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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Article info
Publication history
Published online: August 26, 2022
Accepted:
August 25,
2022
Received in revised form:
August 24,
2022
Received:
June 24,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
