGF than WT LCLs in vitro.
Of the many positive regulators of angiogenesis, VEGF represents
the most potent angiogenic factor characterized to date (
18).
To determine if the angiogenesis defect of Z-KO LCLs was a consequence
of decreased VEGF secretion, we performed Western blot analysis
of supernatants harvested from serum-starved WT and Z-KO LCLs
growing in vitro. As depicted in Fig.
4a, Z -KO LCLs secreted
markedly lower levels of VEGF than WT LCLs, suggesting that
lytically infected cells are the major source of VEGF secretion.
To verify that the defect in VEGF secretion was due to a defect
in lytic infection, we also examined the supernatants from LCLs
derived with the lytic-defective R-KO virus. Similar to the
Z-KO LCLs, R-KO LCLs are also impaired for tumorigenesis in
vivo while exhibiting a similar latency profile to WT LCLs (
26).
In comparison to WT LCLs, R-KO LCLs (from the same donor) also
exhibited decreased secretion of VEGF (Fig.
4a). The decreased
secretion of VEGF in the lytic-defective LCLs did not reflect
a nonspecific defect in transcription, translation, or secretion,
as equivalent amounts of another well-known angiogenic factor,
bFGF, were secreted into the supernatants of WT, Z-KO, and R-KO
LCLs (Fig.
4a). Finally, to further demonstrate that a defect
in lytic gene expression was responsible for decreased VEGF
secretion, we examined supernatants from Z-KO LCLs stably expressing
BZLF1 in
trans (under the control of its natural promoter) (
26).
As demonstrated in Fig.
4b, Z-KO LCLs carrying the BZLF1 expression
vector (Z-KO-ZpZ) secreted higher levels of VEGF than the corresponding
Z-KO LCLs carrying the control vector (Z-KO-vector), again suggesting
that lytic infection contributes to the release of VEGF.
Lytic infection does not regulate VEGF at the level of transcription.
VEGF expression is intricately regulated through both transcriptional
and posttranscriptional mechanisms (
46). For example, in response
to certain stimuli, the cell may upregulate transcription of
VEGF, increase stability of the VEGF mRNA, or enhance translational
initiation of VEGF transcripts. To determine if the increased
secretion of VEGF observed in WT LCLs is due to an upregulation
of VEGF transcription, we analyzed VEGF transcript levels using
semiquantitative RT-PCR. WT, Z-KO, and R-KO LCLs all expressed
similar levels of the various VEGF transcripts (Fig.
5a), suggesting
that increased secretion of VEGF in WT LCLs was not due to enhanced
VEGF transcription. Furthermore, although reintroduction of
BZLF1 expression in the Z-KO LCLs resulted in increased secretion
of VEGF, no increase in the level of VEGF transcripts was observed
in Z-KO LCLs carrying a BZLF1 expression vector (Fig.
5b), again
suggesting that lytic infection enhances VEGF expression/secretion
via a posttranscriptional mechanism.
Lytic-defective and WT LCLs have similar amounts of intracellular VEGF protein.
Immunoblot analysis was performed on cellular extracts to determine
if WT LCLs also have a higher level of intracellular VEGF protein
than the lytic-defective LCLs. As shown in Fig.
6a the amount
of intracellular VEGF protein was similar in the WT LCLs and
the Z-KO and R-KO LCLs. Furthermore, restoration of BZLF1 expression
in the Z-KO LCLs did not increase the amount of intracellular
VEGF (Fig.
6b). Since the total level (intracellular plus extracellular)
of VEGF is clearly greater in the WT versus lytic-defective
cells, while the amount of intracellular VEGF is similar, these
results suggest that lytic infection not only increases the
total amount of VEGF but also enhances its secretion.

DISCUSSION
EBV is strongly associated with several malignancies of both
B-cell and epithelial origin, and the presence of the virus
is believed to contribute to the growth of tumors in vivo (
52).
Although the majority of cells within an EBV-associated malignancy
are latently infected, small subsets of lytically infected cells
are frequently detected in several different malignancies (
11,
40,
42,
70). A role for lytic infection in malignancy was recently
demonstrated by our finding that early-passage LCLs infected
with lytic-defective viruses (Z-KO and R-KO LCLs) were impaired
for growth in SCID mice (
26). Furthermore, Z-KO and R-KO LCLs
secreted lower levels of important paracrine B-cell growth factors
in vitro, suggesting that lytic infection may contribute to
the formation of EBV-associated lymphomas via release of paracrine
factors (
26).
In this paper we demonstrate that lytic infection in early-passage LCLs also induces angiogenesis, suggesting another potential mechanism by which lytic infection may contribute to malignancy. Supernatants from WT LCLs were more angiogenic than supernatants from Z-KO LCLs, and this effect was not dependent on the donor origin of the LCLs. Introduction of a BZLF1 expression vector into Z-KO LCLs, which restores the capacity of Z-KO LCLs to enter lytic cycle (26), enhanced the angiogenic activity of Z-KO LCL supernatants, confirming that lytic infection in LCLs contributes to release of angiogenesis factors. As growth of LCL tumors in SCID mice is characterized by abundant angiogenesis (69) and angiogenesis inhibitors prevent growth of lymphoma cells in mice (48), the impaired capacity of Z-KO LCLs to secrete angiogenesis factors may contribute to their impaired growth in SCID mice.
Despite the readily apparent in vitro angiogenesis defect of the Z-KO LCLs, we were not able to detect a striking difference in angiogenesis of WT or Z-KO LCLs tumors in vivo. However, it should be noted that tumors were harvested once they had reached a certain size, and since the Z-KO LCLs grow at a significantly slower rate than WT LCLs in mice (26), the Z-KO LCL tumors were harvested at a later time point than the corresponding WT LCL tumors. Hence, by the time the Z-KO LCL tumors reach harvest size (
4 mm in diameter), they might have already overcome an initial angiogenesis defect (e.g., via genetic or epigenetic changes) that hinders growth during the early stages of tumorigenesis. Indeed, as angiogenesis is required after a cell is located >100 µm from an existing vessel (8), it seems likely that Z-KO LCL tumors would have likely overcome any angiogenesis defect in order to reach a size of 4 mm. Surprisingly, both Z-KO and WT LCL tumors exhibited human CD31 staining of the tumor vasculature, suggesting that at least a portion of the tumor vasculature is derived from human LCLs as opposed to mouse endothelial cells. A recent report indicates that the vascular cells within different human B-cell lymphomas share the same specific cytogenetic aberrations as the lymphoma cells, suggesting that the tumor vasculature can be directly derived from the lymphoma cells themselves (61). Interestingly, as lymphoma cells are known to express various degrees of CD31 (59) and hypoxia can regulate differentiation of malignant cells (23, 29), the possibility exists that LCLs could switch to an endothelial cell phenotype in vivo under conditions where angiogenesis is needed.
VEGF represents the most potent angiogenic factor characterized to date and is frequently expressed by human B-cell lymphoma cells in vitro and in vivo (19, 20, 24, 64). Both Z-KO and R-KO LCLs secreted substantially lower levels of VEGF than WT LCLs in vitro, suggesting that lytic infection induces VEGF secretion. Furthermore, introduction of a BZLF1 expression vector into Z-KO LCLs enhanced secretion of VEGF. As angiogenesis is a key requirement for lymphoma growth, the impaired growth of Z-KO LCL tumors may be partly a consequence of decreased angiogenesis due to insufficient VEGF secretion. Decreased secretion of VEGF may also directly inhibit the growth of Z-KO LCLs in vivo, as VEGF can function as an autocrine growth factor for lymphoma cells (65). It should also be noted that VEGF stimulation of tumor stromal cells may result in secretion of IL-6 (12), a potent B-cell growth factor that enhances LCL growth in vivo (13, 62).
In addition to its potential effects during malignancy, lytic-induced VEGF secretion may also influence viral pathogenesis during normal infection. VEGF can functionally inhibit dendritic cell maturation (21), and thus induction of VEGF secretion may assist the virus in lessening the host response during lytic infection. VEGF also possesses antiapoptotic effects (20, 22, 32, 35, 36, 44, 45, 65) and may prolong survival of the host cell during lytic infection. Finally, secretion of VEGF can recruit monocytes (10), a cell type capable of being infected with EBV that has been proposed to serve as a vehicle for viral dissemination (55, 56).
The regulation of VEGF is complex and involves both transcriptional and posttranscriptional mechanisms (46). WT, Z-KO, and R-KO LCLs expressed similar levels of VEGF transcripts, suggesting that the decreased VEGF secretion in lytic-defective LCLs is due to a difference in posttranscriptional regulation. Translation of VEGF mRNA is regulated in a cap-dependent manner by eIF-4E (34), an initiation factor that is activated by stress kinase signaling (51, 67, 68). Interestingly, both the BZLF1 and BRLF1 gene products activate stress kinases (1), suggesting a possible mechanism for enhanced VEGF translation during the lytic viral cycle. VEGF translation is also regulated in a cap-independent manner via two internal ribosome entry site elements present in the 5' untranslated region of VEGF transcripts (2, 27, 60). Similar to eIF-4E-mediated translation, internal ribosome entry site-mediated translation of some genes can also be positively regulated by stress kinases (57), suggesting yet another mechanism for lytic infection to increase VEGF translation. Our results also suggest the possibility that lytic EBV infection enhances the secretion of VEGF, as the level of extracellular VEGF was clearly increased to a greater degree than the amount of intracellular VEGF in lytically infected LCLs.
It is also possible that angiogenesis factors in addition to VEGF contribute to the increased angiogenicity of the WT LCL supernatants. Although VEGF is the most potent and well-characterized angiogenesis factor to date, many other positive regulators of angiogenesis are known, and the possibility exists that lytic infection induces additional positive regulators of angiogenesis. It should also be noted that EBV has the capacity to infect and replicate within endothelial cells in vitro (31); furthermore, binding of the EBV virion to endothelial cells induces secretion of IL-6 (31), another positive regulator of angiogenesis. Hence, it is possible that lytic infection also contributes to angiogenesis by direct interaction with or infection of endothelial cells by EBV virions.
The angiogenesis studies presented in this paper were all performed using LCLs. LCLs represent a suitable model for EBV-associated PTLD, as injection of LCLs into SCID mice results in lymphomas similar to PTLD in regard to viral gene expression and histology (52, 54). Whether or not lytic infection contributes to angiogenesis in other types or models of EBV malignancy is currently unknown. Latent infection has been proposed to contribute to NPC angiogenesis via LMP1-mediated secretion of the angiogenesis factors VEGF, IL-8, and matrix metalloproteinases (MMPs) (38, 43, 72). Since up to 65% of NPC biopsies exhibit no evidence of LMP1 protein expression (52), lytic infection may be important for the induction of angiogenesis in the absence of LMP1. Indeed, BZLF1 can induce the angiogenesis factors MMP-1/MMP-9 in NPC cells (38, 73) as well as transforming growth factor ß(9) in other epithelial cell lines. BL, another EBV-associated B-cell malignancy, frequently exhibits small subsets of lytically infected cells (70) and is dependent on angiogenesis for successful tumor growth in mouse models (48, 49). As BL does not express LMP1, lytic infection may be important for angiogenesis and successful tumor growth in this context.
In conclusion, we demonstrate an unexpected and novel contribution of lytic EBV infection in angiogenesis. In the future it will be important to determine which lytic EBV protein(s) contributes to VEGF induction and the precise mechanism for this posttranscriptional effect. Our demonstration that lytic infection in LCLs contributes to VEGF release has important implications not only for angiogenesis in EBV-associated tumors but also for understanding viral pathogenesis during normal infection.

ACKNOWLEDGMENTS
This work was supported by Public Health Service grants P01-CA19014,
R01-CA66519, and R01-CA58853 (to S.C.K.) and RO1-CA096500 (to
B.D.) from the National Cancer Institute.

FOOTNOTES
* Corresponding author. Mailing address: 22-038 Lineberger Comprehensive Cancer Center, CB #7295, University of North Carolina, Chapel Hill, Chapel Hill, NC 27599. Phone: (919) 966-1248. Fax: (919) 966-8212. E-mail:
shann{at}med.unc.edu.


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Journal of Virology, November 2005, p. 13984-13992, Vol. 79, No. 22
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