{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:07:32Z","timestamp":1790665652335,"version":"4.1.0"},"reference-count":50,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"SATT Linksium"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>The ZEBRA (Z EBV replication activator) protein is the major transcription factor of EBV, expressed upon EBV lytic cycle activation. An increasing body of studies have highlighted the critical role of EBV lytic infection as a risk factor for lymphoproliferative disorders, such as post-transplant lymphoproliferative disease (PTLD). We studied 108 transplanted patients (17 PTLD and 91 controls), retrospectively selected from different hospitals in France and in the Netherlands. The majority of PTLD were EBV-positive diffuse large B-cell lymphomas, five patients experienced atypical PTLD forms (EBV-negative lymphomas, Hodgkin\u2019s lymphomas, and T-cell lymphomas). Fourteen patients among the seventeen who developed a pathologically confirmed PTLD were sZEBRA positive (soluble ZEBRA, plasma level above 20 ng\/mL, measured by an ELISA test). The specificity and positive predictive value (PPV) of the sZEBRA detection in plasma were 98% and 85%, respectively. Considering a positivity threshold of 20 ng\/mL, the sensitivity of the sZEBRA was 82.35% and the specificity was 94.51%. The mean of the sZEBRA values in the PTLD cases were significantly higher than in the controls (p &lt; 0.0001). The relevance of the lytic cycle and, particularly, the role of ZEBRA in lymphomagenesis is a new paradigm pertaining to the prevention and treatment strategies for PTLD. Given the high-specificity and the predictive values of this test, it now appears relevant to investigate the lytic EBV infection in transplanted patients as a prognostic biomarker.<\/jats:p>","DOI":"10.3390\/pathogens11080928","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T22:53:30Z","timestamp":1660776810000},"page":"928","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["High Predictive Value of the Soluble ZEBRA Antigen (Epstein-Barr Virus Trans-Activator Zta) in Transplant Patients with PTLD"],"prefix":"10.3390","volume":"11","author":[{"given":"Julien","family":"Lupo","sequence":"first","affiliation":[{"name":"Institut de Biologie Structurale, Universit\u00e9 Grenoble-Alpes, 38000 Grenoble, France"},{"name":"Laboratoire de Virologie, Institut de Biologie-Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Wielandts","sequence":"additional","affiliation":[{"name":"Laboratoire de Virologie, Institut de Biologie-Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlyse","family":"Buisson","sequence":"additional","affiliation":[{"name":"Institut de Biologie Structurale, Universit\u00e9 Grenoble-Alpes, 38000 Grenoble, France"},{"name":"Laboratoire de Virologie, Institut de Biologie-Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CRYOSTEM","family":"Consortium","sequence":"additional","affiliation":[{"name":"CRYOSTEM Consortium: Marseille Innovation\u2014H\u00f4tel Technologique, 13382 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Habib","sequence":"additional","affiliation":[{"name":"Laboratoire de Virologie, Institut de Biologie-Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan","family":"Hamoudi","sequence":"additional","affiliation":[{"name":"Institut de Biologie Structurale, Universit\u00e9 Grenoble-Alpes, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Morand","sequence":"additional","affiliation":[{"name":"Institut de Biologie Structurale, Universit\u00e9 Grenoble-Alpes, 38000 Grenoble, France"},{"name":"Laboratoire de Virologie, Institut de Biologie-Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans","family":"Verduyn-Lunel","sequence":"additional","affiliation":[{"name":"Department of Microbiology, UMC Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Caillard","sequence":"additional","affiliation":[{"name":"D\u00e9partement de N\u00e9phrologie et de Transplantation Centre, Hospitalier Universitaire de Strasbourg, 67091 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Drouet","sequence":"additional","affiliation":[{"name":"Institut de Biologie Structurale, Universit\u00e9 Grenoble-Alpes, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,17]]},"reference":[{"key":"ref_1","unstructured":"Knipe, D.M., and Howley, P.M. 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