Epstein-Barr virus is associated with gray matter atrophy and lesion injury in multiple sclerosis

• Published in: Multiple sclerosis Vol. 14; p. S249
• Main Authors: Zivadinov, R, Zorzon, M, Weinstock-Guttman, B, Serafin, M, Bosco, A, Bratina, A, Maggiore, C, Grop, A, Tommasi, MA, Srinivasaraghavan, B, Ramanathan, M
• Format: Journal Article
• Language: English
• Published: 01-09-2008
• Subjects: Epstein-Barr virus
• ISSN: 1352-4585

Background: Because Epstein Barr virus (EBV) specifically affects immune cells and is capable of causing the dysimmunity that is a hallmark of multiple sclerosis (MS), it has long been considered a promising hypothesis as the environmental trigger or disease-modifying pathogen for MS. Objective: To determine whether the presence of anti-EBV antibodies is associated with magnetic resonance imaging (MRI) measures of brain injury and neurodegeneration in MS patients. Methods: A total of 135 MS patients (86 females; 49 males) underwent brain MRI and testing for antibodies against EBV. The MRI measurements included gadolinium-enhancing (Gd) lesion volume (LV), Tl-and T2-LVs and fractions of whole brain parenchyma (BPF), white matter (WMF) and gray matter (GMF). The anti-EBV panel included measurements of the levels of anti-EBV early antigen (EA) IgG, anti-EBV nuclear antigen (EBNA) IgG and anti-EBV viral capsid antigen (VCA) IgG. The relationships between antibody levels and MRI parameters were assessed in regression analysis. limited longitudinal analysis of the effects of anti-EBV VCA IgG antibodies on evolution of MRI measures was available for a subset of 50 patients after mean follow-up of 3.1 years. Results: The proportion of MS patients positive for anti-EBV-EA IgG, anti-EBV-EBNA IgG and anti-EBV-VCA IgG antibodies were 17.0%, 97.0% and 99.3%, respectively. The anti-EBV-VCA IgG levels were significantly associated with higher T2- and Tl-LVs and lower GMF and BPF. The GMF (R2 = 0.24 for overall model and Standardized beta = -0.26, p = 0.002) and BPF (R2 = 0.39 for overall model and Standardized beta = -0.28, p < 0.001) showed the strongest negative associations with anti-EBV-VCA IgG levels. Higher decline in BPF was significantly associated with increased baseline anti-EBV VCA IgG levels (R2 = 0.61, p < 0.001 for overall model and Standardized beta = -0.38, p = 0.008). Conclusions: Our data suggest that the presence of anti-EBV antibodies is associated with MRI markers of GM atrophy and lesion injury in MS. Increased levels of anti-EBV VCA IgG at baseline were associated with increased loss of brain volume over 3-year follow-up.