Epstein-Barr Virus Infection in Childhood May Precipitate Atopic Diseases

ABSTRACT Background Epstein Barr virus (EBV) has been suspected of being involved in the development of atopy. There are several studies suggesting a positive as well as negative association between EBV infection and atopic diseases. Here, we carried out a large-scale, systematic investigation to address the issue of the possible association between EBV infection and atopic diseases. Methods Anti-EBV-viral capsid antigen (VCA) antibody titer, anti-EBV nuclear antigen (EBNA) antibody titer, atypical lymphocyte (AtLy) count and EBV-DNA copy number in 10 6 WBC were examined as evidence for EBV infection, and characteristic parameters of atopic disease such as total serum immunoglobulin E (IgE) level, highest antigen-specific IgE antibody titer (h-RAST) and peripheral blood eosinophil (Eos) count were measured and compared among atopic subjects and non-atopic controls, and correlations between parameters of atopy and EBV infection were subjected to statistical analysis. Results Anti-EBV, in particular anti-EBNA antibody titer and AtLy count in peripheral blood were markedly higher in patients with bronchial asthma (BA) and/or atopic dermatitis (AD) than in non-atopic controls, especially in early childhood. No similar findings were obtained for antibodies to cytomegalovirus (CMV). EBV-DNA copy numbers in WBC were elevated in atopic subjects. Correlations between EBV-DNA copy number and other parameters of EBV infection (anti-EBV antibody titer and AtLy count) but those with cytomegalovirus (CMV) infection and markers of atopic disease (IgE, h-RAST level, and Eos count) were demonstrated. It was found that anti-EBNA seronegative atopics have higher copy numbers of EBV DNA in WBC and more elevated levels of IgE and h-RAST than anti-EBNA seropositive atopics. Anti-EBV VCA antibody titer in individuals aged 15 years and younger and anti-EBNA antibody titer among Japanese were suggested to have declined considerably in the past 15 years. Conclusions The present study suggests that EBV infection in early childhood could precipitate atopic diseases.