Epstein-Barr virus persistence and reactivation in neuromyelitis optica

J Neurol Neurosurg Psychiatry. 2015 Oct;86(10):1137-42. doi: 10.1136/jnnp-2014-308095. Epub 2014 Nov 28.

Abstract

Objective: Epstein-Barr virus (EBV) infection has been thought to be a key environmental factor in the development of multiple sclerosis (MS). The aim of this study is to investigate the association of EBV infection with neuromyelitis optica (NMO).

Methods: We measured levels of serum antibodies against EBV antigens, including anti-viral capsid antigen (VCA) IgM, anti-VCA IgG, anti-early antigen (EA) IgM, anti-EA IgG and anti-EBV nuclear antigen-1 IgG, in 50 patients with NMO (including 12 partial form with antiaquaporin 4 antibodies), 51 patients with MS, and 52 healthy controls, and cerebrospinal fluid (CSF) antibodies in 37 patients with NMO and 33 patients with MS with ELISA.

Result: Compared with patients with MS and normal participants, patients with NMO more frequently had serum anti-EA IgG antibodies (52%), indicating more active viral replication than patients with MS (26%) and controls (25%). The antibody titres were significantly higher in the NMO group than in the MS (p=0.005) and control (p=0.005) groups. The CSF antibody titres were also higher in patients with NMO than in those with MS (p=0.03).

Conclusions: Our results raise the hypothesis that persistent, active EBV replication is present in NMO, and may contribute to the immunological alterations that play a pathogenetic role in the disorder.

Keywords: MULTIPLE SCLEROSIS; NEUROIMMUNOLOGY.

MeSH terms

  • Adult
  • Antibodies, Viral / analysis
  • Antigens, Viral / analysis
  • Antigens, Viral / immunology
  • Epstein-Barr Virus Infections / virology*
  • Female
  • Herpesvirus 4, Human / immunology
  • Herpesvirus 4, Human / physiology*
  • Humans
  • Immunoglobulin G / cerebrospinal fluid
  • Immunoglobulin G / genetics
  • Longitudinal Studies
  • Male
  • Multiple Sclerosis / virology
  • Neuromyelitis Optica / virology*
  • Virus Activation*

Substances

  • Antibodies, Viral
  • Antigens, Viral
  • Immunoglobulin G