r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИАr-n-j-34Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ И НАБЛЮДЕНИЯCLINICAL RESEARCH AND SURVEILLANCEСерологические маркеры Эпштейна–Барр вирусной инфекции у больных педиатрическим рассеянным склерозомSerologic markers of Еpstein-Вarr virus infection in patients with pediatric multiple sclerosishttps://orcid.org/0000-0002-7947-4529СмагинаИ. В.SmaginaI. V.

Барнаул, 656038.

Barnaul, 656038.

siv7000@yandex.ruhttps://orcid.org/0000-0003-4500-4913ЕльчаниноваЕ. Ю.ElchaninovaE. Yu.

Барнаул, 656038.

Barnaul, 656038.

Алтайский государственный медицинский университет Минздрава РоссииРоссияAltai state medical UniversityRussian Federation2019150120202453845Copyright © Смагина И.В., Ельчанинова Е.Ю., 20202020Смагина И.В., Ельчанинова Е.Ю.Smagina I.V., Elchaninova E.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/34

Предполагается, что фактором риска рассеянного склероза (РС) и, возможно, фактором неблагоприятного течения этого заболевания является Эпштейна–Барр вирусная инфекция (ЭБВИ).

В исследовании приняли участие 43 больных ремиттирующим РС в стадии ремиссии с дебютом заболевания в возрасте до 18 лет и 49 добровольцев, не страдающих РС. Установлено, что большинство больных РС, также как большинство участников контрольной группы серопозитивны по ЭБВИ (100% и 91,8% соответственно, р = 0,120). Все выявленные серопозитивные паттерны характерны для паст-инфекции ЭБВИ. Сочетание анти-VCA IgG и анти-EBNA-1 IgG чаще встречается у больных РС (97,7% против 83,7% в контроле, р = 0,034). Уровень анти-VCA IgG выше медианы и серопозитивность по анти-EBNA-1 IgG ассоциированы с РС (отношение шансов — ОШ 5,29; 95% доверительный интервал — ДИ 1,99–14,04; р < 0,001; ОШ 15,36; 95% ДИ 1,95–20,70; р = 0,009 соответственно). У больных РС уровень анти-VCA IgG выше медианы ассоциирован с HLA-DRB1*1501 (ОШ 8,4; 95% ДИ 0,87–80,92; р = 0,047). Уровни анти-VCA IgG, анти-EBNA-1 IgG не коррелировали с возрастом дебюта РС, степенью инвалидизации, частотой обострений, а также с концентрацией 25-гидрокси-витамина D в сыворотке крови. Можно полагать, что у больных ремиттирующим РС в период ремиссии заболевания имеются особенности иммунного статуса паст-инфекции ЭБВИ. Представляется актуальным динамическое исследование уровня серологических маркеров ЭБВИ не только в период ремиссии, но и в период обострения РС. Результаты этих исследований позволят оценить перспективность контроля и лечения ЭБВИ для управления течением РС.

Epstein–Barr virus (EBV) infection is considered as risk factor for multiple sclerosis (MS) and possibly a factor in the adverse course of the disease. Forty-three patients with remitting MS in remission with the onset of the disease before the age of 18 years and 49 volunteers without MS participated in the study. It was found that the majority of patients with MS, as well as the majority of the control were seropositive for EBV infection (100% and 91.8%, respectively, р = 0.120). All identified seropositive patterns are typical of EBV past-infection. The combination of anti-VCA IgG and anti-EBNA-1 IgG is more common in patients with MS (97.7% vs. 83.7% in control, p = 0.034). The anti-VCA IgG level above the median and the seropositive result for anti-EBNA-1 IgG are associated with MS (OR 5.29; 95СI 1.99–14.04; p < 0.001 and OR 15.36; 95СI 1.95–20.70; p = 0.009, respectively). Anti-VCA IgG levels above the median are associated with HLA-DRB1*1501  in patients with MS (OR 8.4; 95CI 0.87–80.92; p = 0.047). Anti-VCA IgG level, anti-EBNA-1 IgG are not correlated with the age of the MS onset, disability, frequency of exacerbations, as well as with serum concentrations of 25-hydroxy vitamin D. It can be assumed  that the patients  with remitting  MS have features  of the EBV past-infection  immune  status. Dynamic observation of the serological markers levels of EBV infection is important not only in remission, but also in exacerbation of MS. The results of these observations will assess the prospects of EBV infection control and treatment for the management of patients with MS.

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The authors declare that there are no conflicts of interest present.