多发性硬化症和爱斯坦-巴尔病毒
Lynn I Levin1, Kassandra L Munger, Mark V Rubertone
1Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC, USA.
JAMA
|April 4, 2003
概括
爱斯坦-巴尔病毒 (EBV) 抗体,特别是针对病毒囊抗原 (VCA) 和EBNA复合物的IgG,在多发性硬化症 (MS) 发病前几年显著增加. 这表明EBV感染和MS发展之间存在强烈联系.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 爱斯坦-巴尔病毒 (EBV) 感染是多发性硬化症 (MS) 的已知危险因素.
- 在EBV感染和MS发病之间确切的时间关系仍然不清楚.
- 了解这种联系对于潜在的MS预防策略至关重要.
研究的目的:
- 调查爱斯坦-巴尔病毒 (EBV) 抗体水平与随后多发性硬化症 (MS) 的发展之间的时间关联.
- 为了确定EBV抗体的升高是否先于MS的临床发病.
主要方法:
- 一项嵌套病例控制研究使用了大量的美国军事人员 (300多万) 进行.
- 在1988-2000年间收集的血液样本被分析为针对EBV抗原 (VCA,EBNA复合物,早期抗原) 和细胞巨血病毒的抗体.
- 病例是被诊断患有多发性硬化症的个体,对照组与年龄,性别,种族/种族以及样本采集日期相匹配.
主要成果:
- 对EBV病毒体抗原 (VCA) 和EBNA复合物的IgG抗体升高是MS风险的强有力的预测因素.
- 随着抗体标位,MS风险单调增加,EBNA复合体的相对风险高达33.9.
- 即使在MS诊断前5年或更长时间收集的样本中也观察到显著的关联.
- 细胞巨病毒抗体和MS风险之间没有发现任何关联.
结论:
- 这些发现强烈表明爱斯坦-巴尔病毒感染和多发性硬化症的发展之间存在因果关系.
- EBV抗体是MS风险的潜在早期生物标志物.
- 进一步研究将EBV和MS病原体联系在一起的机制是合理的.
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