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Eckert S, Jakimovski D, Zivadinov R, Hicar M, Weinstock-Guttman B. How to and should we target EBV in MS? Expert Rev Clin Immunol 2024; 20:703-714. [PMID: 38477887 DOI: 10.1080/1744666x.2024.2328739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION The etiology of multiple sclerosis (MS) remains unknown. Pathogenesis likely relies on a complex interaction between multiple environmental, genetic, and behavioral risk factors. However, a growing body of literature supports the role of a preceding Epstein-Barr virus (EBV) infection in the majority of cases. AREAS COVERED In this narrative review, we summarize the latest findings regarding the potential role of EBV as a predisposing event inducing new onset of MS. EBV interactions with the genetic background and other infectious agents such as human endogenous retrovirus are explored. Additional data regarding the role of EBV regarding the rate of mid- and long-term disease progression is also discussed. Lastly, the effect of currently approved disease-modifying therapies (DMT) for MS treatment on the EBV-based molecular mechanisms and the development of new EBV-specific therapies are further reviewed. EXPERT OPINION Recent strong epidemiological findings support that EBV may be the primary inducing event in certain individuals that shortly thereafter develop MS. More studies are needed in order to better understand the significant variability in susceptibility based on environmental factors such as EBV exposure. Future investigations should focus on determining the specific EBV-related risk antigen(s) and phenotyping people with likely EBV-induced MS. Targeting EBV via several different avenues, including development of an EBV vaccine, may become the mainstay of MS treatment in the future.
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Affiliation(s)
- Svetlana Eckert
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Dejan Jakimovski
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
- Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Mark Hicar
- Department of Pediatrics Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
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2
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Bose A, Khalighinejad F, Hoaglin DC, Hemond CC. Evaluating the Clinical Utility of Epstein-Barr Virus Antibodies as Biomarkers in Multiple Sclerosis: A Systematic Review. Mult Scler Relat Disord 2024; 84:105410. [PMID: 38401201 DOI: 10.1016/j.msard.2023.105410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND EBV is a necessary but not sufficient factor in the pathophysiology of multiple sclerosis (MS). EBV antibodies to the nuclear antigen (EBNA1) and viral capsid antigen (VCA) rise rapidly prior to MS disease manifestations, and their absence has clinical utility with a high negative predictive value. It remains unclear whether EBV levels act as prognostic, monitoring, or pharmacodynamic/response biomarkers. Substantial literature on this topic exists but has not been systematically reviewed. We hypothesized that EBV levels against EBNA1 and VCA are potential prognostic and monitoring biomarkers in MS, and that patient population, MS clinical phenotype, and EBV assay method may play important roles in explaining variation among study outcomes. METHODS We systematically searched PubMed and EMBASE from inception to April 1, 2022. After removal of duplicates, records were screened by abstract. Remaining full-text articles were reviewed. Clinical and MRI data were extracted from full-text articles for comparison and synthesis. RESULTS Searches yielded 696 unique results; 285 were reviewed in full, and 36 met criteria for data extraction. Heterogeneity in sample population, clinical outcome measures, assay methods and statistical analyses precluded a meta-analysis. EBV levels were not consistently associated with clinical disease markers including conversion from CIS to RRMS, neurological disability, or disease phenotype. Studies using repeated-measures design suggest that EBNA1 levels may temporarily reflect inflammatory disease activity as assessed by gadolinium-enhancing Magnetic Resonance Imaging (MRI) lesions. Limited data also suggest a decrease in EBV levels following initiation of certain disease-modifying therapies. CONCLUSION Heterogeneous methodology limited generalization and meta-analysis. EBV antibody levels are unlikely to represent prognostic biomarkers in MS. The areas of highest ongoing promise relate to diagnostic exclusion and pharmacodynamic/disease response. Use of EBV antibodies as biomarkers in clinical practice remains additionally limited by lack of methodological precision, reliability, and validation.
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Affiliation(s)
- Abigail Bose
- University of Massachusetts Chan Medical School.
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3
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Gao J, Wang A, Bu X, Jia W. Acute murine cytomegalovirus infection boosts cell-type specific response and lipid metabolism changes in the liver of infant mice. Front Immunol 2023; 14:1169869. [PMID: 37638012 PMCID: PMC10449610 DOI: 10.3389/fimmu.2023.1169869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Human cytomegalovirus (HCMV) infection in infants can lead to severe diseases, including neonatal hepatitis. The single-cell dimensional changes in immune cells after the initial CMV infection remain elusive, as do the effects of CMV infection on hepatic lipid metabolism. Methods We employed single-cell RNA-sequencing to investigate the changes in liver cell types and immune responses in infant mice following murine CMV (MCMV) infection. Additionally, we examined alterations in protein expression profiles related to lipid metabolism in hepatocytes and the role of the key transcription factor PPAR-γ in hepatocytes during CMV infection. Results Our study revealed that MCMV infects most liver cell types in infant mice, leading to an increase in the proportion of proliferating CD8 effector T cells and a subset of Nos2+ monocytes, potentially playing an essential role in early anti-viral responses. Furthermore, MCMV infection resulted in altered protein expression of lipid metabolism in hepatocytes. Knocking down the transcription factor PPAR-γ in hepatocytes effectively inhibited CMV infection. Discussion Our findings underscore the immune system's response to early-stage MCMV infection and the subsequent impact on hepatic lipid metabolism in infant mice. This research provides new insights into the mechanisms of CMV infection and could pave the way for novel therapeutic strategies.
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Affiliation(s)
- Juanzi Gao
- Department of Hepatic Surgery, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Anmin Wang
- Institute of Immunology, the Chinese Academy of Sciences Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiangyi Bu
- Department of Hepatic Surgery, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Weidong Jia
- Department of Hepatic Surgery, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of University of Science and Technology of China (USTC), Hefei, China
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Jakhmola S, Upadhyay A, Jain K, Mishra A, Jha HC. Herpesviruses and the hidden links to Multiple Sclerosis neuropathology. J Neuroimmunol 2021; 358:577636. [PMID: 34174587 DOI: 10.1016/j.jneuroim.2021.577636] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/01/2021] [Accepted: 06/17/2021] [Indexed: 01/08/2023]
Abstract
Herpesviruses like Epstein-Barr virus, human herpesvirus (HHV)-6, HHV-1, VZV, and human endogenous retroviruses, have an age-old clinical association with multiple sclerosis (MS). MS is an autoimmune disease of the nervous system wherein the myelin sheath deteriorates. The most popular mode of virus mediated immune system manipulation is molecular mimicry. Numerous herpesvirus antigens are similar to myelin proteins. Other mechanisms described here include the activity of cytokines and autoantibodies produced by the autoreactive T and B cells, respectively, viral déjà vu, epitope spreading, CD46 receptor engagement, impaired remyelination etc. Overall, this review addresses the host-parasite association of viruses with MS.
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Affiliation(s)
- Shweta Jakhmola
- Infection Bioengineering Group, Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, India
| | - Arun Upadhyay
- Cellular and Molecular Neurobiology Unit, Indian Institute of Technology, Jodhpur, India
| | - Khushboo Jain
- Infection Bioengineering Group, Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, India
| | - Amit Mishra
- Cellular and Molecular Neurobiology Unit, Indian Institute of Technology, Jodhpur, India
| | - Hem Chandra Jha
- Infection Bioengineering Group, Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, India.
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Vanheusden M, Broux B, Welten SPM, Peeters LM, Panagioti E, Van Wijmeersch B, Somers V, Stinissen P, Arens R, Hellings N. Cytomegalovirus infection exacerbates autoimmune mediated neuroinflammation. Sci Rep 2017; 7:663. [PMID: 28386103 PMCID: PMC5428769 DOI: 10.1038/s41598-017-00645-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 03/07/2017] [Indexed: 12/28/2022] Open
Abstract
Cytomegalovirus (CMV) is a latent virus which causes chronic activation of the immune system. Here, we demonstrate that cytotoxic and pro-inflammatory CD4+CD28null T cells are only present in CMV seropositive donors and that CMV-specific Immunoglobulin (Ig) G titers correlate with the percentage of these cells. In vitro stimulation of peripheral blood mononuclear cells with CMVpp65 peptide resulted in the expansion of pre-existing CD4+CD28null T cells. In vivo, we observed de novo formation, as well as expansion of CD4+CD28null T cells in two different chronic inflammation models, namely the murine CMV (MCMV) model and the experimental autoimmune encephalomyelitis (EAE) model for multiple sclerosis (MS). In EAE, the percentage of peripheral CD4+CD28null T cells correlated with disease severity. Pre-exposure to MCMV further aggravated EAE symptoms, which was paralleled by peripheral expansion of CD4+CD28null T cells, increased splenocyte MOG reactivity and higher levels of spinal cord demyelination. Cytotoxic CD4+ T cells were identified in demyelinated spinal cord regions, suggesting that peripherally expanded CD4+CD28null T cells migrate towards the central nervous system to inflict damage. Taken together, we demonstrate that CMV drives the expansion of CD4+CD28null T cells, thereby boosting the activation of disease-specific CD4+ T cells and aggravating autoimmune mediated inflammation and demyelination.
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Affiliation(s)
- Marjan Vanheusden
- Hasselt University, Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium
| | - Bieke Broux
- Hasselt University, Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium
| | - Suzanne P M Welten
- Leiden University Medical Centre, Department of Immunohematology and Blood Transfusion, Leiden, The Netherlands
| | - Liesbet M Peeters
- Hasselt University, Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium
| | - Eleni Panagioti
- Leiden University Medical Centre, Department of Immunohematology and Blood Transfusion, Leiden, The Netherlands
| | - Bart Van Wijmeersch
- Hasselt University, Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium.,Rehabilitation and Multiple Sclerosis Centre, Overpelt, Belgium
| | - Veerle Somers
- Hasselt University, Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium
| | - Piet Stinissen
- Hasselt University, Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium
| | - Ramon Arens
- Leiden University Medical Centre, Department of Immunohematology and Blood Transfusion, Leiden, The Netherlands
| | - Niels Hellings
- Hasselt University, Biomedical Research Institute and Transnationale Universiteit Limburg, School of Life Sciences, Diepenbeek, Belgium.
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Milovanovic J, Popovic B, Milovanovic M, Kvestak D, Arsenijevic A, Stojanovic B, Tanaskovic I, Krmpotic A, Arsenijevic N, Jonjic S, Lukic ML. Murine Cytomegalovirus Infection Induces Susceptibility to EAE in Resistant BALB/c Mice. Front Immunol 2017; 8:192. [PMID: 28289417 PMCID: PMC5326788 DOI: 10.3389/fimmu.2017.00192] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 02/09/2017] [Indexed: 12/24/2022] Open
Abstract
In contrast to C57BL/6 mice, BALB/c mice are relatively resistant to the induction of experimental autoimmune encephalomyelitis (EAE) after challenge with MOG35–55 peptide. Here, we provide the first evidence that infection with murine cytomegalovirus (MCMV) in adulthood abrogates this resistance. Infected BALB/c mice developed clinical and histological signs similar to those seen in susceptible C57BL/6 mice. In addition to CD4+ cells, large proportion of cells in the infiltrate of diseased BALB/c mice was CD8+, similar with findings in multiple sclerosis. CD8+ cells that responded to ex vivo restimulation with MOG35–55 were not specific for viral epitopes pp89 and m164. MCMV infection favors proinflammatory type of dendritic cells (CD86+CD40+CD11c+) in the peripheral lymph organs, M1 type of microglia in central nervous system, and increases development of Th1/Th17 encephalitogenic cells. This study indicates that MCMV may enhance autoimmune neuropathology and abrogate inherent resistance to EAE in mouse strain by enhancing proinflammatory phenotype of antigen-presenting cells, Th1/Th17, and CD8 response to MOG35–55.
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Affiliation(s)
- Jelena Milovanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Faculty of Medical Sciences, Institute of Histology, University of Kragujevac, Kragujevac, Serbia
| | - Branka Popovic
- Center for Proteomics, Faculty of Medicine, Department for Histology and Embryology, University of Rijeka , Rijeka , Croatia
| | - Marija Milovanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
| | - Daria Kvestak
- Center for Proteomics, Faculty of Medicine, Department for Histology and Embryology, University of Rijeka , Rijeka , Croatia
| | - Aleksandar Arsenijevic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
| | - Bojana Stojanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Faculty of Medical Sciences, Institute of Pathophysiology, University of Kragujevac, Kragujevac, Serbia
| | - Irena Tanaskovic
- Faculty of Medical Sciences, Institute of Histology, University of Kragujevac , Kragujevac , Serbia
| | - Astrid Krmpotic
- Center for Proteomics, Faculty of Medicine, Department for Histology and Embryology, University of Rijeka , Rijeka , Croatia
| | - Nebojsa Arsenijevic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
| | - Stipan Jonjic
- Center for Proteomics, Faculty of Medicine, Department for Histology and Embryology, University of Rijeka , Rijeka , Croatia
| | - Miodrag L Lukic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
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Uher T, Fellows K, Horakova D, Zivadinov R, Vaneckova M, Sobisek L, Tyblova M, Seidl Z, Krasensky J, Bergsland N, Weinstock-Guttman B, Havrdova E, Ramanathan M. Serum lipid profile changes predict neurodegeneration in interferon-β1a-treated multiple sclerosis patients. J Lipid Res 2016; 58:403-411. [PMID: 27923871 DOI: 10.1194/jlr.m072751] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/01/2016] [Indexed: 12/20/2022] Open
Abstract
The purpose of this work was to determine whether changes in cholesterol profiles after interferon-β (IFN-β)1a treatment initiation following the first demyelinating event suggestive of multiple sclerosis are associated with clinical and MRI outcomes over 4 years. A group of 131 patients (age: 27.9 ± 7.8 years, 63% female) with serial 3-monthly clinical and 12-monthly MRI follow-ups over 4 years were investigated. Serum cholesterol profiles, including total cholesterol (TC), HDL cholesterol (HDL-C), and LDL cholesterol (LDL-C) were obtained at baseline, 1 month, 3 months, and every 6 months thereafter. IFN-β1a initiation caused rapid decreases in serum HDL-C, LDL-C, and TC within 1 month of IFN-β1a initiation (all P < 0.001) that returned slowly toward baseline. In predictive mixed model analyses, greater percent decreases in HDL-C after 3 months of IFN-β1a treatment initiation were associated with less brain atrophy over the 4 year time course, as assessed by percent brain volume change (P < 0.001), percent gray matter volume change (P < 0.001), and percent lateral ventricle volume change (P = 0.005). Decreases in cholesterol biomarkers following IFN-β1a treatment are associated with brain atrophy outcomes over 4 years. Pharmacological interventions targeting lipid homeostasis may be clinically beneficial for disrupting neurodegenerative processes.
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Affiliation(s)
- Tomas Uher
- Department of Neurology and Center of Clinical Neuroscience Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Kelly Fellows
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.,MR Imaging Clinical Translational Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Manuela Vaneckova
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Lukas Sobisek
- Department of Statistics and Probability, University of Economics in Prague, Czech Republic
| | - Michaela Tyblova
- Department of Neurology and Center of Clinical Neuroscience Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Zdenek Seidl
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Jan Krasensky
- Department of Radiology, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "S.Maria Nascente", Don Gnocchi Foundation, Milan, Italy
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Eva Havrdova
- Department of Neurology and Center of Clinical Neuroscience Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY .,Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
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8
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Zivadinov R, Cerza N, Hagemeier J, Carl E, Badgett D, Ramasamy DP, Weinstock-Guttman B, Ramanathan M. Humoral response to EBV is associated with cortical atrophy and lesion burden in patients with MS. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2016; 3:e190. [PMID: 26770996 PMCID: PMC4708926 DOI: 10.1212/nxi.0000000000000190] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/30/2015] [Indexed: 11/17/2022]
Abstract
Objective: Because dysregulated Epstein-Barr virus (EBV)-infected B cells may induce meningeal inflammation, which contributes to cortical pathology in multiple sclerosis (MS), we investigated associations between antibody responses to EBV and development of cortical pathology in MS. Methods: We included 539 patients with MS (369 with relapsing-remitting MS, 135 with secondary progressive MS, and 35 with primary progressive MS), 66 patients with clinically isolated syndrome (CIS), 63 patients with other neurologic diseases (OND), and 178 age- and sex-matched healthy controls (HC). All participants were scanned on 3T MRI. Serum samples were analyzed for IgG antibodies against EBV viral capsid antigen (VCA) and EBV nuclear antigen-1 (EBNA-1), and their quartiles were determined on the whole study sample. Differences between the study groups were assessed using analysis of covariance adjusted for multiple comparisons. Results: More than 30% of patients with MS and CIS presented with the highest quartile of anti-EBV-VCA and -EBNA-1 status compared to ≤10% of HC (p < 0.001). The figures were 9 (14.3%) and 7 (12.3%) for patients with OND. Patients with MS with the highest quartile of anti-EBV-VCA showed significantly increased T2 lesion volume (p = 0.001), T1 lesion number (p = 0.002), and T1 lesion volume (p = 0.04) and decreased gray matter (p = 0.041) and cortical (p = 0.043) volumes compared to patients with MS with lower quartiles. No significant differences of MRI outcomes in patients with CIS, patients with OND, and HC with lower or highest quartiles of anti-EBV-VCA and -EBNA-1 were detected. Conclusions: Humoral response to anti-EBV-VCA and -EBNA-1 is associated with more advanced cortical atrophy, accumulation of chronic T1 black holes, and focal white matter lesions in patients with MS.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Nicole Cerza
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Ellen Carl
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Darlene Badgett
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Bianca Weinstock-Guttman
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
| | - Murali Ramanathan
- Buffalo Neuroimaging Analysis Center (R.Z., D.B., M.R.) and Jacobs Multiple Sclerosis Center (B.W.-G.), Department of Neurology; MR Imaging Clinical Translational Research Center (R.Z., N.C., J.H., E.C., D.P.R., M.R.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY; and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo, NY
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Zhornitsky S, McKay KA, Metz LM, Teunissen CE, Rangachari M. Cholesterol and markers of cholesterol turnover in multiple sclerosis: relationship with disease outcomes. Mult Scler Relat Disord 2016; 5:53-65. [DOI: 10.1016/j.msard.2015.10.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/08/2015] [Accepted: 10/19/2015] [Indexed: 01/29/2023]
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10
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Vanheusden M, Stinissen P, ’t Hart BA, Hellings N. Cytomegalovirus: a culprit or protector in multiple sclerosis? Trends Mol Med 2015; 21:16-23. [DOI: 10.1016/j.molmed.2014.11.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/07/2014] [Accepted: 11/14/2014] [Indexed: 12/26/2022]
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11
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MRI correlates of disability progression in patients with CIS over 48 months. NEUROIMAGE-CLINICAL 2014; 6:312-9. [PMID: 25379444 PMCID: PMC4215387 DOI: 10.1016/j.nicl.2014.09.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/22/2014] [Accepted: 09/22/2014] [Indexed: 01/08/2023]
Abstract
Background Gray matter (GM) and white matter (WM) pathology has an important role in disease progression of multiple sclerosis (MS). Objectives To investigate the association between the development of GM and WM pathology and clinical disease progression in patients with clinically isolated syndrome (CIS). Methods This prospective, observational, 48-month follow-up study examined 210 CIS patients treated with 30 µg of intramuscular interferon beta-1a once a week. MRI and clinical assessments were performed at baseline, 6, 12, 24, 36 and 48 months. Associations between clinical worsening [24-weeks sustained disability progression (SDP) and occurrence of a second clinical attack] and longitudinal changes in lesion accumulation and brain atrophy progression were investigated by a mixed-effect model analysis after correction for multiple comparisons. Results SDP was observed in 32 (15.2%) CIS patients, while 146 (69.5%) were stable and 32 (15.2%) showed sustained disability improvement. 112 CIS patients (53.3%) developed clinically definite MS (CDMS). CIS patients who developed SDP showed increased lateral ventricle volume (p < .001), and decreased GM (p = .011) and cortical (p = .001) volumes compared to patients who remained stable or improved in disability. Converters to CDMS showed an increased rate of accumulation of number of new/enlarging T2 lesions (p < .001), decreased whole brain (p = .007) and increased lateral ventricle (p = .025) volumes. Conclusions Development of GM pathology and LVV enlargement are associated with SDP. Conversion to CDMS in patients with CIS over 48 months is dependent on the accumulation of new lesions, LVV enlargement and whole brain atrophy progression. We examined 210 clinically isolated syndrome patients on interferon beta. MRI and clinical assessments were performed at 0, 6, 12, 24, 36 and 48 months. 15.2% of patients developed disability progression and 53.3 % converted to MS. Gray matter atrophy was strongly associated with sustained disability progression.
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Browne RW, Weinstock-Guttman B, Horakova D, Zivadinov R, Bodziak ML, Tamaño-Blanco M, Badgett D, Tyblova M, Vaneckova M, Seidl Z, Krasensky J, Bergsland N, Ramasamy DP, Hagemeier J, Havrdova E, Ramanathan M. Apolipoproteins are associated with new MRI lesions and deep grey matter atrophy in clinically isolated syndromes. J Neurol Neurosurg Psychiatry 2014; 85:859-64. [PMID: 24470599 DOI: 10.1136/jnnp-2013-307106] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES There is increasing evidence that serum lipoprotein cholesterol biomarkers are associated with disease progression in clinically isolated syndromes (CIS). Apolipoproteins (Apo) are recognition ligands that mediate the physiological interactions of cholesterol-containing lipoproteins. The objective of this study was to investigate whether serum Apo levels are associated with CIS disease progression. METHODS ApoB, ApoAI, ApoAII, ApoE and lipoprotein (a) (Lpa) levels were measured in serum samples obtained prior to the start of treatment from 181 CIS patients (123 women, 58 men, 68% women; mean age: 28.1±SD 8.1 years). All patients were treated with intramuscular interferon-β as part of the prospective study. Clinical and MRI assessments were obtained at baseline, 6, 12 and 24 months after start of interferon-β treatment. RESULTS Greater ApoB levels were associated with increased number of new T2 lesions (p<0.001) and increased number of new or enlarging T2 lesions (p<0.001) over 2 years. Each 10 mg/dL of greater baseline ApoB is associated with a 16% increase in the number of new T2 lesions over 2 years. ApoAI, ApoAII, ApoE and Lpa were not associated with T2 lesions. Greater ApoE levels were associated with greater deep grey matter atrophy (partial correlation rp=-0.28, p<0.001). Each 1 mg/dL increment in ApoE levels was associated with a 1% increase in deep grey matter atrophy over 2 years. CONCLUSIONS Serum ApoB levels are associated with new lesion accumulation whereas ApoE levels are associated with deep grey matter atrophy in high risk CIS patients treated with interferon β-1a.
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Affiliation(s)
- Richard W Browne
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, New York, USA
| | | | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Robert Zivadinov
- Department of Neurology, State University of New York, Buffalo, New York, USA Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, New York, USA
| | - Mary Lou Bodziak
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, New York, USA
| | - Miriam Tamaño-Blanco
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, New York, USA
| | - Darlene Badgett
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, New York, USA
| | - Michaela Tyblova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Manuela Vaneckova
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Zdenek Seidl
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jan Krasensky
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, New York, USA
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, New York, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, New York, USA
| | - Eva Havrdova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Murali Ramanathan
- Department of Neurology, State University of New York, Buffalo, New York, USA Department of Pharmaceutical Sciences, State University of New York, Buffalo, New York, USA
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