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Epstein–Barr virus antibody in newly diagnosed multiple sclerosis patients and its association with relapse severity and lesion location

  • Onder Olmez
    Affiliations
    Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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  • Cavid Baba
    Affiliations
    Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
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  • Zuhal Abasiyanik
    Correspondence
    Corresponding author at: Physical Therapy and Rehabilitation, Graduate School of Health Sciences, Dokuz Eylül University, Inciraltı mah. Mithatpaşa cad., Izmir 35340, Turkey.
    Affiliations
    Physical Therapy and Rehabilitation, Graduate School of Health Sciences, Dokuz Eylül University, Inciraltı mah. Mithatpaşa cad., Izmir 35340, Turkey

    Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
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  • Serkan Ozakbas
    Affiliations
    Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Published:August 26, 2022DOI:https://doi.org/10.1016/j.msard.2022.104149

      Highlights

      • Epstein–Barr virus is considered a risk factor for the development of multiple sclerosis.
      • EBNA IgG titer increases during the inflammatory phase of the MS and as the disease duration increases.
      • EBNA IgG was significantly associated with disease activity regarding relapse severity and lesion location and could be a potential biomarker for predicting disease exacerbation.
      • However, more extensive studies are needed to evaluate the cut-off level of antibody titer for practical use.

      Abstract

      Background

      Epstein–Barr virus is considered a risk factor for the development of multiple sclerosis, and recent findings reveal infected plasma -cells in meningeal ectopic lymphoid deposits. Activation of the dormant virus could be responsible for the multiple sclerosis exacerbation

      Aims

      To compare Epstein–Barr nuclear IgG (EBNA IgG) titer in newly diagnosed treatment-naive multiple sclerosis patients regarding the diagnoses date, clinical and radiological activity.

      Methods

      Treatment-naive multiple sclerosis patients were divided into two groups according to Poser (late group) and McDonald2017(early group) diagnostic criteria. EBNA IgG, EDSS, physical (Timed 25 Foot Walk test, Nine-hole Peg test), and cognitive tests (Brief International Cognitive Assessment for Multiple Sclerosis) were done before the methylprednisolone infusion. The lesion location was evaluated by an MRI. Myelitis was considered a severe attack, and optic neuritis a mild relapse.

      Results

      In total, 69 patients were enrolled. 44 (63.8%) of them were diagnosed by McDonald2017, and 25 (36.2%) were diagnosed with Poser criteria. There was a significant difference (p = 0.049) between the EBNA IgG titer of the late (median:238 U/ml, IQR: 154–362) and early (median: 154 U/ml, IQR:100.25–293.25). Severe relapse, having a spinal cord lesion, and not being treated with methylprednisolone was associated with higher EBNA IgG titer.

      Conclusion

      Study results show that EBNA IgG was significantly associated with disease activity regarding relapse severity and lesion location and could be a potential biomarker for predicting disease exacerbation.

      Keywords

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