Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Levin and colleagues1 reported an association between EBV antibody and
risk of MS. There are many possible explanations for this association, including
a nonspecific increased antibody response to EBV and a direct pathogenic role
of EBV via T cells or antibody that cross-reacts with autoantigens.
One potential target of cross-reacting antibody is interleukin 10 (IL-10).
This cytokine decreases TH1 lymphocyte function2 and
may be important in MS pathogenesis because increased TH1 activity
has been related to MS disease activity.3 Furthermore,
the EBV BCRF-1 gene product, termed viral IL-10 (vIL-10),
shares structural and functional similarity with human IL-10 (hIL-10), and
antibody to vIL-10 cross reacts with hIL-10.4 It
is possible that antibody to EBV vIL-10 cross reacts with hIL-10 and decreases
hIL-10 activity, thereby resulting in increased TH1 function and
pathogenesis of MS. In addition to measuring antibody to the "standard" EBV
antigens (viral capsid antigen, early antigens, EBNA), it would thus be of
interest to measure antibody to EBV vIL-10 in patients with MS because this
antibody might directly relate to disease progression.
Tenser RB. Epstein-Barr Virus and Risk of Multiple SclerosisEpstein-Barr Virus and Risk of Multiple Sclerosis. JAMA. 2003;290(2):192. doi:10.1001/jama.290.2.192-a