Abstract
Epstein–Barr Virus (EBV) has been associated with development of rheumatic connective tissue diseases like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in genetically susceptible individuals. Diagnosis of RA and SLE relies on clinical criteria in combination with the presence of characteristic autoantibodies. In addition, antibodies to several EBV antigens have been shown to be elevated in patients with these diseases compared to healthy controls (HC). Here, we elaborated improved enzyme-linked immunosorbent assays for antibodies (IgM, IgA, IgG) to the EBV proteins Epstein-Barr Virus nuclear antigen (EBNA)1 and early antigen diffuse (EAD) in order to determine their potential diagnostic role. We showed that especially EBNA1 IgM distinguished RA from SLE and HCs and also distinguished SLE from HCs. EBNA1 IgA was almost as effective in differentiating RA from SLE and HC, while EAD IgG and IgA were able to discern SLE patients from RA patients and HCs. Collectively, these findings illustrate the potential diagnostic use of antibodies to EBV proteins to diagnose RA and to differentiate SLE from RA.
Highlights
Epstein-Barr virus (EBV), is one of the most common human viruses to encounter
Sera from systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and healthy control (HC) individuals were tested for antibody reactivity (IgM, IgA, IgG) to early antigen diffuse (EAD)
Sera from SLE, RA and HC individuals were tested for antibody reactivity (IgM, IgA, IgG) to EAD and EBNA1 by enzyme-linked immunosorbent assay (ELISA)
Summary
Up to 99% of the world’s population is infected at some stage during their lifetime [1,2,3]. The majority of the population is infected during early childhood (up to 95%) [1,2,3]. Primary infection with EBV is usually mild but may give rise to infectious mononucleosis (IM), a condition with fever, excessive production of lymphocytes and swollen nasopharyngeal lymph nodes, in adolescents [4]. Besides IM, EBV has been associated with a broad range of diseases including lymphomas, nasopharyngeal cancer, gastric cancer, multiple sclerosis, rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The precise role of EBV in the etiology of these diseases remains unknown
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