Opoka-Winiarska Violetta, Grywalska Ewelina, Sobiesiak Aleksandra, Roliński Jacek
Department of Paediatric Pulmonology and Rheumatology, Medical University of Lublin, 20-093 Lublin, Poland.
Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland.
J Clin Med. 2020 Oct 27;9(11):3453. doi: 10.3390/jcm9113453.
This study aimed to investigate the relationship between Epstein-Barr virus (EBV) infection and the onset of juvenile idiopathic arthritis (JIA), disease activity, and response to treatment. The study included 44 children with JIA, 23 children with different types of arthritis, and 44 controls. We measured EBV infection markers, including the EBV DNA load and the concentration of antibodies to viral antigens, at disease onset, before treatment. Six months after JIA diagnosis and the initiation of treatment patients with anti-viral capsid antigen IgG had a higher disease activity and worse response to treatment than patients without previous infection. After six months of treatment, the probability of disease inactivity in children without a history of EBV infection was almost 6.5 times greater than in a child with a history of infection. Furthermore, the probability of a better response after six months of treatment in a child with a history of EBV infection was more than five times smaller than in a child without infection. A past EBV infection can have a negative effect on achieving disease remission and may be associated with a worse response to treatment. Our results do not indicate the need for routine assessment of EBV infection markers in patients with JIA.
本研究旨在调查爱泼斯坦-巴尔病毒（EBV）感染与幼年特发性关节炎（JIA）的发病、疾病活动度及治疗反应之间的关系。该研究纳入了44例JIA患儿、23例患有不同类型关节炎的儿童以及44例对照。在疾病发作时、治疗前，我们检测了EBV感染标志物，包括EBV DNA载量和病毒抗原抗体浓度。JIA诊断及开始治疗6个月后，既往有抗病毒衣壳抗原IgG感染的患者比无既往感染的患者疾病活动度更高，对治疗的反应更差。治疗6个月后，无EBV感染史的儿童疾病不活动的概率几乎是有感染史儿童的6.5倍。此外，有EBV感染史的儿童治疗6个月后反应较好的概率比无感染史的儿童小5倍多。既往EBV感染可能对实现疾病缓解产生负面影响，且可能与较差的治疗反应相关。我们的结果并不表明需要对JIA患者常规评估EBV感染标志物。
