Association between clinical disease activity and Epstein-Barr virus reactivation in MS
Association between clinical disease activity and Epstein-Barr virus reactivation in MS
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DOI：
10.1212/wnl.55.2.178
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发表时间：
2000-07-25
期刊：
影响因子：
9.9
通讯作者：
Hennig, H
中科院分区：
文献类型：
--
作者：
Wandinger, KP;Jabs, W;Hennig, H
目的：探讨EB病毒（EBV）再激活在多发性硬化（MS）患者疾病活动中的潜在意义。研究方法：在一组108例MS患者和163例健康对照受试者中测定了单纯疱疹病毒1型（HSV-1）、HSV-2、EBV和巨细胞病毒抗体的患病率。使用采用高度纯化的病毒和重组抗原的新型测定系统的组合来分析血清。此外，在系列样品中进行用于检测EBV DNA的PCR。结果：与对照人群相比，100%的MS患者存在抗EBV抗体。在测试的人类疱疹病毒中，仅发现EBV的这种高程度的血清阳性。原发性感染仅见于对照组（3.7%），而EBV再激活的血清学证据见于MS患者（13.9%）和对照组（17.2%）。在MS患者中EBV再激活和疾病活动之间没有时间上的一致性。然而，在19例每月随访1年的患者中，通过对EBV早期抗原（p54 +/- p138）的免疫球蛋白（IG）M和伊加应答增加和血清DNA阳性测量，在研究期间72.7%的急性加重患者中观察到活跃的病毒复制，而在临床稳定疾病的患者中没有观察到病毒复制。结论：结果表明，随着时间的推移，MS患者的EBV再激活和疾病活动之间存在关联，并表明EBV可能在MS中作为潜在疾病过程的激活剂发挥间接作用。
Objective: To assess the potential significance of Epstein-Barr virus (EBV) reactivation in disease activity in MS patients. Methods: The prevalence of antibodies against herpes simplex virus type 1 (HSV-1), HSV-2, EBV, and cytomegalovirus was determined in a group of 108 MS patients and in 163 healthy control subjects. Sera were analyzed using combinations of novel assay systems employing highly purified viral and recombinant antigens. In addition, PCR for the detection of EBV DNA was performed in serial samples. Results: In contrast to the control populations, antibodies against EBV were present in 100% of MS patients. Among the tested human herpesviruses, this high extent of seropositivity was only found for EBV. Primary infection was found exclusively in the control group (3.7%), whereas serologic evidence of EBV reactivation was seen in MS patients (13.9%) as well as control subjects (17.2%). There was no temporal coincidence between EBV reactivation and disease activity in MS patients. However, in 19 patients followed monthly for 1 year, active viral replication as measured by increased immunoglobulin (Ig) M and IgA responses to EBV early antigens (p54 +/- p138) and positive serum DNA was seen in 72.7% of patients with exacerbations during the study period and in none of the patients with clinically stable disease. Conclusions: The results demonstrate an association between EBV reactivation and disease activity in MS patients over time, and suggest that EBV might play an indirect role in MS as an activator of the underlying disease process.