September 1988

Antibodies to Epstein-Barr Virus—Specific DNase and DNA Polymerase in the Chronic Fatigue Syndrome

Author Affiliations

From the Department of Pediatrics National Jewish Center for Immunology and Respiratory Medicine (Dr Jones), and the Department of Pathology, Children's Hospital and University of Colorado Health Sciences Center (Dr Robinson), Denver; the Department of Medical Microbiology and Immunology, The Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus (Drs Williams and Glaser); and the Infectious Disease Unit, Massachusetts General Hospital, Boston (Dr Schooley).

Arch Intern Med. 1988;148(9):1957-1960. doi:10.1001/archinte.1988.00380090047012

• In an attempt to examine further the association between active Epstein-Barr virus (EBV) infection and the chronic fatigue syndrome (chronic EBV syndrome, or chronic or atypical mononucleosis), antibodies acting against EBV-specific DNase and DNA polymerase, which are expressed only during virus replication, were assayed. Serum samples from 25 healthy EBV-seropositive individuals neutralized 3.5±5.1 U (mean±SD) of DNase activity and 14.7±8.5 U of DNA polymerase activity. From these values were selected upper limits of anti-EBV enzyme activity of 17.9 and 31.3 U neutralized in normal individuals, respectively (representing the 95% confidence limit). Serum samples from six groups of subjects representing a variety of EBV-related illnesses were then studied. Only patients with notably elevated anti-EBV antibody titers to viral capsid antigen (VCA) (>10 000) had elevated levels of anti-EBV DNase (38 to 56 U neutralized) and anti-EBV DNA polymerase (72 to 106 U neutralized). Three additional patients and two geriatric controls with average anti-EBV early antigen/VCA titers had slightly elevated levels of antibody to EBV DNA polymerase. IgA anti-VCA, anti—early antigen antibodies, or both, were also detected in the same patients who had high EBV DNase and polymerase antibody levels. These antibody profiles are similar to those in patients with nasopharyngeal carcinoma. Since three of the six patients with elevated anti-EBV enzyme antibody levels developed fatal lymphomas, patients with chronic EBV and this antibody profile might be in another illness category at risk for malignant disease.

(Arch Intern Med 1988;148:1957-1960)