Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Strong Viral Associations among Filipinos with Systemic Lupus Erythematosus.

Vista6,  Evan Glenn, Weisman3,  Michael H., Ishimori1,  Mariko L., Anderson5,  Jourdan, Tanangunan8,  Robelle, Gal2,  Noga, Harley7,  John B.

Cedars Sinai Medical Center, Los Angeles, CA
Cedars-Sinai
Cedars-Sinai Medical Center, Los Angeles, CA
Oklahoma Med Research Foundation, Oklahoma City, OK
Oklahoma Medical Research Foundation
Oklahoma Medical Research Foundation, Oklahoma City, OK
Univ of OK Hlth Sci Ctr, Oklahoma City, OK
University of Santo Tomas Hospital

Background:

Specific environmental determinants could determine development of SLE among susceptible individuals. Among potential viral environmental agents, the ubiquitous Epstein Barr virus (EBV) has been associated with SLE through seroprevalent exposure in pediatric and adult populations, viral DNA association, increased viral loads in the peripheral blood of SLE patients and increased evidence of viral reactivation. SLE patients have also been shown to have abnormal humoral and T cell responses against EBV. Filipinos, compared to other populations, could have potential major differences in terms of genetic risk, environmental exposure and disease causation brought about by their location as an archipelago separated from other Asian nations and a strong history of racial admixture.

Methods:

Filipinos with written and informed consent belonging to the University of Santo Tomas Hospital lupus cohort and fulfilling the 1997 American College of Rheumatology criteria (ACR) for SLE (233 cases) along with 544 unaffected first degree relatives (FDRs) and 220 unrelated controls were studied. Sera were tested for seroconversion to EBV, Cytomegalovirus (CMV) and Herpes simplex viruses (HSV1 and HSV2) by standardized ELISAs for IgG responses to EBV early antigen (EA), EBV viral capsid antigen (VCA), EBNA1, CMV immediate early antigen, HSV-1 (strain F) and HSV-2 (strain G). Correlation statistics (Fisher's exact test, student's t-test, and one-way ANOVA) were done to determine associations between patients and their controls and FDRs.

Results:

Filipino patients have significantly higher seroconversion for EBV EA (92.3%), EBV VCA (99.6%), CMV (94.4%), HSV1 (87.5%) and HSV2 (79.4%). Seroconversion against EBV-EA (a measure of reactivation) was dramatically higher in SLE patients compared to controls (92.3% vs 40.4%; OR=17.6, p <0.0001) or compared to FDRs (92.3% vs 49.4%; OR=12.2, p< 0.0001). For VCA, the cases have higher seroconversion than controls (OR 7.62, p 0.03). The cases have higher seroconversion for CMV than controls (OR 4.85, p<0.0001). Higher seroconversion for HSV1 was also seen for cases than controls (OR 7.2, P< 0.0001). Lastly, the cases have higher seroconversion for HSV2 compared among controls (OR 7.9, p <0.0001) and FDRs (OR 2.17, p <0.0001). Significantly higher antibody titers were seen for all viruses among the cases compared to controls and FDRs (p <0.0001).

Conclusions:

This study shows strong viral associations among Filipinos with SLE by the significantly higher seroconversion for EBV-EA, EBV-VCA, CMV, HSV1 and 2. Exposure to these environmental determinants could predispose Filipinos with high susceptibility in developing clinical disease.

To cite this abstract, please use the following information:
Vista, Evan Glenn, Weisman, Michael H., Ishimori, Mariko L., Anderson, Jourdan, Tanangunan, Robelle, Gal, Noga, et al; Strong Viral Associations among Filipinos with Systemic Lupus Erythematosus. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1197
DOI: 10.1002/art.28963

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