EBV and Lupus

How Prevalent is EBV?

The virus responsible for mononucleosis, the Epstein-Barr virus (EBV), happens to be one of the most common human infections worldwide. In the US, 95% of all men and women between the ages of 35-40 have been infected by EBV at one point in their lives. This initial exposure creates a lifelong relationship between the individual and the virus, because once it has entered the body, it remains there "'til death us do part."

What are the Symptoms of Mono?

Although older adults and infants can contract mononucleosis (mono), it is most frequently seen in teens and college-age males and females. It is highly contagious and has often been referred to as the Kissing Disease because it is passed so readily through contact and is seen most often in young people. Mono presents with symptoms that, in milder cases, appear like flu symptoms. The commonly reported symptoms of mono include:

· Fever

· Sore throat

· Lethargy

· Swollen lymph glands

· Loss of appetite leading to weight loss

In more serious cases of mono, additional symptoms of:

· Throat closure causing breathing difficulties due to swollen lymph nodes

· Tonsillitis

· Strep infection

· Dehydration

· Abdominal pain

· Swelling of the spleen which could lead to a burst spleen and surgery

· Swelling of the liver

· Seizures

· Nerve palsies

· Extreme weakness

What Illnesses are Associated with EBV?

Several immune system diseases are associated with the Epstein-Barr virus, and research is indicating that many of them are initially triggered by a bout of mononucleosis when the patient was a teen. Some of the diseases associated with EBV include:

· Guillian-Barre Syndrome

· Meningoencephalitis

· Burkitt's lymphoma

· Hodgkin's lymphoma

· Multiple Sclerosis

· Chronic fatigue syndrome

· Bell's Palsy

· Meningitis

How Does EBV Cause Autoimmune Disease?

The virus settles into the cells of the immune system called B cells. However, it isn't active the entire time. It becomes dormant or it triggers other autoimmune illnesses. In order for the body to keep the virus latent, another immune cell is required. The T cells play a major pole in the healthy function of the immune system. EBV interferes with both of these immune cells, B and T, which can lead to autoimmune reactions in the form of diseases.

The EBV/SLE Connection

Recent research has now made the link between EBV and systemic lupus erythematorisus (SLE), commonly known as lupus. Lupus is a chronic autoimmune disease that is potentially debilitating, affecting more women than men. Additionally, it appears that lupus is more common in African Americans who tend to develop the disease earlier and often have a more severe course of disease than other races. Lupus presents with these symptoms:

· Joint aches

· Muscle aches

· Feeling tired

· Skin rash, especially after exposure to the sun

· Associated heart problems

· Blood clotting problems

· Issues with the lungs, kidneys and nervous system

Research into the Lupus Connection

In order to determine if there was a connection between EBV and lupus, a group of researchers in North and South Carolina compared the frequency of EBV antibodies in blood samples from lupus patients with a control group. The results indicated a strong association of EBV-IgA antibodies with lupus in African-American people. The findings help to further the concept of a T-cell response gene that may have an impact upon immune response to EBV in people with lupus. The study was based upon 230 patients all recently diagnosed with lupus. 90 percent were women, 60 percent were African-American. Of the control group, 30 percent were also African-American in order to represent racial distribution. All involved gave blood samples.

A higher incidence of EBV-IgG antibodies was seen in African-Americans, implying a history of EBV infection, than in white subjects. Another antibody, EBV-IgA, which occurs with repeated or reactivated EBV infection, was also more frequent in African-Americans with lupus. There was also a genetic variation of a particular protein (CTLA-4) that works on T cells in regulating immunity observed in both African-American and white lupus patients.

This study provided blood-serum-based evidence of the connection between lupus and the Epstein-Barr virus. More research is encouraged into the role of race, age, and genetics as they relate to autoimmune diseases.