EB病毒与干燥综合征的相关性研究
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摘要
目的研究EB病毒感染与干燥综合征发病及致病作用的关系。方法通过回顾2016年1月至2017年12月在山西大医院就诊的72例干燥综合征病例和60名健康体检者并收集其外周血样本和乙二胺四乙酸(EDTA)抗凝外周血标本,用酶联免疫吸附试验检测血清EB病毒抗体4项[抗早期抗原IgG抗体(EAIgG)、抗衣壳抗原IgM抗体(VCA-IgM)、抗衣壳抗原IgG抗体(VCA-IgG)、抗核心抗原IgG抗体(EBNA-IgG)],用实时荧光免疫定量聚合酶链反应(PCR)检测外周血单个核细胞的EB病毒核酸。比较2组各检测项目的阳性率,使用Kappa一致性检验评估2类检测结果之间的一致性,并根据EV病毒DNA阳性与否进行分组,研究EB病毒活动与干燥综合征临床表现是否相关。结果 (1)VCA-IgG在疾病组及健康对照组中的阳性率为97.2%(70/72)及98.3%(59/60)(χ2=0.182,P=0.670);EBNA-IgG在疾病组及健康对照组中的阳性率为95.8%(69/72)及95.0%(57/60)(χ2=0.052,P=0.819);EA-IgG在疾病组及健康对照组中的阳性率为11.1%(8/72)及5.0%(3/60)(χ2=1.600,P=0.206);VCA-IgM在疾病组及健康对照组中的阳性率为23.6%(17/72)及0(0/60)(χ2=16.261,P<0.01)。外周血单核细胞中EB病毒核酸在2组中的阳性率分别为31.9%(23/72)及13.3%(8/60)(χ2=6.308,P=0.012)。(2)相同标本单个核细胞EB病毒核酸与血清EA-IgG、VCA-IgM检测结果的一致性较差(Kappa值分别为0.023和0.050)。(3)EB病毒活动与干燥综合征临床表现无相关性(P>0.05)。结论干燥综合征患者EB病毒感染阳性率明显高于健康体检人群;EB病毒核酸与EB病毒血清学检测结果之间的一致性较差;EB病毒活动与干燥综合征的病情无关。因此,EB病毒可能参与了干燥综合征的发病,而非促进病情活动。
Objective To investigate the relationship between Epstein-Barr(EB) virus infection and the pathogenesis of Sjgren′s syndrome. Methods A total of 72 cases of Sjgren′s syndrome and 60 health-checkup recipients who visited the Shanxi Dayi Hospital between January 2016 and December 2017 were included in this retrospective study. The subjects were collected for peripheral blood samples with and without EDTA anticoagulation. Enzyme-linked immunosorbent assay was used to detectthe serum EB virus antibodies [early antigen IgG(EA-IgG), viral capsid antigen IgM(VCA-IgM), viral capsid antigen IgG(VCA-IgG), EB nuclear antigen IgG(EBNA-IgG)], and real-time fluorescent immunoassay to detect the EB virus nucleic acids in peripheral blood mononuclear cells. The positive rates of each test were compared between the two groups. Kappa consistency test was used to evaluate the consistency in findings between the two tests. With the subjects stratified by positivity or negativity of EV virus DNA, the correlation between EB virus activity and the clinical manifestations of Sjgren′s syndrome was further studied. Results The positive rate of VCA-IgG in the disease group and healthy control group were 97.2%(70/72) and 98.3%(59/60)( χ2=0.182, P=0.670). The positive rates of EBNA-IgG in the disease group and healthy control group were 95.8%(69/72)and 95.0%(57/60)( χ2=0.052, P=0.819). The positive rates of EA-IgG in the disease group and the healthy control group were 11.1%(8/72) and 5.0%(3/60)( χ2=1.600, P=0.206). The positive rates of VCA-IgM in the disease group and the healthy control group were 23.6(17/72) and 0%(0/60)( χ2=16.261, P<0.01). The positive rates of EBV nucleic acids in peripheral blood mononuclear cells were 31.9%(23/72) and 13.3%(8/60), respectively( χ2=6.308, P =0.012). In any given specimen, the EBV nucleic acids in mononuclear cellswas poorly consistent with serum EA-IgG and VCA-IgM(Kappa = 0.023 and 0.050, respectively). There was no correlation between EB virus activity and the clinical manifestations of Sjgren′s syndrome(P>0.05). Conclusion The positive rate of EB virus infection in patients with Sjgren′s syndrome is significantly higher than that in healthy individuals. The agreement between the EB virus nucleic acids and the EB virus serology is poor. EB virus activity is not associated with the clinical presentation of Sjgren′s syndrome. Therefore, EB virus may be involved in the development of Sjgren′s syndrome but does not promote disease activity.
Objective To investigate the relationship between Epstein-Barr(EB) virus infection and the pathogenesis of Sjgren′s syndrome. Methods A total of 72 cases of Sjgren′s syndrome and 60 health-checkup recipients who visited the Shanxi Dayi Hospital between January 2016 and December 2017 were included in this retrospective study. The subjects were collected for peripheral blood samples with and without EDTA anticoagulation. Enzyme-linked immunosorbent assay was used to detectthe serum EB virus antibodies [early antigen IgG(EA-IgG), viral capsid antigen IgM(VCA-IgM), viral capsid antigen IgG(VCA-IgG), EB nuclear antigen IgG(EBNA-IgG)], and real-time fluorescent immunoassay to detect the EB virus nucleic acids in peripheral blood mononuclear cells. The positive rates of each test were compared between the two groups. Kappa consistency test was used to evaluate the consistency in findings between the two tests. With the subjects stratified by positivity or negativity of EV virus DNA, the correlation between EB virus activity and the clinical manifestations of Sjgren′s syndrome was further studied. Results The positive rate of VCA-IgG in the disease group and healthy control group were 97.2%(70/72) and 98.3%(59/60)( χ2=0.182, P=0.670). The positive rates of EBNA-IgG in the disease group and healthy control group were 95.8%(69/72)and 95.0%(57/60)( χ2=0.052, P=0.819). The positive rates of EA-IgG in the disease group and the healthy control group were 11.1%(8/72) and 5.0%(3/60)( χ2=1.600, P=0.206). The positive rates of VCA-IgM in the disease group and the healthy control group were 23.6(17/72) and 0%(0/60)( χ2=16.261, P<0.01). The positive rates of EBV nucleic acids in peripheral blood mononuclear cells were 31.9%(23/72) and 13.3%(8/60), respectively( χ2=6.308, P =0.012). In any given specimen, the EBV nucleic acids in mononuclear cellswas poorly consistent with serum EA-IgG and VCA-IgM(Kappa = 0.023 and 0.050, respectively). There was no correlation between EB virus activity and the clinical manifestations of Sjgren′s syndrome(P>0.05). Conclusion The positive rate of EB virus infection in patients with Sjgren′s syndrome is significantly higher than that in healthy individuals. The agreement between the EB virus nucleic acids and the EB virus serology is poor. EB virus activity is not associated with the clinical presentation of Sjgren′s syndrome. Therefore, EB virus may be involved in the development of Sjgren′s syndrome but does not promote disease activity.
引文
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[2] Croia C,Astorri E,Murray-Brown W,et al.Implication of EpsteinBarr virus infection in disease specific autoreactive B cell activation in ectopic lymphoid structures of Sjgren′s syndrome[J].Arthritis Rheumatol,2014,66:2545-2557.
[3]朱耀武,王玉春,潘莹莹,等.EB病毒核酸及血清学检测在EB病毒相关疾病中的应用研究[J].中华检验医学杂志,2017,40(3):195-200.
[4] Lossius A,Johansen JN,Torkildsen覫,et al. Epstein-Barr virus in Systemic Lupus erythematosus,rheumatoid arthritis and multiple sclerosis-association and causation[J]. Viruses, 2012,4(12):3701-3730.
[5]刘焱,黄静,孙凌云,等.系统性红斑狼疮患者抗EB病毒抗体表达研究[J].中华风湿病学杂志,2011,15(5):291-294.
[6]曹晓宇,吴迪,侯勇. Epstein-Barr病毒和结缔组织病[J].中华临床免疫和变态反应杂志,2016,4(10):402-406.
[7] Anaya JM,Rojas-Villarraga A,Ruben D,et al. Polyautoimmunity in Sjgren syndrome[J]. Rheum Dis Clin North Am,2016,42(3):457-472.
[8] Narkeviciute I,Sudzius G,Mieliauskaite D,et al. Are cytotoxic effector cells changes in peripheral blood of patients with Sj-gren′s syndrome related to persistent virus infection:suggestions and conundrums[J]. Cell Immunol,2016,12(310):123-130.
[9] Kivity S,Teresa-Arango M,Ehrenfeld M,et al. Infection and autoimmunity in Sjgren′s syndrome:a clinical study and comprehensive review[J]. J Autoimmunity,2014,51:12-22.
[10] Voulgarelisand M,Moutsopoulos HM. Mucosa-associate lymphoid tissue lymphoma in Sjgren′s syndrome risks:management,and prognosis[J].Rheum Dis Clin North Am,2008,34(4):921-933.
[11] Nagata Y,Inoue H,Yamada K,et al. Activation of Epstein-Barr virus by saliva from Sjgren′s syndrome patient[J].Immunology,2004,111(2):223-229.
[2] Croia C,Astorri E,Murray-Brown W,et al.Implication of EpsteinBarr virus infection in disease specific autoreactive B cell activation in ectopic lymphoid structures of Sjgren′s syndrome[J].Arthritis Rheumatol,2014,66:2545-2557.
[3]朱耀武,王玉春,潘莹莹,等.EB病毒核酸及血清学检测在EB病毒相关疾病中的应用研究[J].中华检验医学杂志,2017,40(3):195-200.
[4] Lossius A,Johansen JN,Torkildsen覫,et al. Epstein-Barr virus in Systemic Lupus erythematosus,rheumatoid arthritis and multiple sclerosis-association and causation[J]. Viruses, 2012,4(12):3701-3730.
[5]刘焱,黄静,孙凌云,等.系统性红斑狼疮患者抗EB病毒抗体表达研究[J].中华风湿病学杂志,2011,15(5):291-294.
[6]曹晓宇,吴迪,侯勇. Epstein-Barr病毒和结缔组织病[J].中华临床免疫和变态反应杂志,2016,4(10):402-406.
[7] Anaya JM,Rojas-Villarraga A,Ruben D,et al. Polyautoimmunity in Sjgren syndrome[J]. Rheum Dis Clin North Am,2016,42(3):457-472.
[8] Narkeviciute I,Sudzius G,Mieliauskaite D,et al. Are cytotoxic effector cells changes in peripheral blood of patients with Sj-gren′s syndrome related to persistent virus infection:suggestions and conundrums[J]. Cell Immunol,2016,12(310):123-130.
[9] Kivity S,Teresa-Arango M,Ehrenfeld M,et al. Infection and autoimmunity in Sjgren′s syndrome:a clinical study and comprehensive review[J]. J Autoimmunity,2014,51:12-22.
[10] Voulgarelisand M,Moutsopoulos HM. Mucosa-associate lymphoid tissue lymphoma in Sjgren′s syndrome risks:management,and prognosis[J].Rheum Dis Clin North Am,2008,34(4):921-933.
[11] Nagata Y,Inoue H,Yamada K,et al. Activation of Epstein-Barr virus by saliva from Sjgren′s syndrome patient[J].Immunology,2004,111(2):223-229.