Epstein–Barr Virus in Inflammatory Bowel Disease—Correlation with Different Therapeutic Regimens

Magro, Fernando; Santos-Antunes, João; Albuquerque, Andreia; Vilas-Boas, Filipe; Macedo, G.; Nazareth, Naïr; Lopes, Susana; Sobrinho‐Simões, Joana; Teixeira, Sérgio; Dias, Cláudia Camila; Cabral, José; Sarmento, Amélia; Macedo, Guilherme

doi:10.1097/mib.0b013e318281f31c

Cited by 46 publications

(29 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because colon polyps are more common in elder people, the mean age of those in the control group was higher than that of the IBD group. It has been reported that EBV seroprevalence increased in the first 3 years and older age is a risk factor for EBV infection in colon mucosa [21]. We, therefore, believe that the higher EBV prevalence in IBD patients is due to the disease instead of age.…”

Section: Discussionmentioning

confidence: 65%

See 1 more Smart Citation

The Status of Epstein-Barr Virus Infection in Intestinal Mucosa of Chinese Patients with Inflammatory Bowel Disease

Chen

Peng

et al. 2018

Digestion

View full text Add to dashboard Cite

Aims: This cross-sectional study is to investigate the presence of Epstein-Barr virus (EBV) in colonic mucosa of inflammatory bowel disease (IBD) patients and its correlation with the clinical disease activities and therapeutic regimens. Methods: Subjects undergoing colonoscopy for screening of polyps were recruited as control. EBV DNA load was analyzed by means of quantitative real-time polymerase chain reaction and EBV-encoded RNAs were tested by in situ hybridization in intestinal mucosa of IBD patients. EBV infection was defined as positive with either method. Clinical disease activity was assessed using the Mayo Clinic Score for ulcerative colitis and Crohn’s disease activity index for CD. Results: EBV was detectable in 33 out of 99 IBD patients (33.3%). In controls, EBV prevalence was 7.5% (3/40). We found a significant correlation between EBV prevalence and clinical disease activities (mild [10.71%, 3/28] versus moderate [32.73%, 18/55], severe [75.00%, n = 12/16], p < 0.001). However, no significant difference was found in EBV prevalence between patients who received immunosuppressive therapy and those who did not. Conclusions: EBV infection is common in colonic mucosa of IBD patients. There is a significant correlation between EBV infection and clinical disease activities of IBD. However, prospective studies are still needed to explore the exact role of EBV in IBD.

show abstract

Section: Discussionmentioning

confidence: 65%

“…In our study, the risk of EBV infection increases at a rate of 3.7% per year. Similarly, age above 60 years was related to EBV DNA positivity in Magro's research [21]. Aging of the immune system, also termed as immunosenescence, may play a role.…”

Section: Discussionmentioning

confidence: 99%

The Status of Epstein-Barr Virus Infection in Intestinal Mucosa of Chinese Patients with Inflammatory Bowel Disease

Chen

Peng

et al. 2018

Digestion

View full text Add to dashboard Cite

show abstract

“…A further multiple regression analysis identified T-helper lymphocytopenia \250/lL as the best predictor for severe infections, with a positive predictive value of 0.53 and a negative predictive value of 0.97. In this respect, the risk of lymphoproliferative diseases related to immunosuppression is higher among patients who are seronegative for Epstein-Barr virus [155], and guidelines addressing organ and bone marrow transplantation recommend more aggressive monitoring in high-risk patients [156,157], although more research on this matter is warranted in IBD [158]. It should be emphasized that the immunization status of patients receiving immunomodulators should be considered regularly, and vaccination for varicella, human papilloma virus, influenza, hepatitis B, and pneumococcus, as well as routinely administered vaccines for tetanus, diphtheria, and poliomyelitis, might be prescribed [159].…”

Section: Routine Blood Monitoring Of Patients On Immunomodulator Therapymentioning

confidence: 97%

Pharmacology and Optimization of Thiopurines and Methotrexate in Inflammatory Bowel Disease

et al. 2015

View full text Add to dashboard Cite

Improving the efficacy and reducing the toxicity of thiopurines and methotrexate (MTX) have been areas of intense basic and clinical research. An increased knowledge on pharmacodynamics and pharmacokinetics of these immunomodulators has optimized treatment strategies in inflammatory bowel disease (IBD). This review focuses on the metabolism and mode of action of thiopurines and MTX, and provides an updated overview of individualized treatment strategies in which efficacy in IBD can be increased without compromising safety. The patient-based monitoring instruments adapted into clinical practice include pretreatment thiopurine S-methyltransferase testing, thiopurine metabolite monitoring, and blood count measurements that may help guiding the dosage to improve clinical outcome. Other approaches for optimizing thiopurine therapy in IBD include combination therapy with allopurinol, 5-aminosalicylates, and/or biologics. Similar strategies are yet to be proven effective in improving the outcome of MTX therapy. Important challenges for the management of IBD in the future relate to individualized dosing of immunomodulators for maximal efficacy with minimal risk of side effects. As low-cost conventional immunomodulators still remain a mainstay in pharmacotherapy of IBD, more research remains warranted, especially to substantiate these tailored management strategies in controlled clinical trials.

show abstract

“…EBV positivity is an important infectious adverse event as it can lead to both malignant and non-malignant complications (223). EBV serology was positive in 98.3% of serological samples collected before IFX infusions in consecutive CD patients, showing latent viral presence (201).…”

Section: Epstein-barr Virusmentioning

confidence: 99%

“…Risk factors for detectable EBV DNA in whole blood include IBD, regardless of treatment, compared to healthy volunteers (p<0.05), IFX compared to non-biological treatments, age ≥60, and UC compared to CD (223). A 17 year-old IBD patient whose blood tested positive for EBV was treated with IFX without any reported adverse events (202).…”

Section: Epstein-barr Virusmentioning

confidence: 99%

Risk of Infections of Biological Therapies with Accent on Inflammatory Bowel Disease

2014

View full text Add to dashboard Cite

Background: Biological therapies using anti-tumor necrosis factor (TNF)-α agents have an important impact in the treatment of inflammatory bowel disease, rheumatoid arthritis, psoriasis, and other inflammatory conditions. However, a significant number of patients lose their response to these medications over time. Clinical trials have demonstrated that antibodies against anti-TNF agents may impact treatment response and increase the risk of infusion reactions. Of concern is also the possibility of developing adverse events induced by anti-TNF agents. The purpose of the present systematic review is to describe the current knowledge on the risk of infections associated with anti-TNF agents antagonists, as well as integrin antagonists. We also intend to describe case reports of these adverse events in inflammatory bowel disease patients. Methods: Currently approved anti-TNF biologicals in IBD include the monoclonal antibodies infliximab, adalimumab, certolizumab pegol and golimumab. Integrin antagonists include natalizumab, etrolizumab and vedolizumab. Results: The most frequently-reported adverse events of these biologicals were infections, and these are described in detail in this study. Discussion: Most adverse events are due to the failure of host immunological control, which involves de novo infection, or reactivation of latent bacterial or viral infection, often with a different expression of disease. Conclusion: Risk assessment in individuals undergoing treatment with biologicals represents a step towards achieving treatment personalization to identify those patients that will safely benefit from this therapeutic approach. Patients and physicians must be alert for anti-TNF agents and anti-integrin medication as potential causes of drug-induced infections and monitor the therapies. Personalizing therapeutic vigilance promises to optimize benefits while minimizing infections.This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

show abstract

Epstein–Barr Virus in Inflammatory Bowel Disease—Correlation with Different Therapeutic Regimens

Abstract: IBD is a risk factor for the presence of EBV DNA in blood, particularly in older patients and in those taking infliximab. C-reactive protein was not related to EBV DNA prevalence.

Cited by 46 publications

References 14 publications

The Status of Epstein-Barr Virus Infection in Intestinal Mucosa of Chinese Patients with Inflammatory Bowel Disease

The Status of Epstein-Barr Virus Infection in Intestinal Mucosa of Chinese Patients with Inflammatory Bowel Disease

Pharmacology and Optimization of Thiopurines and Methotrexate in Inflammatory Bowel Disease

Risk of Infections of Biological Therapies with Accent on Inflammatory Bowel Disease

Contact Info

Product

Resources

About