Prevalence rate of cytomegalovirus infection in individuals with and without systemic lupus erythematosus
Researcher Bulletin of Medical Sciences,
Vol. 24 No. 1 (2019),
,
Page e5
Abstract
Background: The role of cytomegalovirus (CMV) infection in triggering or exacerbating systemic lupus erythematosus (SLE) remains a subject of debate. The aim of this study was to compare the prevalence rate of CMV infection between individuals with and without SLE.
Materials and Methods: This cross-sectional comparative study recruited 52 consecutive patients with SLE (based on the criteria determined by the Systemic Lupus Collaborating Clinics, 2012) and 52 healthy subjects. The exclusion criteria were immunodeficiency and other background diseases. CMV infection was assessed according to serology (enzyme-linked immunosorbent assay) and polymerase chain reaction (PCR).
Results: Immunoglobulin G (IgG) was positive in all participants. Immunoglobulin M (IgM) was positive in eight SLE patients (15.4%) and none of the controls (p = 0.003). The PCR was positive in four SLE patients (7.7%) and none of the controls (p = 0.041). IgM level was not related to age, gender, literacy, marital status, family history, SLE disease activity index (SLEDAI), or duration of the disease (p > 0.05).
Conclusion: According to this study, CMV infection was higher in SLE patients but was not related to the type of organ involvement, type of immunosuppressive drug, or SLEDAI.
Keywords:
- Cytomegalovirus; Systemic lupus erythematosus; Infection
How to Cite
Ferdowsi , F., Haghigh, A., Barati, M., Shirani, F., Keyvani, H., Naghdalipour, M., & Kianmehr, N. (2020). Prevalence rate of cytomegalovirus infection in individuals with and without systemic lupus erythematosus. Researcher Bulletin of Medical Sciences, 24(1), e5. Retrieved from https://journals.sbmu.ac.ir/index.php/rbms/article/view/32140
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23. S. Bendiksen, M. van Ghelue, O. P. Rekvig, T. Gutteberg, H.-J. Haga, and U. Moens, “A longitudinal study of human cytomegalovirus serology and viruria fails to detect active viral infection in 20 systemic lupus erythematosus patients,” Lupus, vol. 9, no. 2, pp. 120–126, 2000.
24. P. Stratta, C. Canavese, G. Ciccone et al., “Correlation between cytomegalovirus infection and Raynaud's phenomenon in lupus nephritis,” Nephron, vol. 82, no. 2, pp. 145–154, 1999.
25. J. R. Rider, W. E. R. Ollier, R. J. Lock, S. T. Brookes, and D. H. Pamphilon, “Human cytomegalovirus infection and systemic lupus erythematosus,” Clinical and Experimental Rheumatology, vol. 15, no. 4, pp. 405–409, 1997.
26. Rasmussen NS, Draborg AH, Nielsen CT, Jacobsen S, Houen G. Antibodies to early EBV, CMV, and HHV6 antigens in systemic lupus erythematosus patients. Scand J Rheumatol. 2015;44(2):143-9.
27. O. Barzilai, Y. Sherer, M. Ram, D. Izhaky, J. M. Anaya, and Y. Shoenfeld, “Epstein-Barr virus and cytomegalovirus in autoimmune diseases: Are they truly notorious? A preliminary report,” Annals of the New York Academy of Sciences, vol. 1108, pp. 567– 577, 2007.
28. Berkun Y, Zandman-Goddard G, Barzilai O, et al. Infectious antibodies in systemic lupus erythematosus patients. Lupus 2009; 18: 1129–1135.
29. Hrycek A, Kus´mierz D, Mazurek U, Wilczok T. Human cytomegalovirus in patients with systemic lupus erythematosus. Autoimmunity 2005; 38: 487–491.
30. B. Y.-J. Su, C.-Y. Su, S.-F. Yu, and C.-J. Chen, “Incidental discovery of high systemic lupus erythematosus disease activity associated with cytomegalovirus viral activity,” Medical Microbiology and Immunology, vol. 196, no. 3, pp. 165–170, 2007.
31. Mohamed AE, Hasen AM, Mohammed GF, Elmaraghy NN. Real-Time PCR of cytomegalovirus and Epstein-Barr virus in adult Egyptian patients with systemic lupus erythematosus. Int J Rheum Dis. 2015 May;18(4):452-8.
32. Tsai WP1, Chen MH, Lee MH, Yu KH, Wu MW, Liou LB Cytomegalovirus infection causes morbidity and mortality in patients with autoimmune diseases, particularly systemic lupus: in a Chinese population in Taiwan. Rheumatol Int. 2012 Sep;32(9):2901-8.
33. P. Stratta, C. Canavese, G. Ciccone et al., “Correlation between cytomegalovirus infection and Raynaud’s phenomenon in lupus nephritis,” Nephron, vol. 82, no. 2, pp. 145–154, 1999.
34. Amel R, Monia K, Anis M, Fatma BF, Chadia L. Systemic lupus erythematous revealed by cytomegalovirus infection. Pan Afr Med J. 2016 Jul 15;24:241.
35. Sakamoto O, Ando M, Yoshimatsu S, Kohrogi H, Suga M, Ando M. Systemic lupus erythematosus complicated by cytomegalovirus-induced hemophagocytic syndrome and colitis. Intern Med. 2002 Feb;41(2):151-5.
36. Tanaka Y, Seo R, Nagai Y, Mori M, Togami K, Fujita H, et al. Systemic lupus erythematosus complicated by cytomegalovirus-induced hemophagocytic syndrome and pneumonia. Nihon Rinsho Meneki Gakkai Kaishi 2008 Feb;31(1):71-5.)
37. Ramos-Casals M, Cuadrado MJ, Alba P, et al. Acute viral infections in patients with systemic lupus erythematosus: description of 23 cases and review of the literature. Medicine (Baltimore). 2008 Nov;87(6):311-8.
38. Aditya Kelkar, Jai Kelkar, Shreekant Kelkar, Shilpa Bhirud, Jyotirmoy Biswas Cytomegalovirus retinitis in a seronegative patient with systemic lupus erythematosus on immunosuppressive therapy. J Ophthalmic Inflamm Infect. 2011 Sep; 1(3): 129–132.
2. PETRI M: Infection in systemic lupus erythematosus. Rheum Dis Clin North Am 1998; 24: 423-56. 2. DENMANAM: Systemic lupus erythematosus – is a viral aetiology a credible hypothesis ? J Infect 2000; 40: 229-33. 3. SE K I G AWA I, O G A S AWARA H, K A N E KO H, HISHIKAWA T, HASHIMOTO H: Retroviruses and autoimmunity. Intern Med 2001; 40: 80-Wadee S, Tikly M, Hopley M. Causes and predictors of death in South Africans with systemic lupus erythematosus. Rheumatology (Oxford). 2007 Sep;46(9):1487-91.
3. Moorthy LN, Peterson MG, Hassett AL, et al. Relationship between health-related quality of life and SLE activity and damage in children over time. Lupus. 2009 Jun;18(7):622-9.
4. Tikly M, Navarra SV. Lupus in the developing world--is it any different? Best Pract Res Clin Rheumatol. 2008 Aug;22(4):643-55.
5. OGASAWARA H, NAITO T, KANEKO H et al.: Quantitative analyses of messenger RNA of human endogenous re t rov i rus in SLE patients. J Rheumatol 2001; 28: 533-8.
6. . TA NA K A A , S U G AWA R A A , S AWAI K, K UWAHARA T: Human parvovirus B19 infection resembling systemic lupus erythematosus. Intern Med 1998; 37: 708-10.
7. JAMES JA, NEAS BR, MOSER KL et al.: Systemic lupus erythematosus in adults is associated with previous Epstein-Barr virus exposure. Arthritis Rheum 2001: 44; 1122-6.
8. Halenius A. Hengel H. Human Cytomegalovirus and Autoimmune Disease. BioMed Research International, Volume 2014 (2014), Article ID 472978, 15 pages
9. H. Hengel, W. Brune, and U. H. Koszinowski, “Immune evasion by cytomegalovirus—survival strategies of a highly adapted opportunist,” Trends in Microbiology, vol. 6, no. 5, pp. 190–197, 1998.
10. M. Babic, A. Krmpoti ´ c, and S. Jonji ´ c, “All is fair in virus- ´ host interactions: NK cells and cytomegalovirus,” Trends in Molecular Medicine, vol. 17, no. 11, pp. 677–685, 2011.
11. L. Amsler, M. C. Verweij, and V. R. DeFilippis, “The tiers and dimensions of evasion of the type I interferon response by human cytomegalovirus,” Journal of Molecular Biology, vol. 425, no. 24, pp. 4857–4871, 2013.
12. B. P. McSharry, S. Avdic, and B. Slobedman, “Human cytomegalovirus encoded homologs of cytokines, chemokines and their receptors: roles in immunomodulation,” Viruses, vol. 4, no. 11, pp. 2448–2470, 2012. 10 BioMed Research International.
13. N. Stern-Ginossar, B. Weisburd, A. Michalski et al., “Decoding human cytomegalovirus,” Science, vol. 338, pp. 1088–1093, 2012.
14. C. Sinzger, A. Grefte, B. Plachter, A. S. H. Gouw, T. Hauw The, and G. Jahn, “Fibroblasts, epithelial cells, endothelial cells and smooth muscle cells are major targets of human cytomegalovirus infection in lung and gastrointestinal tissues,” Journal of General Virology, vol. 76, no. 4, pp. 741–750, 1995.
15. Y. N. Ji, L. An, P. Zhan, and X. H. Chen, “Cytomegalovirus infection and coronary heart disease risk: a meta-analysis,” Molecular Biology Reports, vol. 39, no. 6, pp. 6537–6546, 2012.
16. G. Pawelec, J. E. McElhaney, A. E. Aiello, and E. Derhovanessian, “The impact of CMV infection on survival in older humans,” Current Opinion in Immunology, vol. 24, pp. 507–511, 2012.
17. C. S. Cobbs, “Cytomegalovirus and brain tumor: epidemiology, biology and therapeutic aspects,” Current Opinion on Oncology, vol. 25, pp. 682–688, 2013.
18. Söderberg-Nauclér C. Autoimmunity induced by human cytomegalovirus in patients with systemic lupus erythematosus. Arthritis Res Ther. 2012;14:101.
19. Chang M, Pan MR, Chen DY, Lan JL. Humman cytomegalovirus pp65 lower matrix protein: a humoral immunogen for systemic lupus erythematosus patients and autoantibody accelerator for NZB/WF1 mice. Clin Exp Immunol 2006; 143(1):167-79.
20. Bombardier, C, Gladman, D.D, Urowitz, M.D, Caron, D, Chang, C.H and the Committee on Prognosis Studies in SLE (1992): Derivation of the SLEDAI, disease activity index for lupus patients. Arthritis Rheum 35:630-40.
21. C. G. Parks, G. S. Cooper, L. L. Hudson et al., “Association of Epstein-Barr virus with systemic lupus erythematosus: effect modification by race, age, and cytotoxic T lymphocyte-associated antigen 4 genotype,” Arthritis & Rheumatism, vol. 52, no. 4, pp. 1148–1159, 2005.
22. J. A. James, B. R. Neas, K. L. Moser et al., “Systemic lupus erythematosus in adults is associated with previous Epstein-Barr virus exposure,” Arthritis & Rheumatism, vol. 44, pp. 1122–1126, 2001.
23. S. Bendiksen, M. van Ghelue, O. P. Rekvig, T. Gutteberg, H.-J. Haga, and U. Moens, “A longitudinal study of human cytomegalovirus serology and viruria fails to detect active viral infection in 20 systemic lupus erythematosus patients,” Lupus, vol. 9, no. 2, pp. 120–126, 2000.
24. P. Stratta, C. Canavese, G. Ciccone et al., “Correlation between cytomegalovirus infection and Raynaud's phenomenon in lupus nephritis,” Nephron, vol. 82, no. 2, pp. 145–154, 1999.
25. J. R. Rider, W. E. R. Ollier, R. J. Lock, S. T. Brookes, and D. H. Pamphilon, “Human cytomegalovirus infection and systemic lupus erythematosus,” Clinical and Experimental Rheumatology, vol. 15, no. 4, pp. 405–409, 1997.
26. Rasmussen NS, Draborg AH, Nielsen CT, Jacobsen S, Houen G. Antibodies to early EBV, CMV, and HHV6 antigens in systemic lupus erythematosus patients. Scand J Rheumatol. 2015;44(2):143-9.
27. O. Barzilai, Y. Sherer, M. Ram, D. Izhaky, J. M. Anaya, and Y. Shoenfeld, “Epstein-Barr virus and cytomegalovirus in autoimmune diseases: Are they truly notorious? A preliminary report,” Annals of the New York Academy of Sciences, vol. 1108, pp. 567– 577, 2007.
28. Berkun Y, Zandman-Goddard G, Barzilai O, et al. Infectious antibodies in systemic lupus erythematosus patients. Lupus 2009; 18: 1129–1135.
29. Hrycek A, Kus´mierz D, Mazurek U, Wilczok T. Human cytomegalovirus in patients with systemic lupus erythematosus. Autoimmunity 2005; 38: 487–491.
30. B. Y.-J. Su, C.-Y. Su, S.-F. Yu, and C.-J. Chen, “Incidental discovery of high systemic lupus erythematosus disease activity associated with cytomegalovirus viral activity,” Medical Microbiology and Immunology, vol. 196, no. 3, pp. 165–170, 2007.
31. Mohamed AE, Hasen AM, Mohammed GF, Elmaraghy NN. Real-Time PCR of cytomegalovirus and Epstein-Barr virus in adult Egyptian patients with systemic lupus erythematosus. Int J Rheum Dis. 2015 May;18(4):452-8.
32. Tsai WP1, Chen MH, Lee MH, Yu KH, Wu MW, Liou LB Cytomegalovirus infection causes morbidity and mortality in patients with autoimmune diseases, particularly systemic lupus: in a Chinese population in Taiwan. Rheumatol Int. 2012 Sep;32(9):2901-8.
33. P. Stratta, C. Canavese, G. Ciccone et al., “Correlation between cytomegalovirus infection and Raynaud’s phenomenon in lupus nephritis,” Nephron, vol. 82, no. 2, pp. 145–154, 1999.
34. Amel R, Monia K, Anis M, Fatma BF, Chadia L. Systemic lupus erythematous revealed by cytomegalovirus infection. Pan Afr Med J. 2016 Jul 15;24:241.
35. Sakamoto O, Ando M, Yoshimatsu S, Kohrogi H, Suga M, Ando M. Systemic lupus erythematosus complicated by cytomegalovirus-induced hemophagocytic syndrome and colitis. Intern Med. 2002 Feb;41(2):151-5.
36. Tanaka Y, Seo R, Nagai Y, Mori M, Togami K, Fujita H, et al. Systemic lupus erythematosus complicated by cytomegalovirus-induced hemophagocytic syndrome and pneumonia. Nihon Rinsho Meneki Gakkai Kaishi 2008 Feb;31(1):71-5.)
37. Ramos-Casals M, Cuadrado MJ, Alba P, et al. Acute viral infections in patients with systemic lupus erythematosus: description of 23 cases and review of the literature. Medicine (Baltimore). 2008 Nov;87(6):311-8.
38. Aditya Kelkar, Jai Kelkar, Shreekant Kelkar, Shilpa Bhirud, Jyotirmoy Biswas Cytomegalovirus retinitis in a seronegative patient with systemic lupus erythematosus on immunosuppressive therapy. J Ophthalmic Inflamm Infect. 2011 Sep; 1(3): 129–132.
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