title: Epstein-Barr Virus Specific Antibody Response in Multiple Sclerosis Patients during 21 Months of Natalizumab Treatment.
abstract: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. Natalizumab, a humanized anti-α4 integrin monoclonal antibody, is a highly effective treatment approved for MS. An association between MS and an exposure to Epstein-Barr Virus (EBV) sustained by the levels of antiviral capsid antigen (VCA) and anti-Epstein-Barr nuclear antigen-1 (EBNA-1) IgG has been described. Our goal was to verify the utility of EBV-specific IgG as a marker in Natalizumab treated MS. Twenty patients (17 female and 3 male) in treatment with Natalizumab were enrolled. Serum levels of anti-VCA and anti-EBNA-1 IgG were determined and expressed as arbitrary units (AU) before treatment and every three months for 21 months of therapy. Anti-VCA IgG levels were increased at the 15th month (235410 ± 196712 AU) comparing with the 3rd (98146 ± 47145 AU) and the 6th (109866 ± 52270 AU) months of therapy (p < 0.05). No significant differences were found for serum anti-EBNA-1 IgG levels. Our data indicate that a transient, self-limited, EBV reactivation can occur in MS during Natalizumab therapy but our results do not support the use of serum EBV-specific antibody levels as biomarkers for monitoring therapeutic response to Natalizumab in the course of MS.
authors.affiliation: Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, 44124 Ferrara, Italy.
authors.forename: Massimiliano
authors.identifier: 0000-0001-6555-6075
authors.initials: M
authors.lastname: Castellazzi
authors.affiliation: Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Delbue
authors.affiliation: Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Elia
authors.affiliation: Department of General Neurology, National Neurological Institute C. Mondino, 27100 Pavia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Gastaldi
authors.affiliation: Department of General Neurology, National Neurological Institute C. Mondino, 27100 Pavia, Italy.
authors.forename: Diego
authors.identifier: 0000-0002-3014-3913
authors.initials: D
authors.lastname: Franciotta
authors.affiliation: Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy.
authors.forename: Roberta
authors.identifier: 0000-0001-9507-9126
authors.initials: R
authors.lastname: Rizzo
authors.affiliation: Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, 44124 Ferrara, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Bellini
authors.affiliation: Department of General Neurology, National Neurological Institute C. Mondino, 27100 Pavia, Italy.
authors.forename: Roberto
authors.identifier: 0000-0002-1397-511X
authors.initials: R
authors.lastname: Bergamaschi
authors.affiliation: Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, 44124 Ferrara, Italy.
authors.forename: Enrico
authors.identifier: 0000-0003-4038-3192
authors.initials: E
authors.lastname: Granieri
authors.affiliation: Department of Neurosciences and Rehabilitation, Azienda Ospedaliero-Universitaria, 44124 Ferrara, Italy.
authors.forename: Enrico
authors.identifier: 0000-0003-0477-724X
authors.initials: E
authors.lastname: Fainardi
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000914:Antibodies, Viral / Q000097:blood*; D000956:Antigens, Viral / Q000276:immunology; D036022:Capsid Proteins / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000150:complications / Q000276:immunology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000069442:Natalizumab / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000914:Antibodies, Viral; D000956:Antigens, Viral; D036022:Capsid Proteins; D000069442:Natalizumab