Genetics of immune response to Epstein-Barr virus: prospects for multiple sclerosis pathogenesisInfections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centrum for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centrum for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centrum for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centrum for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centrum for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centrum for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centrum for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
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2024 (English)In: Brain, ISSN 0006-8950, E-ISSN 1460-2156, Vol. 147, no 10, p. 3573-3582Article in journal (Refereed) Published
Abstract [en]
Epstein-Barr virus (EBV) infection has been advocated as a prerequisite for developing multiple sclerosis (MS) and possibly the propagation of the disease. However, the precise mechanisms for such influences are still unclear. A large-scale study investigating the host genetics of EBV serology and related clinical manifestations, such as infectious mononucleosis (IM), may help us better understand the role of EBV in MS pathogenesis. This study evaluates the host genetic factors that influence serological response against EBV and history of IM and cross-evaluates them with MS risk and genetic susceptibility in the Swedish population. Plasma IgG antibody levels against EBV nuclear antigen-1 [EBNA-1, truncated = amino acids (aa) (325-641), peptide = aa(385-420)] and viral capsid antigen p18 (VCAp18) were measured using bead-based multiplex serology for 8744 MS cases and 7229 population-matched control subjects. The MS risk association for high/low EBV antibody levels and history of IM was compared to relevant clinical measures along with sex, age at sampling, and associated HLA allele variants. Genome-wide and HLA allele association analyses were also performed to identify genetic risk factors for EBV antibody response and IM history. Higher antibody levels against VCAp18 [odds ratio (OR) = 1.74, 95% confidence interval (CI) = 1.60-1.88] and EBNA-1, particularly the peptide (OR = 3.13, 95% CI = 2.93-3.35), were associated with an increased risk for MS. The risk increased with higher anti-EBNA-1 IgG levels up to 12× the reference risk. We also identified several independent HLA haplotypes associated with EBV serology overlapping with known MS risk alleles (e.g. DRB1*15:01). Although there were several candidates, no variants outside the HLA region reached genome-wide significance. Cumulative HLA risk for anti-EBNA-1 IgG levels, particularly the peptide fragment, was strongly associated with MS. In contrast, the genetic risk for high anti-VCAp18 IgG levels was not as strongly associated with MS risk. IM history was not associated with class II HLA genes but negatively associated with A*02:01, which is protective against MS. Our findings emphasize that the risk association between anti-EBNA-1 IgG levels and MS may be partly due to overlapping HLA associations. Additionally, the increasing MS risk with increasing anti-EBNA-1 levels would be consistent with a pathogenic role of the EBNA-1 immune response, perhaps through molecular mimicry. Given that high anti-EBNA-1 antibodies may reflect a poorly controlled T-cell defence against the virus, our findings would be consistent with DRB1*15:01 being a poor class II antigen in the immune defence against EBV. Last, the difference in genetic control of IM supports the independent roles of EBNA-1 and IM in MS susceptibility.
Place, publisher, year, edition, pages
Oxford University Press, 2024. Vol. 147, no 10, p. 3573-3582
Keywords [en]
DRB1, EBNA1, EBV, GWAS, HLA
National Category
Neurology Microbiology in the medical area
Identifiers
URN: urn:nbn:se:umu:diva-230818DOI: 10.1093/brain/awae110ISI: 001299193900001PubMedID: 38630618Scopus ID: 2-s2.0-85199819501OAI: oai:DiVA.org:umu-230818DiVA, id: diva2:1908808
Funder
The Swedish Brain FoundationSwedish Association of Persons with Neurological DisabilitiesSwedish Research Council, 2017–00777Swedish Research Council, 2020-01638EU, Horizon 2020, 733161Karolinska InstituteForte, Swedish Research Council for Health, Working Life and Welfare2024-10-292024-10-292024-10-29Bibliographically approved