Reduced response to Epstein-Barr virus antigens by T-cells in systemic lupus erythematosus patients.
OBJECTIVE
Epstein-Barr virus (EBV) has for long been associated with systemic lupus erythematosus (SLE). In this study, we investigated the levels of latent and lytic antigen EBV-specific T-cells and antibodies in SLE patients.


METHODS
T cells were analyzed by flow cytometry and antibodies were analyzed by enzyme-linked immunosorbent assay.


RESULTS
SLE patients showed a significantly reduced number of activated (CD69) T-cells upon ex vivo stimulation with EBV nuclear antigen (EBNA) 1 or EBV early antigen diffuse (EBV-EA/D) in whole blood samples compared with healthy controls. Also, a reduced number of T-cells from SLE patients were found to produce interferon-γ upon stimulation with these antigens. Importantly, responses to a superantigen were normal in SLE patients. Compared with healthy controls, SLE patients had fewer EBV-specific T-cells but higher titres of antibodies against EBV. Furthermore, an inverse correlation was revealed between the number of lytic antigen EBV-specific T-cells and disease activity of the SLE patients, with high-activity SLE patients having fewer T-cells than low-activity SLE patients.


CONCLUSIONS
These results indicate a limited or a defective EBV-specific T-cell response in SLE patients, which may suggest poor control of EBV infection in SLE with an immune reaction shift towards a humoral response in an attempt to control viral reactivation. A role for decreased control of EBV as a contributing agent in the development or exacerbation of SLE is proposed.
Department of Clinical Biochemistry, Immunology and Genetics , Statens Serum Institut , Copenhagen , Denmark.
Anette Holck
AH
Draborg
Department of Infectious Diseases and Rheumatology, Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark.
Søren
S
Jacobsen
Department of Clinical Biochemistry, Immunology and Genetics , Statens Serum Institut , Copenhagen , Denmark.
Marie
M
Westergaard
Department of Microbiological Diagnostics and Virology , Statens Serum Institut , Copenhagen , Denmark.
Shila
S
Mortensen
Department of Infectious Diseases and Rheumatology, Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark.
Janni Lisander
JL
Larsen
Department of Clinical Biochemistry, Immunology and Genetics , Statens Serum Institut , Copenhagen , Denmark.
Gunnar
G
Houen
Department of Clinical Biochemistry, Immunology and Genetics , Statens Serum Institut , Copenhagen , Denmark.
Karen
K
Duus
Epstein-Barr virus; Systemic lupus erythematosus; T-cells; antibodies