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Lupus
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Association of Epstein-Barr virus infection with systemic lupus erythematosus in Taiwan

J J-Y Lu

National Taichung Nursing College, Taichung, Taiwan; Taipei Medical University, Taipei, Taiwan

D-Y Chen

Department of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan; National Yang-Ming University, Taipei and National Chung-Hsing University, Taichung, Taiwan

C-W Hsieh

Department of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan

J-L Lan

National Yang-Ming University, Taipei and National Chung-Hsing University, Taichung, Taiwan; Taipei Medical University, Taipei, Taiwan; Department of Allergy, Immunology and Rheumatology, Taichung Veteran General Hospital, 160 Taichung-Harbor Road, Section 3, Taichung 407, Taiwan, ROC; jllan{at}vghtc.gov.tw

F-J Lin

Department of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan; National Yang-Ming University, Taipei and National Chung-Hsing University, Taichung, Taiwan

S-H Lin

Department of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan

An association between Epstein-Barr virus (EBV) infection and systemic lupus erythematosus (SLE) has been suggested from previous serologic evidence. Since most adults in Taiwan are EBV-infected, seroepidemiologic studies based on standard assays for EBV are unlikely to dissociate SLE patients and control groups. We reexamine this question by using novel methodologies in which IgA anti-EBV-coded nuclear antigens-1 (EBNA-1) and IgG anti-EBV DNase antibodies were analysed by ELISA, and EBV viral loads were detected by real-time quantitative PCR for 93 adult SLE patients and 370 age-, sex- and living place-matched healthy controls in Taiwan. The specificities of antibodies for extractible nuclear antigens were determined by Western blot. Our results show that IgA anti-EBV EBNA1 antibodies were detectable in 31.2% SLE patients but only in 4.1% of controls (odds ratio [OR] = 10.72, 95% confidence interval [CI] = 5.19–22.35; P < 10-7), IgG anti-EBV DNase antibodies were detected in 53.8% SLE patients but only in 12.2% controls (OR = 8.40, 95% CI = 4.87–14.51; P < 10-7). EBV DNA was amplifiable from the sera of 41.9% SLE patients but from only 3.24% controls (P < 0.05). A significant association of IgG anti-EBV DNase antibodies with anti-Sm/RNP antibodies was observed (P < 0.005). The higher seroreactivity and higher copy numbers of EBV genome indicated association of EBV infection with SLE in Taiwan.

Key Words: EBV loads • EBV nuclear antigen-1 (EBNA-1) • Epstein-Barr virus (EBV) • real-time quantitative polymerase chain reaction (RQ-PCR) • systemic lupus erythematosus (SLE)

Lupus, Vol. 16, No. 3, 168-175 (2007)
DOI: 10.1177/0961203306075800


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[Abstract] [PDF]



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