title: No evidence for intrathecal IgG synthesis to Epstein Barr virus nuclear antigen-1 in multiple sclerosis.
abstract: BACKGROUND
  Recent studies suggest an intrathecal IgG response against Epstein Barr virus (EBV) in multiple sclerosis (MS), implicating a pathogenic role for the virus in MS.
  
  
  OBJECTIVE
  To determine the spectrum of anti-EBV antibodies and B-cell epitopes within EBV nuclear antigen-1 (EBNA-1). Furthermore, to determine whether EBNA-1-specific IgG is produced intrathecally.
  
  
  METHODS
  Immunoblot analysis was used to study the anti-EBV IgG response in serum and cerebral spinal fluid (CSF) in MS and controls. EBNA-1 B-cell epitopes were identified by immunoscreening of 12 residue long peptides, with 11 residue overlap, spanning EBNA-1. Thirteen peptides containing all immunoreactive regions were constructed and used in paired serum and CSF of MS patients (n=17) and controls (n=18). Subsequently, reactivity to the identified immunodominant peptide was analysed in a large cohort of serum and CSF of MS patients (n=114) and disease controls (n=62).
  
  
  RESULTS
  No difference was observed in the overall anti-EBV antibody diversity, but EBNA-1 reactivity was increased in MS patients versus controls for immunoblot and ELISA (p<0.0001). Epitope analysis on EBNA-1 revealed one immunodominant region covering residues 394-451: EBNA-1(394-451). Anti-EBNA-1(394-451) IgG levels in serum and CSF were significantly higher in MS patients compared to controls. However, normalization for total IgG content of paired serum and CSF samples abrogated this disease association.
  
  
  CONCLUSIONS
  MS patients have normal overall anti-EBV antibody responses with increased reactivity to EBNA-1(394-451). No evidence was found for intrathecal EBNA-1-specific IgG synthesis in MS.
authors.affiliation: Department of Neurology, MS center ErasMS, Erasmus MC, Dr. Molewaterplein 50-60, 3015 GE Rotterdam, The Netherlands.
authors.forename: Naghmeh
authors.initials: N
authors.lastname: Jafari
authors.forename: Gijsbert P
authors.initials: GP
authors.lastname: van Nierop
authors.forename: Georges M G M
authors.initials: GM
authors.lastname: Verjans
authors.forename: Albert D M E
authors.initials: AD
authors.lastname: Osterhaus
authors.forename: Jaap M
authors.initials: JM
authors.lastname: Middeldorp
authors.forename: Rogier Q
authors.initials: RQ
authors.lastname: Hintzen
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood / Q000134:cerebrospinal fluid*; D018985:Epitopes, B-Lymphocyte; D019309:Epstein-Barr Virus Nuclear Antigens / Q000276:immunology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000276:immunology / Q000821:virology*
chemical_list: D000914:Antibodies, Viral; D018985:Epitopes, B-Lymphocyte; D019309:Epstein-Barr Virus Nuclear Antigens; D007074:Immunoglobulin G; C417029:EBV-encoded nuclear antigen 1