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Serum Epstein-Barr virus DNA, detected by droplet digital PCR, correlates with disease activity in patients with rheumatoid arthritis

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11

 

  1. University of Helsinki, Clinicum, Helsinki, Finland. elina.kuusela@helsinki.fi
  2. University of Helsinki, Clinicum, Helsinki, Finland.
  3. University of Helsinki, Clinicum, Helsinki, Finland.
  4. Department of Rheumatology, Helsinki University and Helsinki University Hospital, Finland.
  5. Department of Oral and Maxillofacial Diseases, University of Helsinki, Finland.
  6. University of Helsinki, Clinicum, Helsinki, Finland.
  7. Department of Rheumatology, Helsinki University and Helsinki University Hospital, Finland.
  8. Internal Medicine and Rehabilitation, Helsinki University and Helsinki University Hospital, Finland.
  9. Department of Rheumatology, Helsinki University and Helsinki University Hospital, Finland.
  10. University of Helsinki, Clinicum, Helsinki, Finland.
  11. Department of Rheumatology, Helsinki University and Helsinki University Hospital, and ORTON Orthopaedic Hospital, Helsinki, Finland.

CER10686
2018 Vol.36, N°5
PI 0778, PF 0784
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PMID: 29600942 [PubMed]

Received: 13/07/2017
Accepted : 18/12/2017
In Press: 20/03/2018
Published: 26/09/2018

Abstract

OBJECTIVES:
To study the prevalence of asymptomatic activation of Epstein-Barr virus (EBV) in patients with rheumatoid arthritis (RA) and to analyse the correlation of serum EBV DNA with the disease activity.
METHODS:
The level of EBV DNA was determined by droplet digital PCR assay from the serum of 46 DMARD naive early RA (ERA) and 22 chronic RA (CRA)-patients at study onset. Follow-up samples from 31 ERA and 16 CRA patients were obtained after starting or modifying the anti-rheumatic treatment. EBV DNA was also measured from 33 healthy controls and 9 patients with adult onset Still’s disease (AOSD). Disease activity was assessed by the disease activity score (DAS28).
RESULTS:
At baseline, EBV DNA was detected in the serum of 7 of the 46 ERA patients all of whom had moderate or high disease activity. In the follow-up samples, 11 of 31 patients were EBV DNA positive. At baseline EBV positive patients had significantly higher disease activity (p=0.036) and the concentration of EBV DNA correlated significantly with DAS28 (rs=0.333, p=0.024). EBV DNA was detected in 3 of 22 CRA patients at study onset and in 8 of 16 in the follow-up samples. At follow-up EBV positive patients had significantly higher DAS28 (p=0.027) and the concentration of EBV DNA correlated significantly with DAS28 (rs=0.724, p=0.002). Only one of the healthy controls and none of the AOSD patients were positive for EBV DNA.
CONCLUSIONS:
Active RA is associated with a lytic EBV infection which may have a role in the pathogenesis of RA.

Rheumatology Article

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