Humoral response to Epstein-Barr virus (EBV) antigens is associated with more advanced cortical atrophy, accumulation of chronic T1 black holes, and focal white matter lesions in patients with multiple sclerosis, Dr. Robert Zivadinov of the State University of New York, Buffalo, and his colleagues reported in Neurology.

Researchers enrolled 846 participants for the study, including 539 patients with MS (369 with relapsing-remitting MS, 135 with secondary progressive MS, and 35 with primary progressive MS); 66 patients with clinically isolated syndrome (CIS); 63 patients with other neurologic diseases (OND); and 178 healthy controls. They used 3T MRI to scan participants’ brains and evaluated serum samples for IgG antibodies against EBV viral capsid antigen (VCA) and EBV nuclear antigen-1 (EBNA-1), dividing the group into quartiles based on their responses.

More than 30% of patients with MS and CIS presented with the highest quartile of anti–EBV-VCA and anti–EBNA-1 status, compared with 10% or fewer of healthy controls (P less than .001). The figures were 9 (14.3%) and 7 (12.3%) for patients with OND. Patients with MS with the highest quartile of anti–EBV-VCA showed significantly increased T2 lesion volume (P= .001), T1 lesion number (P = .002), and T1 lesion volume (P = .04), as well as decreased gray matter (P= .041) and cortical volumes (P= .043), compared with patients with MS in lower quartiles.

“The results provide evidence for further research aimed at modulating the response of patients with MS to these viruses via drug and vaccine strategies,” the authors wrote.

Read the article in Neurology (2016;3:e190. doi: 10.1212/NXI.0000000000000190 ).


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