Costa-Neto João Batista, Kaefer Michelle, Freitas Thalita de Paula Medeiros Mota, Ciceri Ana Carolina Marques, Casal Laura Bonai, Lopes Bheatriz Souza, Arruda-Filho Vicente Mamede de, de Carvalho José Antonio Mainardi, Paniz Clóvis
Postgraduate Program in Pharmaceutical Sciences, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Applied Clinical Analysis Research Laboratory (LAPACA), Department of Clinical and Toxicologic Analysis, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil.
Postgraduate Program in Pharmaceutical Sciences, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Applied Clinical Analysis Research Laboratory (LAPACA), Department of Clinical and Toxicologic Analysis, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; University Hospital of Santa Maria, Federal University of Santa Maria, RS, Brazil.
Mult Scler Relat Disord. 2025 Aug;100:106551. doi: 10.1016/j.msard.2025.106551. Epub 2025 May 26.
Demyelinating diseases (DD) encompass disorders characterized by varying and nonspecific triggers of both infectious and autoimmune origins, leading to varied signs and symptoms. These complexities necessitate a multifaceted diagnostic approach. In 2022, Bjornevik et al. established a correlation between multiple sclerosis (main DD) and the Epstein-Barr virus (EBV), setting the stage for further investigation into this association. Given this context, this study aimed to measure the levels of IgG antibodies specific to EBV viral capsid antigen (VCA) in the cerebrospinal fluid (CSF) and serum to calculate the specific antibody index (SAI), correlating it with other diagnostic measures such as oligoclonal bands (OCB), the Reibergram, and clinical laboratory findings in patients with DD treated at the University Hospital of Santa Maria and the Institute of Neurology of Goiania, both in Brazil, from March 2022 to March 2024. The study included sixty-one patients, ranging in age from 28 days to 84 years, divided into two groups: 34 patients with DD and 27 patients without demyelinating diseases (NDD). The assessments performed were OCB, total IgG and albumin in serum and CSF, Reibergrams, and activity for EBV VCA IgG, from which the SAI was calculated. Most DD patients were women, who demonstrated a higher incidence of EBV VCA IgG antibody activity in both serum and CSF as compared to NDD patients. OCB presence was identified in 7 (33.3 %) of MS patients. The presence of intrathecal synthesis, assessed by Reibergrams, was concordant in 88.9 % of patients with OCB detection. The SAI for EBV VCA IgG remained below 2.5 in 96.9 % of DD patients, even when OCB was present and the Reibergram indicated intrathecal synthesis. These findings suggest that the majority of DD patients, despite demonstrating intrathecal synthesis and reactivity to EBV VCA IgG in both serum and CSF, exhibited an SAI within normal ranges.
脱髓鞘疾病（DD）包括由感染性和自身免疫性起源的多种非特异性触发因素所导致的疾病，这些触发因素会引发各种不同的体征和症状。这些复杂性使得需要采取多方面的诊断方法。2022年，比约内维克等人确定了多发性硬化症（主要的脱髓鞘疾病）与爱泼斯坦-巴尔病毒（EBV）之间的关联，为进一步研究这种关联奠定了基础。在此背景下，本研究旨在测量脑脊液（CSF）和血清中针对EBV病毒衣壳抗原（VCA）的IgG抗体水平，以计算特异性抗体指数（SAI），并将其与其他诊断指标（如寡克隆带（OCB）、赖伯图）以及2022年3月至2024年3月在巴西圣玛丽亚大学医院和戈亚尼亚神经病学研究所接受治疗的脱髓鞘疾病患者的临床实验室检查结果相关联。该研究纳入了61名患者，年龄从28天至84岁不等，分为两组：34名脱髓鞘疾病患者和27名无脱髓鞘疾病（NDD）的患者。所进行的评估包括OCB、血清和脑脊液中的总IgG和白蛋白、赖伯图以及EBV VCA IgG活性，据此计算SAI。大多数脱髓鞘疾病患者为女性，与NDD患者相比，她们在血清和脑脊液中EBV VCA IgG抗体活性的发生率更高。7名（33.3%）多发性硬化症患者检测到OCB。通过赖伯图评估的鞘内合成情况，在88.9%检测到OCB的患者中是一致的。即使存在OCB且赖伯图显示鞘内合成，96.9%的脱髓鞘疾病患者中EBV VCA IgG的SAI仍低于2.5。这些发现表明，大多数脱髓鞘疾病患者尽管在血清和脑脊液中表现出鞘内合成以及对EBV VCA IgG的反应性，但其SAI仍在正常范围内。
