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Vista ES, Weisman MH, Ishimori ML, et al. Strong viral associations with SLE among Filipinos. Lupus Sci Med. 2017;4(1):e000214doi: 10.1136/lupus-2017-000214.
Vista, E. S., Weisman, M. H., Ishimori, M. L., Chen, H., Bourn, R. L., Bruner, B. F., Hamijoyo, L., Tanangunan, R. D., Gal, N. J., Robertson, J. M., Harley, J. B., Guthridge, J. M., Navarra, S. V., & James, J. A. (2017). Strong viral associations with SLE among Filipinos. Lupus science & medicine, 4(1), e000214. https://doi.org/10.1136/lupus-2017-000214
Vista, Evan S, et al. "Strong viral associations with SLE among Filipinos." Lupus science & medicine vol. 4,1 (2017): e000214. doi: https://doi.org/10.1136/lupus-2017-000214
Vista ES, Weisman MH, Ishimori ML, Chen H, Bourn RL, Bruner BF, Hamijoyo L, Tanangunan RD, Gal NJ, Robertson JM, Harley JB, Guthridge JM, Navarra SV, James JA. Strong viral associations with SLE among Filipinos. Lupus Sci Med. 2017 Jul 28;4(1):e000214. doi: 10.1136/lupus-2017-000214. eCollection 2017. PMID: 29214036; PMCID: PMC5704743.
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Lupus Sci Med. 2017 Jul 28;4(1):e000214. doi: 10.1136/lupus-2017-000214. eCollection 2017.

Strong viral associations with SLE among Filipinos.

Lupus science & medicine

Evan S Vista, Michael H Weisman, Mariko L Ishimori, Hua Chen, Rebecka L Bourn, Ben F Bruner, Laniyati Hamijoyo, Robelle D Tanangunan, Noga J Gal, Julie M Robertson, John B Harley, Joel M Guthridge, Sandra V Navarra, Judith A James

Affiliations

  1. Section of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines.
  2. Arthritis & Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA.
  3. Department of Medicine, Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  4. Department of Biology, Harding University, Searcy, Arkansas, USA.
  5. Center for Autoimmune Genomics and Etiology (CAGE), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
  6. Department of Veterans Affairs Medical Center, Cincinnati, Ohio, USA.
  7. Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

PMID: 29214036 PMCID: PMC5704743 DOI: 10.1136/lupus-2017-000214

Abstract

OBJECTIVES: Epstein-Barr virus (EBV) is considered an important environmental factor in SLE aetiology, but the relationship between SLE and EBV in the Filipino population is unknown. We tested associations between SLE, lupus-associated autoantibodies and seropositivity for EBV and other herpes viruses in the Filipino population.

METHODS: Sera from Filipino patients with SLE (n=233), unaffected first-degree relatives (FDRs, n=543) and unrelated controls (n=221) were tested for antibodies against EBV, cytomegalovirus (CMV) and herpes simplex viruses (HSV-1 and HSV-2) by standardised ELISAs. Humoral specificity against EBV nuclear antigen (EBNA)-1 was compared by solid-phase epitope mapping. Autoantibodies were detected by a bead-based multiplex assay. Results were analysed by Fisher's exact test, Student's t-test, χ

RESULTS: Filipino patients with SLE had increased seroprevalence and elevated antibody concentrations against EBV viral capsid antigen (EBV-VCA), CMV, HSV-1 and HSV-2 compared with unrelated controls (p<0.05). Seropositivity for anti-EBV early antigen (EA), a marker of EBV reactivation, was dramatically increased in patients with SLE compared with unrelated controls (92.3% vs 40.4%; OR 17.15(95% CI 10.10, 30.66), p<0.0001) or unaffected FDRs (49.4%; OR 12.04(7.42, 20.74), p<0.0001), despite similar seroprevalence of EBV-VCA in patients and FDRs. In patients with SLE, EBV-EA seropositivity correlated with lupus-associated autoantibodies (p<0.001), most notably with autoantibodies against dsDNA, chromatin, Sm, SmRNP and RNP A (p<0.01). Patient and unrelated control sera reacted to the highly repetitive glycine and alanine domain of EBNA-1. An epitope spanning EBNA-1

CONCLUSIONS: Filipino patients with SLE have elevated prevalence and concentrations of antibodies against EBV, CMV, HSV-1 and HSV-2 antigens, along with altered anti-EBNA-1 specificities. EBV reactivation is more common among Filipino patients with SLE compared with healthy Filipinos and may contribute to SLE pathogenesis in this population.

Keywords: autoimmunity; infections; systemic lupus erythematosus

Conflict of interest statement

Competing interests: None declared.

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