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July 9, 2003

Epstein-Barr Virus and Risk of Multiple SclerosisEpstein-Barr Virus and Risk of Multiple Sclerosis

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(2):192. doi:10.1001/jama.290.2.192-a

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.

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