RESEARCH - Pathophysiological links between RA and the Epstein-Barr virus: an update

[Guest guest]

Joint Bone Spine. 2007 Oct;74(5):418-26. Epub 2007 Jun 8.

Pathophysiological links between rheumatoid arthritis and the Epstein-Barr

virus: an update.

Toussirot E, Roudier J.

Rheumatology Department, Minjoz Teaching Hospital, Boulevard A.

Fleming, 25030 Besançon, France. etoussirot@...

Numerous associations have been documented between the Epstein-Barr virus

(EBV) and rheumatoid arthritis (RA). Thus, anti-EBV antibody titers are

higher in RA patients than in healthy controls. Lymphocytes from RA patients

show impaired responses to EBV. Several EBV antigens share similarities with

self antigens; more specifically, the glycine/alanine repeats in EBNA-1

resemble synovial proteins and the EBV gp110 glycoprotein contains a copy of

the shared epitope. Cell-mediated responses to EBV replicative cycle

proteins and to gp110 have been documented in joint fluid from RA patients.

In situ hybridization and PCR techniques have identified EBV antigens and

genetic material within the rheumatoid synovium, albeit with variable

yields. The EBV burden in peripheral blood mononuclear cells is higher in RA

patients than in controls. EBNA-1 can undergo citrullination, and the EBV

can induce antibodies to citrullinated peptides. RA patients are at

increased risk for lymphoma, including EBV-associated lymphoma. Despite

these multiple and complex links between EBV and RA, proof of a causal

association is lacking. EBV infection may contribute indirectly to the

pathophysiology of RA by impairing immune control of EBV replication,

causing increased exposure to EBV antigens and, thereby, chronic

inflammation. The effect of biotherapies for RA on EBV-host relations needs

to be investigated.

PMID: 17625943

http://www.ncbi.nlm.nih.gov/pubmed/17625943?ordinalpos=6 & itool=EntrezSystem2

PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Not an MD