Epstein–Barr Virus and Cytomegalovirus in Autoimmune Diseases

Epstein–Barr Virus and Cytomegalovirus in Autoimmune Diseases
O. BARZILAI a , Y. SHERER a , M. RAM a , D. IZHAKY a , J.M. ANAYA b , AND Y. SHOENFELD a , c
a Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel b Cellular Biology and Immunogenetics Unit, CIB-Universitario del Rosario, Medellin, Colombia c Sackler Faculty of Medicine, Incumbent of the Laura Schwarz-Kip Chair for Research of Autoimmune Diseases, Tel Aviv University, Tel Aviv, Israel
Address for correspondence: Yehuda Shoenfeld, M.D., F.R.C.P., Department of Medicine B and Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel. Voice: +972-3-5302652; fax: +972-3-5352855.
shoenfel@post.tau.ac.il
Copyright 2007 New York Academy of Sciences
KEYWORDS
autoimmunity • EBV • cytomegalovirus • autoimmunity • multiplexed assay
ABSTRACT
Abstract : To date, it is believed that the origin of autoimmune diseases is one of a multifactorial background. A genetic predisposition, an immune system malfunction or even backfire, hormonal regulation, and environmental factors all play important roles in the pathogenesis of autoimmune diseases. Among these environmental factors, the role of infection is known to be a major one. Epstein–Barr virus (EBV) and cytomegalovirus (CMV) are considered to be notorious as they are consistently associated with multiple autoimmune diseases. A cohort of 1595 serum samples, of 23 different autoimmune disease groups, was screened for evidence of prior infection with EBV and CMV. All samples were screened for antibodies against EBV nuclear antigen-1 (IgG), EBV viral capsid antigen (IgG and IgM), EBV early antigen (IgG), EBV heterophile antibody, and CMV (IgG and IgM) antibodies using Bio-Rad's BioPlex 2200. A new association is proposed between EBV and polymyositis, as results show a significant increase in titers of various EBV target analytes when compared with healthy controls. Our results also support prior information suggesting the association between EBV and multiple autoimmune diseases, including SLE, antiphospholipid syndrome, rheumatoid arthritis, multiple sclerosis, pemphigus vulgaris, giant cell arthritis, Wegener's granulomatosis, and polyarteritis nodosa (PAN). Elevated CMV IgG titers were observed in sera of SLE patients. Our data support the theory that EBV is notoriously associated with many autoimmune diseases. CMV appears to be associated to autoimmune diseases as well, yet establishing this theory requires further investigation