In addition to the possibility that even extremely low levels of LMP1 expression can facilitate the transformation of NPC cells, it is plausible that EBV may temporally modulate the expression of LMP1 at different stages of NPC pathogenesis: with elevated levels during early stage disease to facilitate host cell malignant transformation, and subsequently downregulating LMP1 expression in late stage disease to avoid eliciting the host immune response. This evidence concerns the gene PDLIM7 and nasopharyngeal carcinoma.