Association of clinical and serological parameters of systemic lupus erythematosus patients with Epstein‐Barr virus antibody profile

Abstract

Epstein-Barr viral infection is one of the known environmental factors involved in development of Systemic Lupus Erythematous (SLE). Though not much is known about the exact role of Epstein-Barr virus (EBV) in SLE pathogenesis, the theory of switching of lytic and lysogenic cycles of EBV in memory B cells fits well with the periods of waning disease activity and intermittent flares in SLE patients. In this study, we investigate the association of EBV antibody profile with clinical and serological parameters in SLE. Eighty-seven clinically diagnosed SLE patients fulfilling the American College of Rheumatology (ACR) classification criteria and fifty healthy individuals were enrolled in this case control study. Anti-VCA IgM, anti-VCA IgG, and anti-EBNA IgG were detected by ELISA technique. Antibodies concentrations between two groups were compared using Mann-Whitney whereas the difference in categorical data was compared using Chi-square considering statistical significance at P < 0.05. This study demonstrated a significant increase in EBV VCA-IgG, VCA-IgM, and EBNA-IgG antibodies levels of SLE patients when compared to healthy controls (P < 0.05). High seroprevalence was seen in both the study groups for EBV VCA-IgG and EBNA-IgG antibodies when compared to VCA-IgM antibodies. A significant increase was noted in the anti-VCA-IgG levels with dsDNA autoantibody positivity (P < 0.05). Though there was no significant association between EBV antibody profile and clinical manifestations, 100% seropositivity for anti-VCA-IgG was seen in SLE patients with renal manifestations. Association of anti-VCA IgG levels with presence of anti-dsDNA antibodies suggests a possible role of EBV as an environmental trigger in pathogenesis of SLE.

Anti-Epstein–Barr virus antibodies in Beijing during 2013–2017: What we have found in the different patients

“…Significant differences were observed not only in the prevalence of VCA-IgA ( P < 0.001), but also in the prevalence of VCA-IgG and EBNA1-IgG antibodies ( P < 0.01) between the 6 – 10 years old SLE patients and controls. The overall EBV past infection with common chronic active infection (as high prevalence of VCA IgA) in pediatric SLE patients in our study provides, on another hand, evidence for the reports [ 6 , 28 ] that EBV infection may pay a big role or being a trigger in the pathogenesis of SLE. For other autoimmune diseases, it seemed that the association with EBV was not as strong as that with SLE patients ( P = 0.039).…”

“…In the meta-analysis of 25 case control studies of EBV and SLE, Hanlon P et al [ 26 ] reported that the seroprevalence of EBV VCA-IgG, IgA, and EA/D IgG antibodies, though possibly not anti-EBNA-1, were significantly higher in cases than controls. However, the study by Chougule D et al [ 6 ] showed that the antibodies levels of EBV VCA-IgG, VCA-IgM, and EBNA-1 IgG in SLE patients were significantly higher than that in healthy controls. Furthermore, a correlation was also shown between EBV infection and disease activity of SLE [ 27 ].…”

“…Viral infections certainly contribute to the environmental factors. Several studies have reported the association between EBV infection and SLE [ 3 – 6 ], or other autoimmune diseases [ 7 – 9 ]. Studies on the association between EBV infection and SLE in Chinese patients in Taiwan have also been performed and the results supported the correlation [ 10 – 11 ].…”

Epstein-Barr virus infection as a predisposing factor for multiple sclerosis. An update from molecular biology, immunology and epidemiology

“…(36) This promotes the production of type I IFNs, pro-inflammatory cytokines and autoantibodies via the TLR3 signaling pathway. (19,34,36) There is a large number of studies that have addressed the relationship between EBV and the development of autoimmune diseases such as systemic lupus erythematosus (37,38) and its exacerbations (39); rheumatoid arthritis (40); type I diabetes mellitus (41); Sjogren's syndrome (42); autoimmune thyroiditis (43); autoimmune hepatitis (44); systemic sclerosis (18); transplant rejection due to viral reactivation (45); autoimmune heart disease (46)(47)(48); adverse drug reactions (49,50); Parkinson's disease (51); and MS. (3,10) Multiple sclerosis MS is an autoimmune disease of the central nervous system with a course that is difficult to predict in each patient. It is characterized by multiple foci of inflammation, demyelination, axonal injury, fibrosis, grey matter involvement and neurodegeneration.…”

A cohort study: The Association Between Autoimmune Disorders and Leptospirosis

“…in the pathogenesis of a variety of autoimmune disorders with the hallmark of inducing the production of autoantibodies in the host 10 . Cytomegalovirus (CMV) infections were correlated with the induction and expansion of a proinflammatory CD4 + /CD28 − T cells in RA patients 11 ; and Epstein-Barr virus (EBV) was regarded as an important trigger in the pathogenesis of SLE as evidenced by the co-existence of anti-viral capsid antigen IgG and anti-dsDNA antibodies in the patients 12 . The relationship between leptospirosis and the development of SARDs is unclear; we thus conducted a longitudinal nationwide retrospective cohort study to investigate the occurrence of leptospirosis and the risk of developing SARDs subsequently in the same patients.…”