I don't have any idea, but that's a really great question. Another question is, if there are pathogens, are they there in a diseased body as scavengers, or are they the cause of disease?
Maybe both, but we must have concrete targets (causes or risk factors) for prevention and therapy!
Several epidemiological studies pointed towards a viral etiology of Hodgkins lymphoma.
Thanks Ahraf, but I think that the specific infectiona (TBC, toxoplasmosis, Epstein-Barr) are also so frequent!
Please note that EBV typically targets lymphocytes and all organs affected by EBV
Ok. But I point out that is necessery the bacteriological, virological and protozoical examination of Lymphnodes and in serum of patients, not only "the old fashion" pathohystological examination!
Hodgkin disease is a type of cancer, better saying neoplasm. As for most of neoplasms, the cause - again, better saying the trigger - is not known. Even speaking about viral associated cancers (such as HPV/cervical cancer; HHV-8/Kaposi sarcoma; HTLV-I/ATL, HBV/HCC, etc.), the viral etiology is "nearly" a 100% finding. Of note, not in all cases or always these viruses lead to malignancy in any individual, in other words, a (chronic) infection is necessary but not sufficient.
The presence of a virus or other intra-cellular microorganism can be a trigger of HLs, because in Hodgkin's disease there is classically a "defect" in cell-mediated immunity which is primarily activated by intra-cellular infectious agents.
For example, it's known that in order to survive in a host organism, T. gondii can induce apoptosis of immune cells (monocytes), initiated from surface receptors and from within the cell. T. gondii suppresses Bak and Bax, and prevents activation of Bax through BimS mechanism, thus regulating the apoptotic processes which may be the first step in the detrimental processes resulting in cell proliferation in HLs. However, I see T. gondii as a risk factor rather than an etiological agent.
Never heard about HL triggered by Koch bacillus, but it's true that there are reported cases of concomitant HL and TB, simultaneous occurrence of both, TB hiding non-HL or mimicking HL.
Very well said, as chemotherapy doesn't cure viral, bacterial or protozoan infections, microbiological investigations of lymphnodes should be considered in the overall approach of some lymphoma types. Overcoming the old fashion in everything is a difficult job for many, isn't it.
Thank You fot Your very brigt answer. I do not agrre with simple classification in medicine today on two type of "diseases" - malignancy and non-malignancy(!?)..., without etiological investigations. I agree with Your constatation :
"...Very well said, as chemotherapy doesn't cure viral, bacterial or protozoan infections, microbiological investigations of lymphnodes should be considered in the overall approach of some lymphoma types. Overcoming the old fashion in everything is a difficult job for many, isn't it..."
The pathohystology is old fashion (Virchov's medicine, end of XIX and beginn of XX cent.) before Koch's time and possibilities for etiological diagnostic (bacteriological, virological, protozoical, endocrine, metabolic, ect.). In last five years i have 3 patients with sc "Hodgin's dieseas" which in bacetriological examination of lynphnodes was TCS, and 1 patient with Toxoplasma gondii.... It was a very hard mission to send the lymphnodes from pathohystology to bacteriology!
How many sc "Hodgkin's diseases" have bacterial, viral and protozoal etiology (TBC, Toxoplasmosis, ect)? - ResearchGate. Available from: https://www.researchgate.net/post/How_many_sc_Hodgkins_diseases_have_bacterial_viral_and_protozoal_etiology_TBC_Toxoplasmosis_ect#58c00f2696b7e464da65cd26 [accessed Mar 9, 2017].
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