Detection of autoimmunity in early primary Epstein-Barr virus infection by Western blot analysis

AbstractObjectivesThe Epstein-Barr virus (EBV) represents a potentially important factor in the pathogenesis of certain autoimmunedisorders such as systemic lupus erythematosus (SLE), and Sjögren’s syndrome, probably through a ’s molecular mimicrymechanism. Several studies have focused on the relationship between previous EBV infection and clinically overtconnective tissue diseases (CTDs), while the aim of this study was to investigate the immunological alterations during theearly phase of primary acute EBV infection by means of ENA Western blotting (WB) analysis. This technique is able todetect a wide spectrum of anti-ENA autoantibodies, potentially directed against diverse epitopes of the same antigen.MethodsSera from 54 subjects (F/M=24/30, mean age 17±6 SD years) with primary acute EBV infection were analysed usingindirect immunofl uorescence (IF) on Hep-2 cells for ANA, and both ELISA and WB for ENA.ResultsOnly 8 ANA+ and no ENA+ were found by means of IF and ELISA techniques, respectively; however, one or more ENAautoantibodies were detected in 24/54 (44%) sera using WB. The autoantibodies were no longer present at the secondevaluation. Subjects with immunological alterations had not developed any signifi cant clinical manifestations at a 5-yearfollow-up.ConclusionsThis study demonstrated the appearance of autoantibody production in a high proportion of individuals with primaryacute EBV infection; interestingly, the observed serological subsets are quite similar to clinical SLE clusters. Moreover,the absence of immunological disorders during the follow-up reinforces the role of multiple genetic and/or environmentalco-factors in the pathogenesis of CTDs.