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Original Article

Detection of Epstein–Barr virus infection

subtype in patients with multiple sclerosis by

indirect immunofluorescence assay

Shan-Chao Zhang , Lei Liu , Rui-Jin Wang , Hou-Zhen Tuo , Yan-Jun Guo , Li Yi , De-Xin Wang , Jia-Wei Wang 2
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1 Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
2 Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
ABSTRA CT
Aim: The aim was to investigate the infectious conditions of Epstein–Barr virus (EBV) in patients with multiple sclerosis (MS).
Methods: Cerebrospinal fluid (CSF) of 20 patients with MS and 20 with other neurological diseases (OND) were tested with indirect
immunofluorescence for anti-EBV capsid antigen (EBV-CA) immunoglobulin G (IgG), IgG affinity for anti-EBV-CA, anti-EBV-CA
immunoglobulin M (IgM), anti-EBV early antigen (EBV-EA) IgG and anti-EBV nuclear antigen (EBNA) IgG. According to the pattern of
antibodies in CSF, infection rates of acute, chronic, primary, recurrent, and past infections were analyzed in the two groups of patients.
Results: There were no significant differences in anti-EBV-CA, anti-EBC-EA, and anti-EBNA antigen IgG in CSF between MS and
OND patients (P > 0.05). The positive rate of low affinity for anti-EBV-CA IgG in MS patients was significantly higher than that for
OND patients (75% vs. 40%, P < 0.05). Furthermore, significant differences in the positive rate of anti-EBV-CA IgM were found
between MS and OND patients (70% vs. 25%, P < 0.05). Of the MS patients, 75% were in an EBV acute infection state compared
with 40% of OND patients (P < 0.05). Conclusion: Acute infection of EBV closely correlates with the occurrence of MS.
Key words: Epstein–Barr virus, fluorescent antibody technique, herpes virus 4, multiple sclerosis

INTRODUCTION results indicate that the high incidence of MS is
correlated with EBV genetic susceptibility in patients.
Multiple sclerosis (MS) is an autoimmune demyelinating Serum epidemiological and immunological evidences
disease of the central nervous system, the etiology and also show that the incidence of MS is significantly
pathogenesis of which are currently poorly understood, higher in serum EBV antigen-antibody-positive
but are known to be primarily associated with genetic patients than in serum antibody-negative patients. [4,5]
and environmental factors. [1,2] However, recent studies In addition, EBV capsid antigen (EBV-CA) and Epstein–
have shown that bacteria and viruses are closely Barr nuclear antigen (EBNA) antibody titers may be
related to the incidence of MS. The characteristic of associated with the prevalence of MS. Previous
[6]
Epstein–Barr virus (EBV) infection, as a latent infection studies were based on enzyme-linked immunosorbent
with periodic recurrence, makes EBV a risk factor for assay (ELISA) to confirm the relationship between
MS. According to an epidemiological survey of MS and serum/cerebrospinal fluid (CSF) EBV antigen-antibody
[3]
infectious mononucleosis patients, the experimental and the occurrence of MS. This method did not,
however, show details of the type of EBV infection.
Access this article online In contrast, indirect immunofluorescence assay
Quick Response Code: (IFA) can not only compensate for this ELISA defect,
Website: but also has the advantage of using a standardized
www.nnjournal.net
preparation. [7,8] As a result, our study has used IFA to
DOI: reveal the correlation of MS with EBV antigen-antibody
10.4103/2347-8659.135572 and thus, provide a better method for diagnosis and
treatment of MS.

Corresponding Author: Dr. Jia‑Wei Wang, Department of Neurology, Beijing Tongren Hospital, Capital Medical University,
No. 1 Dong Jiao Min Xiang, Dongcheng District, Beijing 100730, China. E‑mail: wangjwcq@163.com

24 Neuroimmunol Neuroinflammation | Volume 1 | Issue 1 | June 2014