Epstein‐Barr virus (types 1 and 2) in the tear film in Sjogren's syndrome and HIV infection

Abstract

Evidence of Epstein-Barr virus (EBV) shedding in the saliva and tear film has been sought to explain the pathogenesis of the oral and ocular features of Sjogren's syndrome. Patients with human immunodeficiency virus (HIV) infection are purported to have a higher incidence of keratoconjunctivitis sicca. Twenty patients with definite Sjogren's syndrome (primary and secondary), 19 with HIV infection, and 15 normal controls were recruited and studied. Human herpes viruses (EBV 1 and 2, CMV, HZV, and HSV-1) in tear film were detected by polymerase chain reaction of DNA extracted from Schirmer strips. HSV-1, VZV, and CMV were not detected in any tear samples. EBV-1 DNA was found in the tear film of 4 patients with Sjogren's syndrome, which was not significantly different from the control group (P = 0.18). Twelve patients with HIV infection had evidence of EBV-1 in their tears, which was significantly different from controls (P = 0.0002) and patients with Sjogren's syndrome (P = 0.014). EBV-2 was found in 3 patients with HIV and in 1 patient with secondary Sjogren's syndrome, and was always found as a co-infection with EBV-1 (P = 0.01). This represents the first report examining EBV types 1 and 2 in the tear film and also EBV in the tear film of patients with HIV. Shedding of EBV in the tear film was not related to the presence of keratoconjunctivitis sicca in Sjogren's syndrome. EBV-2 co-infection with EBV-1 has not been previously reported in the tear film. EBV infection is abnormally regulated in Sjogren's syndrome and HIV, and it is likely that the presence of EBV in the tear film is related to the patients' altered immune status.

Quantitative PCR for the detection of genomic DNA of Epstein-Barr virus in ocular fluids of patients with uveitis

“…In the eye, EBV has been reported to be associated with various diseases. [7][8][9][10][11][12][13][14][15][16] Interestingly, EBV genomic DNA and receptors are sometimes detected in normal ocular tissues, including the retinal epithelium and ocular fl uids, 5 under normal conditions. Usui and Sakai 12 reported high anti-VCA IgG in aqueous humor in three patients with EBV-associated uveitis without evidence of infectious mononucleosis.…”

Mouse Models of Primary Sjogren’s Syndrome

“…Among other etiologic factors for SjS, environmental factors, especially viral infections, are believed to be important. Several studies have shown viral involvement in subsets of SjS patients, which includes herpes simplex virus[32], Epstein-Barr virus [33], hepatitis C virus [34], human T-cell lymphocytic virus type 1 (HTLV-1) [35], and human endogenous retrovirus (HERV-11) [36]. Furthermore, because SjS usually occurs in females during peri-or post-menopause, hormone imbalance has also been suggested to trigger SjS with an altered androgen-estrogen ratio potentially giving rise to an increased risk of SjS development [37, 38].…”

Dysfunction of Lacrimal and Salivary Glands in Sjögren′s Syndrome: Nonimmunologic Injury in Preinflammatory Phase and Mouse Model

“…Several viruses such as Epstein-Barr virus (EBV; types 1 and 2) [21, 22] and hepatitis C virus, retroviruses such as human T-cell lymphocytic virus type 1 (HTLV-1) [23], and endogenous retroviruses such as a HERV-K113 [24] have been found to be closely associated with the patients with pSjS and sSjS. Also, the incidence of keratoconjunctivitis sicca is increased in patients with exogenous retroviruses like immunodeficiency virus infection [25].…”