Division of Rheumatology, Immunology, and Allergy, Section of Clinical Sciences, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Autoimmunity. 2012 Mar;45(2):161-8. doi: 10.3109/08916934.2011.616557. Epub 2011 Oct 20.
Epstein-Barr virus (EBV) infection and the immune response may be involved in the pathogenesis of rheumatoid arthritis (RA). Past studies have suggested an association between EBV and RA.
We studied the association between EBV serologies and RA risk in a nested case-control study in the Nurses' Health Study (NHS) cohorts. We confirmed incident RA cases from 1990 to 2002 by questionnaire and medical record review. Each incident case with blood collected prior to RA symptoms was matched with a healthy participant by time of day and date of blood collection, birth year, menopausal status and postmenopausal hormone use. Immunofluorescence assays measured serologic EBV responses: viral capsid antigen, early-antigen-diffuse and early antigen-complex (restricted and diffuse), Epstein Barr nuclear antigen (EBNA)-1, EBNA-2 and cytomegalovirus (CMV), as control. All were reported as titers, except CMV, which was reported as positive or negative. Antinuclear antibody positive samples were excluded. Elevated EBV antibody titers were defined as the upper 20% (or nearest titer) among controls. Conditional logistic regression analyses modeled RA risk associated with elevated EBV titers or the presence/absence of CMV, further adjusted for pack-years smoking and alcohol intake.
Eighty-seven incident RA cases were identified. Mean time to RA after blood draw was 6.2 (± 3.5) years in NHS and 1.9 (± 0.6) years in NHS II. Antibody titers against EBV were not significantly different between pre-RA cases and controls.
In this prospective study of women, we observed no association between EBV serologies and RA risk.
EB 病毒（EBV）感染和免疫反应可能与类风湿关节炎（RA）的发病机制有关。过去的研究表明 EBV 与 RA 之间存在关联。
我们在护士健康研究（NHS）队列的巢式病例对照研究中研究了 EBV 血清学与 RA 风险之间的关系。我们通过问卷调查和病历审查确认了 1990 年至 2002 年期间发生的 RA 病例。每位在 RA 症状出现前采集血液的新发病例均与当天和采血日期、出生年份、绝经状态和绝经后激素使用情况相匹配的健康参与者进行匹配。免疫荧光分析测量 EBV 血清学反应：病毒衣壳抗原、早期抗原弥散和早期抗原复合物（受限和弥散）、EB 核抗原（EBNA）-1、EBNA-2 和巨细胞病毒（CMV），CMV 作为对照。所有结果均以滴度报告，CMV 除外，CMV 以阳性或阴性报告。排除抗核抗体阳性样本。升高的 EBV 抗体滴度定义为对照组中前 20%（或最接近的滴度）。条件逻辑回归分析模型分析了与 EBV 滴度升高或 CMV 存在/缺失相关的 RA 风险，进一步调整了吸烟包年数和饮酒量。
共确定了 87 例新发病例 RA。在 NHS 中，从采血到 RA 的平均时间为 6.2（±3.5）年，在 NHS II 中为 1.9（±0.6）年。RA 发病前病例与对照组的 EBV 抗体滴度无显著差异。
在这项针对女性的前瞻性研究中，我们没有观察到 EBV 血清学与 RA 风险之间存在关联。
