Association of Epstein-Barr virus serological reactivation with transitioning to systemic lupus erythematosus in at-risk individuals

Neelakshi R Jog,Jill M Norris,John B Harley,Michael H Weisman,Melissa E Munroe,David R Karp,Daniel J Wallace,Jennifer A Kelly,Judith A James,Michael T Harmon,Diane L Kamen,Joel M Guthridge,Gary S Gilkeson,Patrick M Gaffney,Kendra A Young

doi:10.1136/annrheumdis-2019-215361

Abstract

ObjectiveSystemic lupus erythematosus (SLE) is a systemic autoimmune disease with unknown aetiology. Epstein-Barr virus (EBV) is an environmental factor associated with SLE. EBV maintains latency in B cells with frequent...

Highlights

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that involves multiple organ systems and causes significant morbidity
What does this study add? ►► This is a prospective study to understand the contribution of Epstein-Barr virus (EBV) reactivation prior to SLE disease onset in at risk individuals. ►► The study shows that previously unaffected relatives of patients with SLE who subsequently develop classified SLE have higher serological reactivation of EBV compared with those who do not transition to SLE. ►► The study shows that variants in genes that are associated with SLE and implicated in EBV infection, associate with transitioning to SLE
Transitioned relatives had a greater number of confirmed American College of Rheumatology (ACR) criteria at study enrolment, and higher percentages were Antinuclear antibodies (ANA) positive at baseline compared with non-transitioned relatives (p

Summary

Introduction

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that involves multiple organ systems and causes significant morbidity. ►► Significant associations between Epstein-Barr virus (EBV) serological markers and systemic lupus erythematosus (SLE) have been shown. ►► Patients with SLE have higher frequencies of EBV-infected cells, higher viral loads and higher early antigen IgG levels. ►► This is a prospective study to understand the contribution of EBV reactivation prior to SLE disease onset in at risk individuals. ►► The study shows that previously unaffected relatives of patients with SLE who subsequently develop classified SLE have higher serological reactivation of EBV compared with those who do not transition to SLE. ►► The study shows that variants in genes that are associated with SLE and implicated in EBV infection, associate with transitioning to SLE What does this study add? ►► This is a prospective study to understand the contribution of EBV reactivation prior to SLE disease onset in at risk individuals. ►► The study shows that previously unaffected relatives of patients with SLE who subsequently develop classified SLE have higher serological reactivation of EBV compared with those who do not transition to SLE. ►► The study shows that variants in genes that are associated with SLE and implicated in EBV infection, associate with transitioning to SLE

Methods

Results

Conclusion