Epstein-Barr Virus and Autoimmunity

Pender, Michael P.

doi:10.1016/b978-044451271-0/50013-2

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…Individuals with a particular autoimmune disease have an increased risk of developing other autoimmune diseases. However, there is increasing evidence that another important genetic component increases the susceptibility to ‘autoimmunity-in-general’ [ 6 ]. Cross-reacting autoantibodies targeting an epitope have the potential to spread the autoimmune response to other RNA-binding proteins through molecular mimicry; subsequently, intramolecular spreading to these specific proteins can occur [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Severe Recurrent Achalasia Cardia Responding to Treatment of Severe Autoimmune Acquired Haemophilia

Al-Jafar¹,

Laffan²,

Al-Sabah³

et al. 2012

Case Rep Gastroenterol

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Acquired haemophilia A and severe acquired achalasia are both very rare conditions with unknown aetiology. Haemophilia A is a haemorrhagic disease induced by deficiency or malfunction of coagulation factor VIII. Congenital haemophilia is an inherited disease transmitted by the mother through X-linked inheritance and primarily affects males. However, acquired haemophilia A is a serious, sudden-onset, autoimmune disease that affects either sex. In addition, achalasia is a disease of the oesophagus caused by abnormal function of the nerves and muscles. It causes swallowing difficulties due to the inability of the lower oesophageal sphincter to relax during swallowing, leading to dysphagia, regurgitation and chest pain. In this report, we describe the case of a patient with severe, newly diagnosed, acquired haemophilia A with long-standing, recurrent achalasia; the achalasia had recurred 3 times despite complete and proper surgical fixation. Acquired haemophilia A is treated with immunosuppressive therapy. High-dose steroid therapy was administered for 7 months, during which the patient responded well; moreover, the achalasia did not recur for more than 2 years. The response of the achalasia to immunosuppressive therapy suggests that achalasia may be an autoimmune disorder and that there may be an association between both diseases. The findings of the present case suggest that achalasia may favourably respond to steroid therapy as a first-line treatment prior to surgery.

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Section: Discussionmentioning

confidence: 99%

Severe Recurrent Achalasia Cardia Responding to Treatment of Severe Autoimmune Acquired Haemophilia

Al-Jafar¹,

Laffan²,

Al-Sabah³

et al. 2012

Case Rep Gastroenterol

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“…In earlier studies, patients with RA exhibited increased titers of anti-EBV nuclear antigen 2 antibodies and increased frequency of circulating EBV-infected B cells compared to the healthy controls [5]. More recently, they also have been shown to have a tenfold increase in EBV DNA load [6]. Several similarities exist between RA and Parvo B19 infection: Both states are characterized by a chronic course, morning stiffness, joint deformation and destruction, rheumatoid nodules, as well as by the induction of rheumatoid factor (RF) and of cytokines such as interleukin-6 (IL-6) and transforming growth factor-α (TGF-α).…”

Section: Clinical Associations With Infectionsmentioning

confidence: 97%

“…Epidemiological studies have shown a significant higher prevalence of anti-EBV antibodies (100 vs 80-95%) and higher titers of anti-EBV viral capsid and anti-EBV nuclear antigen-1 (EBNA-1) antibodies among MS patients compared to the controls [6]. In a more recent systematic review of case control studies comparing EBV seropositivity and the risk for MS, an odds ratio of 13.5 was found [6]. In two recent large-cohorts' retrospective studies, the strongest predictors of MS were serum levels of IgG antibodies to EBNA complex or EBNA-1 [23,24].…”

Section: Clinical Associations With Infectionsmentioning

confidence: 99%

“…Additional works suggest that early-in-life infection with EBV, usually oligo or asymptomatic, has a protective effect as oppose to laterin-life infection, which is associated with an increased risk for the development of MS [25]. Earlier studies demonstrated that MS patients have defective T-cell control of EBV-infected B cells [6]. A more recent study showed an increased frequency of CD8+ T cells responding to two immunodominant EBV epitopes.…”

Section: Clinical Associations With Infectionsmentioning

confidence: 99%

“…A more recent study showed an increased frequency of CD8+ T cells responding to two immunodominant EBV epitopes. In addition, the authors characterized T cell cross reactivity between EBV antigens and the myelin basic protein [6]. The higher titers of measles antibodies in MS patients raised the concern of a possible causal association.…”

Section: Clinical Associations With Infectionsmentioning

confidence: 99%

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Infections and Autoimmunity: A Panorama

Pordeus

Szyper‐Kravitz

Levy

et al. 2008

Clinic Rev Allerg Immunol

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For more than 2,000 years, it was thought that malignant spirits caused diseases. By the end of nineteenth century, these beliefs were displaced by more modern concepts of disease, namely, the formulation of the "germ theory," which asserted that bacteria or other microorganisms caused disease. With the emergence of chronic degenerative and of autoimmune diseases in the last century, the causative role of microorganisms has been intensely debated; however, no clear explanatory models have been achieved. In this review, we examine the current available literature regarding the relationships between infections and 16 autoimmune diseases. We critically analyzed clinical, serological, and molecular associations, and reviewed experimental models of induction of and, alternatively, protection from autoimmune diseases by infection. After reviewing several studies and reports, a clinical and experimental pattern emerges: Chronic and multiple infections with viruses, such as Epstein-Barr virus and cytomegalovirus, and bacteria, such as H. pylori, may, in susceptible individuals, play a role in the evolvement of autoimmune diseases. As the vast majority of infections pertain to our resident microbiota and endogenous retroviruses and healthy carriage of infections is the rule, we propose to focus on understanding the mechanisms of this healthy carrier state and what changes its configurations to infectious syndromes, to the restoration of health, or to the sustaining of illness into a chronic state and/or autoimmune disease. It seems that in the development of this healthy carriage state, the infection or colonization in early stages of ontogenesis with key microorganisms, also called 'old friends' (lactobacilli, bifidobacteria among others), are important for the healthy living and for the protection from infectious and autoimmune syndromes.

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Immunology of multiple sclerosis

Pender

Greer²

2007

Curr Allergy Asthma Rep

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Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) leading to demyelination, axonal damage, and progressive neurologic disability. The development of MS is influenced by environmental factors, particularly the Epstein-Barr virus (EBV), and genetic factors, which include specific HLA types, particularly DRB1*1501-DQA1*0102-DQB1*0602, and a predisposition to autoimmunity in general. MS patients have increased circulating T-cell and antibody reactivity to myelin proteins and gangliosides. It is proposed that the role of EBV is to infect autoreactive B cells that then seed the CNS and promote the survival of autoreactive T cells there. It is also proposed that the clinical attacks of relapsing-remitting MS are orchestrated by myelinreactive T cells entering the white matter of the CNS from the blood, and that the progressive disability in primary and secondary progressive MS is caused by the action of autoantibodies produced in the CNS by meningeal lymphoid follicles with germinal centers.

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Epstein-Barr Virus and Autoimmunity

Cited by 4 publications

References 19 publications

Severe Recurrent Achalasia Cardia Responding to Treatment of Severe Autoimmune Acquired Haemophilia

Severe Recurrent Achalasia Cardia Responding to Treatment of Severe Autoimmune Acquired Haemophilia

Infections and Autoimmunity: A Panorama

Immunology of multiple sclerosis

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