Low vitamin D and elevated immunoreactivity against Epstein-Barr virus before first clinical manifestation of multiple sclerosis
– Source: Journal of Neurology, Neurosurgery and Psychiatry, Aug 11, 2012
By Brenard F Decard, Andrew Chan, et al.
[Apparently pre-onset blood donations provided this insight, underscored by the finding that the MS patients' average vitamin D levels had dropped another 50% by the time of diagnosis.]
Objective: Vitamin D deficiency and Epstein-Barr virus (EBV) infection may be associated with the development of multiple sclerosis (MS).
We investigated serum 25-hydroxyvitamin D (25-OH-D) levels and anti-EBV immunoreactivity in 25 individuals before the first clinical manifestation of MS.
Patients and methods:
• 56 serum samples of 25 individuals who had donated blood prior to the first clinical MS manifestation (clinically isolated syndrome (CIS))
• Four male subjects, 21 female subjects,
• Mean age 31.5 years at time of pre-CIS blood sampling;
• Mean age at disease onset 33.4 years…
….were available, covering an interval of 7.3 years-2 months (mean 31.5 months) before CIS.
In 18 of 25 patients serum samples were also obtained after established diagnosis of MS.
Longitudinal age- and gender-matched healthy blood donors (four male subjects, 21 female subjects, 39 samples, mean age 32.5 years) served as controls.
Serum 25-OH-D was measured by isotope dilution-liquid chromatography-tandem mass spectrometry. 25-OH-D levels were deconvoluted using published seasonal coefficients from a German population.
Immunoglobulin G (IgG) against Epstein-Barr virus nuclear antigen-1 (EBNA1) were assessed using commercially available ELISA.
• Low 25-OH-D levels were observed during the 24-month pre-CIS interval (47.8 (32.5-77.2) nmol/l, median (IQR); healthy controls: 81.6 (57.7-98.5), p=0.004,
• However, still higher than after established diagnosis (24.5 (13.7-47.7), p<0 .0001) compared with controls).
• IgG against EBNA1 during the 36-month pre-CIS interval was increased (185.9 (91.2–460.0) IU/ml, median (IQR); healthy controls 63.7 (29.5–121.6), p=0.002).
Conclusions: Low vitamin D and remote EBV infection may be associated with clinical MS breakthrough within 2–3 years.
Source: Journal of Neurology, Neurosurgery and Psychiatry, Aug 11, 2012. PMID:22888143, by Décard BF, von Ahsen N, Grunwald T, Streit F, Stroet A, Niggemeier P, Schottstedt V, Riggert J, Gold R, Chan A.Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum; Department of Neurology, St. Josef-Hospital, and Department of Molecular and Medical Virology, Ruhr-University Bochum; Department of Clinical Chemistry, University Medical Center Göttingen; German Red Cross Blood Transfusion Service West, Central Laboratory, Hagen; Department of Transfusion Medicine, University of Göttingen, Germany. [E-mail: firstname.lastname@example.org]