Introduction to Lupus and Epstein-Barr Virus
One of the most common viruses in the world could be the cause of lupus, an autoimmune disease with wide-ranging symptoms, according to a study published Wednesday.
Until now, lupus was somewhat mysterious: No single root cause of the disease had been found, and there is no designated treatment for it.
The Role of Epstein-Barr Virus in Lupus
The research, published in the journal Science Translational Medicine, suggests that Epstein-Barr virus — which 95% of people acquire at some point in life — could cause lupus by driving the body to attack its own healthy cells.
It adds to mounting evidence that Epstein-Barr is associated with multiple long-term health issues, including other autoimmune conditions. As this evidence stacks up, scientists have accelerated calls for a vaccine that targets the virus.
“If we now better understand how this fastidious virus is responsible for autoimmune diseases, I think it’s time to figure out how to prevent it,” said Dr. Anca Askanase, clinical director of the Lupus Center at Columbia University, who wasn’t involved in the new research.
Symptoms and Effects of Lupus
In lupus patients, an autoimmune attack can result in extreme fatigue, joint pain and skin rashes. In rare cases, the disease may lead to fatal or life-threatening issues such as kidney damage, or weaken the immune system so the body can’t fight off infections.
Scientists have long suspected a link between Epstein-Barr and lupus, but the exact connection had remained elusive. Dr. William Robinson, a co-author of the new study and chief of the division of immunology and rheumatology at Stanford University, said his new findings solve a major piece of that puzzle.
“From our perspective, it’s the key, missing mechanistic link,” Robinson said.
“We think it applies to all lupus cases,” he added. Hundreds of thousands of people in the U.S. are living with the disease.
Transmission and Prevalence of Epstein-Barr Virus
An infection with Epstein-Barr virus does not necessarily cause symptoms, especially among children, though the virus is also the most common cause of mononucleosis (often referred to as mono).
It’s primarily transmitted by saliva from kissing or sharing drinks, food, utensils or toothbrushes. After someone is infected, the virus lingers permanently in the body, where it usually remains inactive — though not always.
Research Findings and Implications
The new study is not the first to tie Epstein-Barr to autoimmune issues. Past research has linked it to multiple sclerosis. Though not the sole trigger of MS, the virus may be part of a chain of events that leads to the disease.
Robinson said a pathway similar to the one described in his new study could also lead to other autoimmune diseases like rheumatoid arthritis and Crohn’s disease, but more research is needed to tease that out.
Of course, the vast majority of people who contract Epstein-Barr do not go on to get lupus, MS or any other autoimmune disease. Robinson said it’s possible that only certain strains of Epstein-Barr trigger autoimmune reactions.
Mechanism of Lupus Development
To determine the causal link between Epstein-Barr and lupus, Robinson and his co-authors focused on B cells — white blood cells that help fight off infections.
Even in healthy individuals, Epstein-Barr lies dormant in a tiny portion of B cells. But those virus-containing B cells are far more prevalent in lupus patients, who have a 25 times higher share of them, according to the new research.
The study also highlights a type of protein called antinuclear antibodies, which bind to the nucleus of cells and are one of the hallmarks of lupus. The researchers found that Epstein-Barr infects and reprograms B cells to produce antinuclear antibodies that attack the body’s own tissue, thereby causing lupus.
Potential Treatments and Prevention
The new research points to a few potential options for lupus treatment, according to Robinson, who is the co-founder of two drug development companies exploring treatments for autoimmune diseases.
Many of the current medications given to ease lupus symptoms, such as corticosteroids, broadly focus on reducing inflammation. Robinson said future therapeutics could specifically target B cells infected with Epstein-Barr.
But an Epstein-Barr vaccine — several of which are in clinical trials — could someday stop infections in the first place.
“Vaccination to protect people against ever being infected by EBV would be the ultimate, fundamental solution,” Robinson said.
Conclusion
In conclusion, the study provides significant evidence that Epstein-Barr virus may be the cause of lupus, an autoimmune disease with wide-ranging symptoms. The research suggests that the virus drives the body to attack its own healthy cells, leading to the development of lupus. While more research is needed to confirm the findings, the study provides hope for the development of new treatments and prevention strategies for lupus.
FAQs
Q: What is lupus?
A: Lupus is an autoimmune disease with wide-ranging symptoms, including extreme fatigue, joint pain, and skin rashes.
Q: What is Epstein-Barr virus?
A: Epstein-Barr virus is a common virus that can cause mononucleosis and is associated with multiple long-term health issues, including autoimmune conditions.
Q: How is Epstein-Barr virus transmitted?
A: Epstein-Barr virus is primarily transmitted by saliva from kissing or sharing drinks, food, utensils, or toothbrushes.
Q: Can lupus be treated?
A: Current medications for lupus focus on reducing inflammation, but future therapeutics may specifically target B cells infected with Epstein-Barr.
Q: Is there a vaccine for Epstein-Barr virus?
A: Several Epstein-Barr vaccines are in clinical trials, and vaccination could potentially stop infections and prevent lupus.
