title: Interactions of serum cholesterol with anti-herpesvirus responses affect disease progression in clinically isolated syndromes.
abstract: OBJECTIVE
  To investigate whether anti-herpesvirus antibodies are associated with serum cholesterol profiles in clinically isolated syndromes (CIS).
  
  
  METHODS
  Pre-treatment serum samples from 118 high-risk CIS patients were analyzed for IgG antibodies against cytomegalovirus (anti-CMV), Epstein Barr virus (EBV) viral capsid antigen (VCA) and EBV nuclear antigen-1 (EBNA-1). A lipid profile consisting of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) was obtained. Clinical and MRI assessments were obtained at baseline, 6, 12, and 24 months after start of interferon-beta treatment.
  
  
  RESULTS
  The study included 118 CIS patients (77 females, 41 males, 65.3% female; mean age: 28.1±SD 8.1 years). Anti-EBV EBNA-1 antibody levels were associated with LDL-C (p=0.009) and TC (p=0.008) levels. Anti-CMV positivity status was associated with reduced time to relapse (p=0.006) and the greater number of relapses (p=0.009) in patients with high HDL-C. Anti-EBV VCA antibody levels were associated with greater number of new T2 lesions (p=0.002) and with increased brain atrophy (p<0.001) in patients with high LDL-C.
  
  
  CONCLUSIONS
  Our results indicate that higher levels of anti-EBV EBNA-1 antibodies are associated with higher LDL-C and TC levels. Anti-CMV positive individuals have greater disease progression in the presence of higher HDL-C levels. Individuals with higher levels of anti-EBV VCA antibodies have greater progression on MRI measures in the presence of higher LDL-C.
authors.affiliation: Department of Neurology, State University of New York, Buffalo, NY, USA.
authors.forename: Bianca
authors.initials: B
authors.lastname: Weinstock-Guttman
authors.forename: Dana
authors.initials: D
authors.lastname: Horakova
authors.forename: Robert
authors.initials: R
authors.lastname: Zivadinov
authors.forename: Miriam
authors.initials: M
authors.lastname: Tamaño-Blanco
authors.forename: Darlene
authors.initials: D
authors.lastname: Badgett
authors.forename: Michaela
authors.initials: M
authors.lastname: Tyblova
authors.forename: Manuela
authors.initials: M
authors.lastname: Vaneckova
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Seidl
authors.forename: Jan
authors.initials: J
authors.lastname: Krasensky
authors.forename: Niels
authors.initials: N
authors.lastname: Bergsland
authors.forename: Deepa P
authors.initials: DP
authors.lastname: Ramasamy
authors.forename: Jesper
authors.initials: J
authors.lastname: Hagemeier
authors.forename: Eva
authors.initials: E
authors.lastname: Havrdova
authors.forename: Murali
authors.initials: M
authors.lastname: Ramanathan
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D002784:Cholesterol / Q000097:blood*; D003587:Cytomegalovirus / Q000302:isolation & purification; D003711:Demyelinating Diseases / Q000097:blood* / Q000175:diagnosis* / Q000821:virology; D018450:Disease Progression; D020031:Epstein-Barr Virus Infections / Q000276:immunology* / Q000473:pathology / Q000821:virology; D019309:Epstein-Barr Virus Nuclear Antigens / Q000097:blood; D005260:Female; D006564:Herpesviridae / Q000302:isolation & purification*; D004854:Herpesvirus 4, Human / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D019309:Epstein-Barr Virus Nuclear Antigens; D002784:Cholesterol; C417029:EBV-encoded nuclear antigen 1
keywords: Cholesterol; Clinically isolated syndromes; Environmental factor interactions; Epstein–Barr virus; Lipid; Multiple sclerosis