Lu M-C, Yin W-Y, Liu S-Q, Koo M, Tung C-H, Huang K-Y, Lai N-S
Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan School of Medicine, Tzu Chi University, Hualien, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan Division of General Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Lupus. 2015 Jun;24(7):687-94. doi: 10.1177/0961203314559629. Epub 2014 Nov 17.
The objective of this paper is to investigate the prevalence of reactivation of the human polyomavirus John Cunningham virus (JCV) in patients with systemic lupus erythematosus (SLE) and its associated clinical manifestations.
Sixty-one patients with SLE and 22 controls were enrolled. Urine JCV viral load was quantified by real-time polymerase chain reaction (PCR). Length variants of the VP1 gene were analyzed using capillary electrophoresis.
The prevalence of JCV viruria (63.9% vs. 18.2%, p < 0.001) and urine JCV viral load (2.92 ± 2.76 vs. 0.81 ± 1.85 copies/ml by log10 scale, p < 0.001) were significantly higher in patients with SLE compared with controls. JCV viruria (+) SLE patients had a higher occurrence of arthritis/arthralgia compared with JCV viruria (-) SLE patients (64.1% vs. 22.7%, p = 0.003). In SLE patients, the urine JCV viral load was significantly associated with the occurrence of arthritis/arthralgia. SLE patients with urine JCV viral load >10,000 copies/ml exhibited a 12.75-fold (95% confidence interval 2.88-56.40) risk in clinical arthritis/arthralgia, 18.90-fold (95% confidence interval 2.10-170.39) risk in persistent arthritis, and significantly greater number of length variants in the VP1 gene of JCV compared with JCV viruria (-) SLE patients.
Reactivation of JCV in the urinary tract of SLE patients was very common. Both JCV viruria and urine JCV viral load were associated with the occurrence of arthritis/arthralgia in patients with SLE. High urine JCV viral load also was associated with the genetic variant in the VP1 gene.
本文旨在研究系统性红斑狼疮（SLE）患者中人多瘤病毒约翰·坎宁安病毒（JCV）再激活的患病率及其相关临床表现。
纳入61例SLE患者和22例对照。通过实时聚合酶链反应（PCR）对尿液JCV病毒载量进行定量。使用毛细管电泳分析VP1基因的长度变异。
与对照相比，SLE患者的JCV病毒尿患病率（63.9%对18.2%，p<0.001）和尿液JCV病毒载量（以log10尺度计为2.92±2.76对0.81±1.85拷贝/ml，p<0.001）显著更高。与JCV病毒尿（-）的SLE患者相比，JCV病毒尿（+）的SLE患者关节炎/关节痛的发生率更高（64.1%对22.7%，p=0.003）。在SLE患者中，尿液JCV病毒载量与关节炎/关节痛的发生显著相关。尿液JCV病毒载量>10,000拷贝/ml的SLE患者临床关节炎/关节痛的风险为12.75倍（95%置信区间2.88 - 56.40），持续性关节炎的风险为18.90倍（95%置信区间2.10 - 170.39），且与JCV病毒尿（-）的SLE患者相比，JCV的VP1基因长度变异数量显著更多。
SLE患者尿路中JCV再激活非常常见。JCV病毒尿和尿液JCV病毒载量均与SLE患者关节炎/关节痛的发生相关。高尿液JCV病毒载量也与VP1基因的遗传变异相关。
