Is EBV-infection under the control of Vitamin-D?


Ramien C, Pachnio A, Sisay S, Begum J, Leese A, Disanto G, Kuhle J, Giovannoni G, Rickinson A, Ramagopalan SV, Moss P, Meier UC.Hypovitaminosis-D and EBV: no interdependence between two MS risk factors in a healthy young UK autumn cohort. Mult Scler. 2013 Nov 5. [Epub ahead of print]

Late Epstein-Barr virus infection and hypovitaminosis-D as environmental risk factors in the pathogenesis of multiple sclerosis are gaining great interest. We, therefore, tested for in-vivo interdependence between Epstein-Barr-virus (EBV)-status and 25-hydroxyvitamin D3 (25(OH)D3) -level in healthy young individuals from a United Kingdom (UK) autumn cohort. EBV-load was measured by quantitative polymerase chain reaction and 25(OH)D3 levels by isotope-dilution liquid chromatography-tandem mass spectrometry. This young, healthy UK autumn cohort showed surprisingly low levels of 25(OH)D3 (mean value: 40.5 nmol/L ± 5.02). Furthermore, we found that low 25(OH)D3 levels did not impact on EBV load and anti-EBV nuclear antigen-1 (EBNA-1) titers. However, we observed a correlation between EBV load and EBNA-1 titers. These observations should be of value in the study of the potential relationship between hypovitaminosis-D and EBV-status in the pathophysiology of multiple sclerosis
 
“As EBV-status and suboptimal Vitamin-D levels are potential risk factors for MS, we wanted to test whether they acted in concert or independently. In collaboration with Birmingham’s CMV/EBV teams, we measured EBV-status and Vitamin-D levels in young, healthy medical students.

What did we find? To our surprise, the majority of students had insufficient Vitamin-D levels. Interestingly, the samples were obtained in 2007 after one of the wettest UK summers. We did not see an effect on the control of EBV-infection at these suboptimal vitamin-D levels.

There are now two potential scenarios: vitamin-D and EBV-status act independently as risk factors in MS or optimal vitamin-D levels may be needed to exert an effect on EBV-infection.”

Several studies have monitored anti-EBV responses and vitamin-D levels in MSers:

 
Epstein-Barr virus antibodies and vitamin D in prospective multiple sclerosis biobank samples. Salzer J, Nyström M, Hallmans G, Stenlund H, Wadell G, Sundström P. Mult Scler. 2013 Oct;19(12):1587-91. 2013 Apr 2.

Vitamin D supplementation and antibodies against the Epstein-Barr virus in multiple sclerosis patients. Disanto G, Handel AE, Damoiseaux J, Hupperts R, Giovannoni G, Smolders J, Ramagopalan SV. Mult Scler. 2013 Oct;19(12):1679-80.

Review on EBV and VitD: Vitamin D: a link between Epstein-Barr virus and multiple sclerosis development? Disanto G, Meier U, Giovannoni G, Ramagopalan SV.  Expert Rev Neurother. 2011 Sep;11(9):1221-4.

“Furthermore, given my past area of work, I am very interested in the literature on Hepatitis-C/ Hepatitis-B/HIV-infection. They are testing similar ideas on persistent virus infections and Vitamin-D at the moment to see whether vitamin-D supplementation has an effect on anti-viral immune responses, immunopathology and the response to treatment.”

Low vitamin D serum concentration is associated with high levels of hepatitis B virus replication in chronically infected patients. Farnik H, Bojunga J, Berger A, Allwinn R, Waidmann O, Kronenberger B, Keppler OT, Zeuzem S, Sarrazin C, Lange CM. Hepatology. 2013 Oct;58(4):1270-6. doi: 10.1002/hep.26488. Epub 2013 Aug 7.

Vitamin D deficiency is associated with severity of liver disease in HIV/HCV coinfected patients. Guzmán-Fulgencio M, García-Álvarez M, Berenguer J, Jiménez-Sousa MA, Cosín J, Pineda-Tenor D, Carrero A, Aldámiz T, Alvarez E, López JC, Resino S. J Infect. 2013 Nov 1. S0163-4453(13)00326-5. 10.1016/j.jinf.2013.10.011. [Epub ahead of print]

“So far we conclude that rainy UK summers may impact on your health and you may want to consider vitamin-D supplementation in the UK or spending your summer holidays somewhere sunny.”

CI: Ute-Christiane Meier reports no conflict of interest

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