title: Epstein-Barr virus persistence and reactivation in neuromyelitis optica.
abstract: OBJECTIVE
  Epstein-Barr virus (EBV) infection has been thought to be a key environmental factor in the development of multiple sclerosis (MS). The aim of this study is to investigate the association of EBV infection with neuromyelitis optica (NMO).
  
  
  METHODS
  We measured levels of serum antibodies against EBV antigens, including anti-viral capsid antigen (VCA) IgM, anti-VCA IgG, anti-early antigen (EA) IgM, anti-EA IgG and anti-EBV nuclear antigen-1 IgG, in 50 patients with NMO (including 12 partial form with antiaquaporin 4 antibodies), 51 patients with MS, and 52 healthy controls, and cerebrospinal fluid (CSF) antibodies in 37 patients with NMO and 33 patients with MS with ELISA.
  
  
  RESULTS
  Compared with patients with MS and normal participants, patients with NMO more frequently had serum anti-EA IgG antibodies (52%), indicating more active viral replication than patients with MS (26%) and controls (25%). The antibody titres were significantly higher in the NMO group than in the MS (p=0.005) and control (p=0.005) groups. The CSF antibody titres were also higher in patients with NMO than in those with MS (p=0.03).
  
  
  CONCLUSIONS
  Our results raise the hypothesis that persistent, active EBV replication is present in NMO, and may contribute to the immunological alterations that play a pathogenetic role in the disorder.
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Saeko
authors.initials: S
authors.lastname: Masuda
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Neurology, National Hospital Organization Chiba-East-Hospital, Chiba, Japan.
authors.forename: Kimihito
authors.initials: K
authors.lastname: Arai
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Akiyuki
authors.initials: A
authors.lastname: Uzawa
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Muto
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Uchida
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Masuda
authors.affiliation: Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Satoshi
authors.identifier: http://orcid.org/0000-0002-4716-8578
authors.initials: S
authors.lastname: Kuwabara
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D000956:Antigens, Viral / Q000032:analysis / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000821:virology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000502:physiology*; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid / Q000235:genetics; D008137:Longitudinal Studies; D008297:Male; D009103:Multiple Sclerosis / Q000821:virology; D009471:Neuromyelitis Optica / Q000821:virology*; D014775:Virus Activation
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007074:Immunoglobulin G
keywords: MULTIPLE SCLEROSIS; NEUROIMMUNOLOGY