S. Zubchenko, V. Chopyak
Danylo Halytsky Lviv National Medical University
Introduction. In case of weak or insufficient immune response, activation of chronic M. Epstein – I. Barr virus infection initiates different pathological disorders, one of which is allergy.
Aim. To specify the features of patients with allergic diseases and to investigate clinical and laboratory peculiarities of chronic active M. Epstein – I. Barr virus infection course.
Materials and methods. Totally, 298 patients, who were consulted at Lviv regional medical center of clinical immunology and allergology in 2016-2017 years with prior stratification by the presence of allergic symptoms, were examined randomly. All patients underwent clinical, laboratory and instrumental, specific allergy tests. Detection of herpes virus infections was performed by the results of molecular and genetic investigations. In general, the research involved 62 patients with verified allergic diseases, who were infected only with M. Epstein – I. Barr virus (33 (53.3 %) females and 29 (46.7 %) males aged 28.6 ± 2.4 years). The diseases were verified based on ARIA (2016), GINA (2016-2017) criteria and unified clinical protocol “Atopic dermatitis” (2016).
Results. Allergic diseases constituted 20.08 %. Verified persistent allergic rhinitis as well as sensitization with house dust mites, grass and spring trees were the most common. Polysensitization was detected in 75.80 % of individuals, and hyper-IgE syndrome in 50.00 %. Chronic active M. Epstein – I. Barr virus infection was detected in 48.38 % of patients with allergic diseases (1st group). Clinical signs of allergopathy in patients of the 1st group were manifested by rhino-conjunctivitis, cutaneous syndrome (p < 0.05), transitory syndrome of expiratory breathlessness (p < 0.05) and hyper-IgE-syndrome, namely with reliably higher IgE content (p < 0.05) compared to the patients with chronic active M. Epstein – I. Barr virus infection in latent phase (2nd group). In patients of the 1st group, polysensitization and the presence of allergopathy in close relatives were more common (p < 0.05), indicating the probability of genetic predisposition to allergic diseases (p < 0.05).
Conclusions. The results of investigation prove the influence of chronic active M. Epstein – I. Barr virus infection on the course of allergic diseases in adults, and indicate the applicability and perspectives of the research in this direction.
- Zubchenko SO. Prevalence of Epstein Barr virus infection among students. Actual Problems of Pediatry, Obstetrics and Gynecology. 2012;2:153-156. (Ukrainian).
- Chopyak VV, Zubchenko SО, Pasichnyuk ІP. Analysis of hyper-IgE-syndrome prevalence among practically healthy adolscent individuals. Bulletin of Problems Biology and Medicine. 2014;3(1):380-387. (Ukrainian).
- Chopyak VV, Potemkina HO, Bilianska LM, Shchepankevich I. Epstein-Barr viral infection at the stage of reactivation: clinical and immunological criteria of diagnosis and principles of treatment. Immunology and Allergy: Science and Practice. 2010;1:129. (Ukrainian).
- Arianna Mareri, Stuart P, Аdler К. Herpesvirus-associated acute urticaria: an age matched case-control study. J Allergy Clin І 2013;8:203-209. https://doi.org/10.1371/journal.pone.0085378
- Bousquet J, Heinzerling L, Bachert C, Papadopoulos N, Bousquet P, Burney P et al. Practical guide to skin prick tests in allergy to aeroallergens. 2012;67(1):18-24. https://doi.org/10.1111/j.1398-9995.2011.02728.x
- Calvari M, Alssandri C, Paolane G. Correletion between Epstein-Barr virus antibodies, serum IgE and atopic disease. Pediatr Allergy Immunol. 1997;8(1):91-96. https://doi.org/10.1111/j.1399-3038.1997.tb00150.x
- Cohen JI. Epstein-Barr virus infection. N Engl J Med. 2000;343:481-492. https://doi.org/10.1056/NEJM200008173430707
- Li L, Liu D, Hutt-Fletcher L, Morgan A, Masucci MG, Levitsky V. Epstein-Barr virus inhibits the development of dendritic cells by promoting apoptosis of their monocyte precursors in the presence of granulocyte macrophage-colony-stimulating factor and interleukin-4. Blood. 2002;99(10):3725-3734. https://doi.org/10.1182/blood.V99.10.3725
- Nilsson C, Larsson Sigfrinius AK, Montgomery SM, Sverremark-Ekström E, Linde A, Lilja G et al. Epstein-Barr virus and Cytomegalovirus are differentially associated with numbers of cytokine-producing cells and early atopy. Clin Exp Allergy. 2009;39(4):509-517. https://doi.org/10.1111/j.1365-2222.2008.03147.x
- Nilsson C, Linde A, Montgomery SM, Gustafsson L, Näsman P, Blomberg MT et al. Does early EBV infection protect against IgE sensitization? J Allergy Clin Immunol. 2005;116(2):438-444. https://doi.org/10.1016/j.jaci.2005.04.027
- Reiko Okudaira, Tokuko Mukoyama, Naohito Suzuki, Kohei Hashizume, Tsutomu Iwata, Fumiko Juli et al. Epstein-Barr virus infection in childhood may precipitate atopic diseases. Allergology International. 2005;54:483-490. https://doi.org/10.2332/allergolint.54.483
- Rystedt I, Strannegаrd IL, Strannegаrd O. Increased serum levels of antibodies to Epstein Barr virus in adults with history of atopic dermatitis. Int Arch Allergy Appl Immunol. 1984;75(2):179-183. https://doi.org/10.1159/000233610
- Saghafian-Hedengren S, Sundström Y, Sohlberg E, Nilsson C, Linde A, Troye-Blomberg M et al. Herpesvirus seropositivity in childhood associates with decreased monocyte-induced NK cell IFN-gamma production. J Immunol. 2009;182(4):2511-2517. https://doi.org/10.4049/jimmunol.0801699
- Saghafian-Hedengren S, Sverremark-Ekström E, Linde A, Lilja G, Nilsson C. Early-life EBV infection protects against persistent IgE-sensitization. J Allergy Clin Immunol. 2010;125(2):433-438. https://doi.org/10.1016/j.jaci.2009.09.033
- Savard M, Bélanger C, Tardif M, Gourde P, Flamand L, Gosselin J. Infection of primary human monocytes by Epstein-Barr virus. J Virol. 2000;74(6):2612-2619. https://doi.org/10.1128/JVI.74.6.2612-2619.2000
- Sidorchuk A, Wickman M, Pershagen G, Lagarde F, Linde A. Cytomegalovirus infection and development of allergic diseases in early childhood: interaction with EBV infection. J Allergy Clin Immunol. 2004;114(6):1434-1440. https://doi.org/10.1016/j.jaci.2004.08.009
- Strannegard IL, Strannegard O. Epstein-Barr virus antibodies in children with atopic disease. Int Arch Allergy Appl Immunol. 1981;64(3):314-319. https://doi.org/10.1159/000232709
- Thyphronitis G, Tsokos GC, June CH, Levine AD, Finkelman FD. IgE secretion by Epstein-Barr virus infected purified humen B-lymphocytes is stimulated by interleukin 4 and suppressed by interferon gamma. Proceedings of the National Academy of Scinces. 1989;86(14):5580-5584. https://doi.org/10.1073/pnas.86.14.5580
- Tsuge I, Morishima T, Morita M, Kimura H, Kuzushima K, Matsuoka H. Characterization of Epstein-Barr virus (EBV) infected natural killer (NK) cell proliferation in patients with severe mosquito allergy, establishment of an IL-2-dependent NK-like cell line. Clin Exp Immunol. 1999;115(3):385-392. https://doi.org/10.1046/j.1365-2249.1999.00836.x
- Votava M, Bartosová D, Krchnáková A, Crhová K, Kubinová L. Diagnostic importance of heterophile antibodies and immunoglobulins IgA, IgE, IgM and low-avidity IgG against Epstein-Barr virus capsid antigen in children. Acta Virol. 1996;40(2):99-101.
- Bousquet J, Heinzerling L, Bachert C, Papadopoulos N, Bousquet P, Burney P et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67(1):18-24. https://doi.org/10.1111/j.1398-9995.2011.02728.x