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系统性红斑狼疮患者的临床和血清学参数与 Epstein-Barr 病毒抗体谱的关联。

Association of clinical and serological parameters of systemic lupus erythematosus patients with Epstein-Barr virus antibody profile.

机构信息

Department of Clinical and Experimental Immunology, National Institute of Immunohaematology, King Edward Memorial Hospital, Mumbai, India.

Department of Medicine, King Edward Memorial Hospital, Mumbai, India.

出版信息

J Med Virol. 2018 Mar;90(3):559-563. doi: 10.1002/jmv.24904. Epub 2017 Nov 29.

Abstract

Epstein-Barr viral infection is one of the known environmental factors involved in development of Systemic Lupus Erythematous (SLE). Though not much is known about the exact role of Epstein-Barr virus (EBV) in SLE pathogenesis, the theory of switching of lytic and lysogenic cycles of EBV in memory B cells fits well with the periods of waning disease activity and intermittent flares in SLE patients. In this study, we investigate the association of EBV antibody profile with clinical and serological parameters in SLE. Eighty-seven clinically diagnosed SLE patients fulfilling the American College of Rheumatology (ACR) classification criteria and fifty healthy individuals were enrolled in this case control study. Anti-VCA IgM, anti-VCA IgG, and anti-EBNA IgG were detected by ELISA technique. Antibodies concentrations between two groups were compared using Mann-Whitney whereas the difference in categorical data was compared using Chi-square considering statistical significance at P < 0.05. This study demonstrated a significant increase in EBV VCA-IgG, VCA-IgM, and EBNA-IgG antibodies levels of SLE patients when compared to healthy controls (P < 0.05). High seroprevalence was seen in both the study groups for EBV VCA-IgG and EBNA-IgG antibodies when compared to VCA-IgM antibodies. A significant increase was noted in the anti-VCA-IgG levels with dsDNA autoantibody positivity (P < 0.05). Though there was no significant association between EBV antibody profile and clinical manifestations, 100% seropositivity for anti-VCA-IgG was seen in SLE patients with renal manifestations. Association of anti-VCA IgG levels with presence of anti-dsDNA antibodies suggests a possible role of EBV as an environmental trigger in pathogenesis of SLE.

摘要

EB 病毒感染是系统性红斑狼疮(SLE)发病的已知环境因素之一。尽管人们对 EBV 在 SLE 发病机制中的确切作用知之甚少,但 EBV 记忆 B 细胞裂解和溶原周期转换的理论与 SLE 患者疾病活动度下降和间歇性发作的时期非常吻合。在这项研究中,我们研究了 EBV 抗体谱与 SLE 临床和血清学参数的关系。87 例符合美国风湿病学会(ACR)分类标准的临床诊断 SLE 患者和 50 名健康个体被纳入这项病例对照研究。采用 ELISA 技术检测抗 VCA IgM、抗 VCA IgG 和抗 EBNA IgG。使用 Mann-Whitney 比较两组之间的抗体浓度,使用卡方比较分类数据之间的差异,以 P<0.05 为统计学意义。本研究表明,与健康对照组相比,SLE 患者的 EBV VCA-IgG、VCA-IgM 和 EBNA-IgG 抗体水平显著升高(P<0.05)。与 VCA-IgM 抗体相比,两组研究对象的 EBV VCA-IgG 和 EBNA-IgG 抗体的血清阳性率均较高。与 dsDNA 自身抗体阳性相比,抗 VCA-IgG 水平显著升高(P<0.05)。尽管 EBV 抗体谱与临床表现之间没有显著关联,但具有肾脏表现的 SLE 患者中 100%抗 VCA-IgG 呈阳性。抗 VCA IgG 水平与抗 dsDNA 抗体的存在之间的关联表明 EBV 可能作为 SLE 发病机制中的环境触发因素发挥作用。

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