The etiological relation of Epstein-Barr virus to human uveitis

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In order to investigate the etiological relationship of Epstein-Barr virus (EBV) to human uveitis, measurement of EBV antibody levels and detection of EBV DNA by the polymerase chain reaction (PCR) method was performed on various samples from patients with uveitis of unknown etiology. Our results showed that first, among cases of acute anterior uveitis, conventionally regarded to be strongly associated with HLA-B27, EBV antibody levels (VCA IgM) were elevated. However, these cases were all negative for HLA B27, and thus may represent a newly recognized type of uveitis. Second, EBV antibody levels and peripheral EBV-infected lymphocytes were found to be elevated in certain cases of RPE disease, suggesting a relationship with EBV. Third, the presence of EBV DNA and EBV antibody was found in the cerebrospinal fluid of patients with Harada's disease. A high amino acid correlation is reported in the literature between the third hypervariable region of the HLA-DR antigen, that is highly associated with Harada's disease, and gp110, the nucleocapsid glycoprotein present in the nucleus and cytoplasm of cells infected with reproducing EBV. We found that lymphocytes from patients with acute Harada's disease display proliferation responses to peptides incorporating this common amino acid sequence, thus lending support to a specific association between EBV and patients with Harada's disease. Lastly, we looked for expression of the EBV receptor in intraocular tissues from normal autopsy eyes with immunohistological stains and western blotting using OKB7,a monoclonal antibody that recognizes part of the EBV receptor. EBV receptor expression was found to be present in the RPE and parts of the ciliary body, therefore indicating the possibility of direct intraocular infection by EBV.