Wellcome Trust Centre for Human Genetics, University of Oxford, UK.
Mult Scler. 2013 Feb;19(2):162-6. doi: 10.1177/1352458512449682. Epub 2012 Jun 11.
Epstein-Barr virus (EBV) infection is widely considered to be a risk factor for multiple sclerosis (MS). A previous meta-analysis estimated an odds ratio (OR) for MS in individuals seronegative for EBV of 0.06. Given the potential importance of this finding, we aimed to establish a more precise OR for adult and paediatric onset MS in EBV seronegative individuals.
PubMed and EMBASE searches were undertaken to identify studies investigating the association between MS and EBV. Twenty-two adult and three paediatric studies were included. ORs were calculated using a fixed effects model. A sub-group analysis based on the method of EBV detection was performed.
The OR for developing adult MS in EBV seronegatives was 0.18 (95% confidence interval (CI) 0.13-0.26)) and for paediatric MS was 0.18 (95% CI 0.11-0.30). Sub-group analysis on EBV detection method showed that studies which used immunofluoresence generated an OR=0.07 (95% CI 0.03-0.16); for those that used enzyme-linked immunosorbent assay (ELISA) OR=0.33 (95% CI 0.22-0.50) and for studies which used ELISA and immunofluoresence OR=0.00 (95% CI 0-0.43).
The sensitivity and specificity of the assay used to measure EBV antibody titres have an influence on the association between MS and EBV. Looking at studies where two independent methods are used and therefore are likely to be the most robust, EBV appears to be present in 100% of MS patients. This has implications for future studies of EBV in MS. MS patients without EBV infection, if they truly exist, should be studied in more detail.
爱泼斯坦-巴尔病毒（EBV）感染被广泛认为是多发性硬化症（MS）的一个危险因素。先前的荟萃分析估计 EBV 血清阴性个体患 MS 的优势比（OR）为 0.06。鉴于这一发现的潜在重要性，我们旨在确定 EBV 血清阴性个体中成人和儿童发病 MS 的更精确 OR。
通过 PubMed 和 EMBASE 搜索，确定了研究 EBV 与 MS 之间关联的研究。纳入了 22 项成人研究和 3 项儿童研究。使用固定效应模型计算 OR。根据 EBV 检测方法进行了亚组分析。
在 EBV 血清阴性个体中，发生成人 MS 的 OR 为 0.18（95%置信区间（CI）0.13-0.26），发生儿童 MS 的 OR 为 0.18（95% CI 0.11-0.30）。根据 EBV 检测方法的亚组分析，使用免疫荧光法的研究产生的 OR=0.07（95% CI 0.03-0.16）；使用酶联免疫吸附测定（ELISA）的 OR=0.33（95% CI 0.22-0.50）；使用 ELISA 和免疫荧光法的研究的 OR=0.00（95% CI 0-0.43）。
用于测量 EBV 抗体滴度的检测方法的灵敏度和特异性会影响 MS 与 EBV 之间的关联。查看使用两种独立方法的研究，因此它们可能是最可靠的研究，EBV 似乎存在于 100%的 MS 患者中。这对未来 EBV 在 MS 中的研究有影响。如果确实存在没有 EBV 感染的 MS 患者，应更详细地研究他们。
