Paula D. Alves

Dr. Paula D. Alves

Brazilian National Cancer Institute, Rio de Janeiro, Brazil
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Academic Career Length

9Years (2018-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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12 August 2022 in Viruses
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PAPaula D. Alves
Paula D. Alves
MLMarcella Larrate
Marcella Larrate
AGAruanã Garcia-Costa
Aruanã Garcia-Costa
PRPaulo Rohan
Paulo Rohan
BGBianca Ervatti Gama
Bianca Ervatti Gama
RHRocio Hassan
Rocio Hassan
Epstein–Barr virus (EBV) is a saliva-borne ɣ-herpesvirus associated with benign and malignant lymphoproliferation. EBV-mediated tumorigenic mechanisms are not fully understood and may be related to viral genetic variations. In this work, we characterize the genetic diversity of EBV from Brazil, assessing 82 samples derived from saliva from asymptomatic carriers (n = 45), biopsies of benign reactive hyperplasia (n = 4), and lymphomas (n = 33). Phylogenetic and phylogeographic analysis of the entire coding region of the LMP-1 was performed. Additionally, type 1/type 2 distinction by the EBNA3C gene and Zp variants were evaluated. Our results revealed a high diversity of EBV in Brazil, with the co-circulation of four main clades, described here as: Mediterranean (40.2%, n = 33), Raji/Argentine (39%, n = 32), B95-8 (6.1%, n = 5), and Asian II (1.2%, n = 1). The Raji/Argentine and Mediterranean clades were the most prevalent in South America (45% and 28%, respectively). The Raji/Argentine clade was associated with polymorphisms I124V/I152L, del30 bp, and ins15 bp (p < 0.0001, to all clades) and with a high haplotype diversity related to EBV type and Zp variants. We found that a Raji/Argentine subclade spread primarily from Brazil and later to other South American countries. Although no LMP1 variant has been directly associated with disease, the Raji/Argentine clade was predominantly clustered with lymphomas (61%) and the Mediterranean clade with non-malignant cases (59%) (p = 0.1). These data highlight the high genetic diversity of EBV circulating in Brazil, calling attention to a Raji-related variant with great recombination potential in Brazilian lymphomas.

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PAPaula D. Alves
Paula D. Alves
PRPaulo Rohan
Paulo Rohan
RHRocio Hassan
Rocio Hassan
EAEliana Saul Furquim Werneck Abdelhay
Eliana Saul Furquim Werneck Abdelhay
Epstein–Barr virus (EBV) is a ubiquitous gammaherpesvirus etiologically associated with benign and malignant diseases. Since the pathogenic mechanisms of EBV are not fully understood, understanding EBV genetic diversity is an ongoing goal. Therefore, the present work describes the genetic diversity of the lytic gene BZLF1 in a sampling of 70 EBV-positive cases from southeastern Brazil. Additionally, together with the genetic regions previously characterized, the aim of the present study was to determine the impact of viral genetic factors that may influence EBV genetic diversity. Accordingly, the phylogenetic analysis of the BZLF1 indicated two main clades with high support, BZ-A and BZ-B (PP > 0.85). Thus, the BZ-A clade was the most diverse clade associated with the main polymorphisms investigated, including the haplotype Type 1 + V3 (p < 0.001). Furthermore, the multigene phylogenetic analysis (MLA) between BZLF1 and the oncogene LMP1 showed specific clusters, revealing haplotypic segregation that previous single-gene phylogenies from both genes failed to demonstrate. Surprisingly, the LMP1 Raji-related variant clusters were shown to be more diverse, associated with BZ-A/B and the Type 2/1 + V3 haplotypes. Finally, due to the high haplotypic diversity of the Raji-related variants, the number of DNA recombination-inducing motifs (DRIMs) was evaluated within the different clusters defined by the MLA. Similarly, the haplotype BZ-A + Raji was shown to harbor a greater number of DRIMs (p < 0.001). These results call attention to the high haplotype diversity of EBV in southeast Brazil and strengthen the hypothesis of the recombinant potential of South American Raji-related variants via the LMP1 oncogene.

9 May 2018 in British Journal of Haematology
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GLGabriela Vera Lozada
Gabriela Vera Lozada
MBMário H. M. Barros
Mário H. M. Barros
PAPaula D. Alves
Paula D. Alves
PSPriscilla Segges
Priscilla Segges
Marcelo Gerardin Poirot LandMarcelo Gerardin Poirot Land
Marcelo Gerardin Poirot Land
RHRocio Hassan
Rocio Hassan

1 January 2023 in Memórias do Instituto Oswaldo Cruz
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PAPaula D. Alves
Paula D. Alves
VEVanessa Emmel
Vanessa Emmel
GSGustavo Stefanoff
Gustavo Stefanoff
FKFlavia Krsticevic
Flavia Krsticevic
JEJoaquín Ezpeleta
Joaquín Ezpeleta
RHRocio Hassan
Rocio Hassan
Epstein-Barr virus (EBV), also known as human gammaherpesvirus 4 (or HHV-4), is ubiquitous and causally associated with benign and malignant diseases.1 1. Farrell PJ. Epstein-Barr virus and Cancer. Annu Rev Pathol. 2019; 14: 29-53. EBV-associated neoplasms have an unusual distribution, which may depend on ethnographic and genetic factors of the host and the virus.2 2. Barros MHM, Hassan R, Niedobitek G. Disease patterns in pediatric classical Hodgkin lymphoma: a report from a developing area in Brazil. Hematol Oncol. 2011; 29(4): 190-5. ,3 3. Jarrett RF, Stark GL, White J, Angus B, Alexander FE, Krajewski AS, et al. Impact of tumor Epstein-Barr virus status on presenting features and outcome in age-defined subgroups of patients with classic Hodgkin lymphoma: a population-based study. Blood. 2005; 106(7): 2444-51. ,4 4. Niens M, Jarrett RF, Hepkema B, Nolte IM, Diepstra A, Platteel M, et al. HLA-A*02 is associated with a reduced risk and HLA-A*01 with an increased risk of developing EBV+ Hodgkin lymphoma. Blood. 2007; 110(9): 3310-5. ,5 5. Chabay P, Lens D, Hassan R, Pinilla SMR, Gamboa FV, Rivera I, et al. Lymphotropic viruses EBV, KSHV and HTLV in Latin America: epidemiology and associated malignancies. A literature-based study by the RIAL-CYTED. Cancers. 2020; 12(8): 2166. Understanding EBV-mediated oncogenesis is an ongoing goal, and attention has been focused on EBV genomic diversity under the hypothesis that genetic polymorphisms may affect cell transformation properties.6 6. Tzellos S, Farrell P. Epstein-Barr virus sequence variation - Biology and Disease. Pathogens. 2012; 1(2): 156-74. ,7 7. Farrell PJ, White RE. Do Epstein-Barr virus mutations and natural genome sequence variations contribute to disease? Biomolecules. 2021; 12(1): 17. EBV virions have a linear double-stranded DNA genome of approximately 170 kilobase pairs and harbour more than 90 open reading frames and 46 functional small untranslated RNAs, which act concordantly during the latent and lytic cycles.1 1. Farrell PJ. Epstein-Barr virus and Cancer. Annu Rev Pathol. 2019; 14: 29-53. EBV diversity is mainly based on differences in the EBNA latent gene family, dividing EBV into two major types: EBV types 1 and 2.6 6. Tzellos S, Farrell P. Epstein-Barr virus sequence variation - Biology and Disease. Pathogens. 2012; 1(2): 156-74. Although EBV types are not associated with diseases per se, the haplotypic association of type 1 and V3 variants has previously been related to several EBV-associated malignancies.8 8. Bristol JA, Djavadian R, Albright ER, Coleman CB, Ohashi M, Hayes M, et al. A cancer-associated Epstein-Barr virus BZLF1 promoter variant enhances lytic infection. PLoS Pathog. 2018; 14(7): e1007179. V3 polymorphisms in the promoter zone (Zp) of the transactivator BZLF1 lytic gene are responsible for switching from a latent to lytic EBV cycle. More recently, the set of polymorphisms type 1 + V3 were associated to functional gain through the enhance lytic replication.8 8. Bristol JA, Djavadian R, Albright ER, Coleman CB, Ohashi M, Hayes M, et al. A cancer-associated Epstein-Barr virus BZLF1 promoter variant enhances lytic infection. PLoS Pathog. 2018; 14(7): e1007179. Despite this important role of the Zp promoter variation, its gene BZLF1, has shown to present a low nucleotide variation when compared to latent genes, but despite that, its variants seem to have a probable linkage disequilibrium with its Zp promoter with the EBNA3C gene, due to its proximity in the genome.9 9. Correia S, Palser A, Karstegl CE, Middeldorp JM, Ramayanti O, Cohen JI, et al. Natural variation of Epstein-Barr virus genes, proteins, and primary MicroRNA. J Virol. 2017; 91(15): e00375-17. Due to an extensive and heterogeneous genome and the fact that latent persistence occurs in general at low burden,1 1. Farrell PJ. Epstein-Barr virus and Cancer. Annu Rev Pathol. 2019; 14: 29-53. few EBV genomes were known until recently.10 10. Kanda T, Yajima M, Ikuta K. Epstein-Barr virus strain variation and cancer. Cancer Sci. 2019; 110(4): 1132-9. Hence, attention has been focused on the diversity of subgenomic regions to discern viral factors that are geographically restricted from those associated with specific tumorigenic processes.10 10. Kanda T, Yajima M, Ikuta K. Epstein-Barr virus strain variation and cancer. Cancer Sci. 2019; 110(4): 1132-9. 11. Miller WE, Edwards RH, Walling DM, Raab-Traub N. Sequence variation in the Epstein-Barr virus latent membrane protein 1. J Gen Virol. 1994; 75(10): 2729-40. 12. Edwards RH, Seillier-Moiseiwitsch F, Raab-Traub N. Signature amino acid changes in latent membrane protein 1 distinguish Epstein-Barr virus strains. Virology. 1999; 261(1): 79-95. 13. Lorenzetti MA, Gantuz M, Altcheh J, De Matteo E, Chabay PA, Preciado MV. Distinctive Epstein-Barr virus variants associated with benign and malignant pediatric pathologies: LMP1 sequence characterization and linkage with other viral gene polymorphisms. J Clin Microbiol. 2012; 50(3): 609-18. 14. Lorenzetti MA, Gantuz M, Altcheh J, De Matteo E, Chabay PA, Preciado MV. Epstein-Barr virus BZLF1 gene polymorphisms: malignancy related or geographically distributed variants? Clin Microbiol Infect. 2014; 20(11): O861-9. 15. Lei H, Li T, Li B, Tsai S, Biggar RJ, Nkrumah F, et al. Epstein-Barr virus from Burkitt lymphoma biopsies from Africa and South America share novel LMP-1 promoter and gene variations. Sci Rep. 2015; 5(1): 16706. 16. Gantuz M, Lorenzetti MA, Chabay PA, Preciado MV. A novel recombinant variant of latent membrane protein 1 from Epstein-Barr virus in Argentina denotes phylogeographical association. PLoS One. 2017; 12(3): e0174221. 17. Telford M, Hughes DA, Juan D, Stoneking M, Navarro A, Santpere G. Expanding the geographic characterisation of Epstein-Barr virus variation through gene-based approaches. Microorganisms. 2020; 8(11): 1686. 18. Alves P, Larrate M, Garcia-Costa A, Rohan P, Gama BE, Abdelhay E, et al. Spatial dispersal of Epstein-Barr virus in South America reveals an African American variant in Brazilian lymphomas. Viruses. 2022; 14(8): 1762. 19. Liao HM, Liu H, Chin PJ, Li B, Hung GC, Tsai S, et al. Epstein-Barr virus in Burkitt lymphoma in Africa reveals a limited set of whole genome and LMP-1 sequence patterns: analysis of archival datasets and field samples from Uganda, Tanzania, and Kenya. Front Oncol. 2022; 12: 812224. 20. Hu LF, Zabarovsky ER, Chen F, Cao SL, Ernberg I, Klein G, et al. Isolation and sequencing of the Epstein-Barr virus BNLF-1 gene (LMP1) from a Chinese nasopharyngeal carcinoma. J Gen Virol. 1991; 72(10): 2399-409. 21. Walling DM, Shebib N, Weaver SC, Nichols CM, Flaitz CM, Webster-Cyriaque J. The molecular epidemiology and evolution of Epstein-Barr virus: sequence variation and genetic recombination in the latent membrane protein-1 gene. J Infect Dis. 1999; 179(4): 763-74. -22 22. Guiretti DM, Chabay PA, Valva P, Stefanoff CG, Barros MHM, De Matteo E, et al. Structural variability of the carboxy-terminus of Epstein-Barr virus encoded latent membrane protein 1 gene in Hodgkin's lymphomas. J Med Virol. 2007; 79(11): 1730-22. doi: 10.1002/jmv.21020. https://doi.org/10.1002/jmv.21020... Diverse latent genes demonstrated to be expressed mainly in tumours,23 23. Young LS, Rickinson AB. Epstein-Barr virus: 40 years on. Nat Rev Cancer. 2004; 4(10): 757-68. ,24 24. Chabay PA, Barros MHM, Hassan R, De Matteo E, Rey G, Carrico MK, et al. Pediatric Hodgkin lymphoma in 2 South American series: a distinctive epidemiologic pattern and lack of association of Epstein-Barr virus with clinical outcome. J Pediatr Hematol Oncol. 2008; 30(4):285-91. ,25 25. Hadhri-Guiga B, Khabir AM, Mokdad-Gargouri R, Ghorbel AM, Drira M, Daoud J, et al. Various 30 and 69bp deletion variants of the Epstein-Barr virus LMP1 may arise by homologous recombination in nasopharyngeal carcinoma of Tunisian patients. Virus Res. 2006; 115(1): 24-30. ,26 26. Palser AL, Grayson NE, White RE, Corton C, Correia S, Ba abdullah MM, et al. Genome diversity of Epstein-Barr virus from multiple tumor types and normal infection. J Virol. 2015; 89(10): 5222-37. later, it was demonstrated that these genes have an increased number of polymorphisms compared to lytic genes.26 26. Palser AL, Grayson NE, White RE, Corton C, Correia S, Ba abdullah MM, et al. Genome diversity of Epstein-Barr virus from multiple tumor types and normal infection. J Virol. 2015; 89(10): 5222-37. From the latent genes, some EBNA family genes had a greater ratio of nonsynonymous to synonymous codon changes, which led to suggesting that they are evolving under positive selection.26 26. Palser AL, Grayson NE, White RE, Corton C, Correia S, Ba abdullah MM, et al. Genome diversity of Epstein-Barr virus from multiple tumor types and normal infection. J Virol. 2015; 89(10): 5222-37. EBNA-1 is a 641 amino acid protein, which is essential for replication and persistence of EBV genome in latently infected memory B cells.27 27. Gutiérrez MI, Spangler G, Raj A, Magrath IT, Judde JG, Bhatia K, et al. Sequence variations in EBNA-1 may dictate restriction of tissue distribution of Epstein-Barr virus in normal and tumour cells. J Gen Virol. 1997; 78(7): 1663-70. Several studies of genetic variation of EBNA1 demonstrated evidence for a geographic restriction rather than disease association, in addition to show that geographic areas may have different EBNA-1 variants within their host population.26 26. Palser AL, Grayson NE, White RE, Corton C, Correia S, Ba abdullah MM, et al. Genome diversity of Epstein-Barr virus from multiple tumor types and normal infection. J Virol. 2015; 89(10): 5222-37. ,27 27. Gutiérrez MI, Spangler G, Raj A, Magrath IT, Judde JG, Bhatia K, et al. Sequence variations in EBNA-1 may dictate restriction of tissue distribution of Epstein-Barr virus in normal and tumour cells. J Gen Virol. 1997; 78(7): 1663-70.