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Low cytomegalovirus seroprevalence in early multiple sclerosis: a case for the ‘hygiene hypothesis’?
Author(s) -
AlariPahissa E.,
Moreira A.,
Zabalza A.,
AlvarezLafuente R.,
Munteis E.,
Vera A.,
Arroyo R.,
AlvarezCermeño J. C.,
Villar L. M.,
LópezBotet M.,
MartínezRodríguez J. E.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13622
Subject(s) - medicine , serostatus , immunology , cytomegalovirus , multiple sclerosis , odds ratio , human cytomegalovirus , seroprevalence , virus , antibody , virology , herpesviridae , viral load , viral disease , serology
Background and purpose Cytomegalovirus ( CMV ) infection has recently been associated with a lower multiple sclerosis ( MS ) susceptibility, although it remains controversial whether it has a protective role or is merely an epiphenomenon related to westernization and early‐life viral infections. We aimed to evaluate whether CMV serostatus may differ in patients with early MS as compared with patients with non‐early MS , analyzing the putative association of this virus with MS clinical course and humoral immune responses against other herpesviruses. Methods Multicentric analysis was undertaken of 310 patients with MS (early MS , disease duration ≤5 years, n = 127) and controls ( n = 155), evaluating specific humoral responses to CMV , Epstein–Barr virus and human herpesvirus‐6, as well as T‐cell and natural killer ( NK )‐cell immunophenotypes. Results Cytomegalovirus seroprevalence in early MS was lower than in non‐early MS or controls ( P < 0.01), being independently associated with disease duration (odds ratio, 1.04; 95% confidence interval, 1.01–1.08, P < 0.05). CMV + patients with MS displayed increased proportions of differentiated T‐cells ( CD 27− CD 28−, CD 57+, LILRB 1+) and NKG 2C+ NK ‐cells, which were associated with a lower disability in early MS ( P < 0.05). CMV + patients with early MS had an age‐related decline in serum anti‐ EBNA ‐1 antibodies ( P < 0.01), but no CMV ‐related differences in anti‐human herpesvirus‐6 humoral responses. Conclusions Low CMV seroprevalence was observed in patients with early MS . Modification of MS risk attributed to CMV might be related to the induction of differentiated T‐cell and NK ‐cell subsets and/or modulation of Epstein–Barr virus‐specific immune responses at early stages of the disease.