title: Reduced IgG anti-small nuclear ribonucleoprotein autoantibody production in systemic lupus erythematosus patients with positive IgM anti-cytomegalovirus antibodies.
abstract: BACKGROUND
  Systemic lupus erythematosus is characterized by production of autoantibodies to RNA or DNA-protein complexes such as small nuclear ribonucleoproteins (snRNPs). A role of Epstein-Barr virus in the pathogenesis has been suggested. Similar to Epstein-Barr virus, cytomegalovirus (CMV) infects the majority of individuals at a young age and establishes latency with a potential for reactivation. Homology of CMV glycoprotein B (UL55) with the U1snRNP-70 kDa protein (U1-70 k) has been described; however, the role of CMV infection in production of anti-snRNPs is controversial. We investigated the association of CMV serology and autoantibodies in systemic lupus erythematosus.
  
  
  METHODS
  Sixty-one Mexican patients with systemic lupus erythematosus were tested for CMV and Epstein-Barr virus serology (viral capsid antigen, IgG, IgM) and autoantibodies by immunoprecipitation and ELISA (IgG and IgM class, U1RNP/Sm, U1-70 k, P peptide, rheumatoid factor, dsDNA, beta2-glycoprotein I).
  
  
  RESULTS
  IgG anti-CMV and IgM anti-CMV were positive in 95% (58/61) and 33% (20/61), respectively, and two cases were negative for both. Clinical manifestation and autoantibodies in the IgM anti-CMV+ group (n = 20) versus the IgM anti-CMV(-)IgG+ (n = 39) group were compared. Most (19/20) of the IgM anti-CMV+ cases were IgG anti-CMV+, consistent with reactivation or reinfection. IgM anti-CMV was unrelated to rheumatoid factor or IgM class autoantibodies and none was positive for IgM anti-Epstein-Barr virus-viral capsid antigen, indicating that this is not simply due to false positive results caused by rheumatoid factor or nonspecific binding by certain IgM. The IgM anti-CMV+ group has significantly lower levels of IgG anti-U1RNP/Sm and IgG anti-U1-70 k (P = 0.0004 and P = 0.0046, respectively). This finding was also confirmed by immunoprecipitation. Among the IgM anti-CMV(-) subset, anti-Su was associated with anti-U1RNP and anti-Ro (P < 0.05). High levels of IgG anti-CMV were associated with production of lupus-related autoantibodies to RNA or DNA-protein complex (P = 0.0077).
  
  
  CONCLUSIONS
  Our findings suggest a potential role of CMV in regulation of autoantibodies to snRNPs and may provide a unique insight to understand the pathogenesis.
authors.affiliation: Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara, Jalisco, CP 44340, México. kklaumx@yahoo.com
authors.forename: Claudia Azucena
authors.initials: CA
authors.lastname: Palafox Sánchez
authors.forename: Minoru
authors.initials: M
authors.lastname: Satoh
authors.forename: Edward Kl
authors.initials: EK
authors.lastname: Chan
authors.forename: Wendy C
authors.initials: WC
authors.lastname: Carcamo
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Muñoz Valle
authors.forename: Gerardo
authors.initials: G
authors.lastname: Orozco Barocio
authors.forename: Edith
authors.initials: E
authors.lastname: Oregon Romero
authors.forename: Rosa Elena
authors.initials: RE
authors.lastname: Navarro Hernández
authors.forename: Mario
authors.initials: M
authors.lastname: Salazar Páramo
authors.forename: Antonio
authors.initials: A
authors.lastname: Cabral Castañeda
authors.forename: Mónica
authors.initials: M
authors.lastname: Vázquez Del Mercado
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood / Q000276:immunology; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000276:immunology; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D001324:Autoantigens / Q000097:blood / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D047468:Immunoprecipitation; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000276:immunology* / Q000821:virology*; D008297:Male; D017411:Ribonucleoproteins, Small Nuclear / Q000276:immunology*
chemical_list: D000906:Antibodies; D000914:Antibodies, Viral; D000956:Antigens, Viral; D001323:Autoantibodies; D001324:Autoantigens; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D017411:Ribonucleoproteins, Small Nuclear