One of the world’s most common viruses could be the cause of lupus, an autoimmune disease with a wide range of symptoms, according to a study published Wednesday.
Until now, lupus has been a bit of a mystery: no single cause of the disease has been found and there is no specific treatment.
The research, published in the journal Science Translational Medicine, suggests that the Epstein-Barr virus — which 95% of people contract at some point in their lives — could cause lupus by inducing the body to attack its own healthy cells.
This adds to growing evidence associating Epstein-Barr virus with multiple long-term health problems, including other autoimmune diseases. As this evidence accumulates, scientists have stepped up efforts to develop a vaccine against the virus.
“If we now better understand how this very persistent virus is responsible for autoimmune diseases, I think it’s time to find a way to prevent it,” said Dr. Anca Askanase, clinical director of the Columbia University Lupus Center, who was not involved in the new research.
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In lupus patients, an autoimmune attack can cause extreme fatigue, joint pain, and rashes. In rare cases, the disease can cause fatal or life-threatening problems, such as kidney damage, or weaken the immune system, preventing the body from fighting infections.
Scientists have long suspected a link between the Epstein-Barr virus and lupus, but the exact connection remained elusive. Dr. William Robinson, co-author of the new study and chief of the division of immunology and rheumatology at Stanford University, said their new findings solve a key piece of that puzzle.
Robinson said a pathway similar to the one described in their new study could also lead to other autoimmune diseases such as rheumatoid arthritis and Crohn’s disease, but more research is needed to elucidate this.
Of course, the vast majority of people who contract Epstein-Barr virus do not develop lupus, multiple sclerosis, or any other autoimmune disease. Robinson noted that only certain strains of the Epstein-Barr virus may trigger autoimmune reactions.
To determine the causal relationship between the Epstein-Barr virus and lupus, Robinson and his co-authors focused on B lymphocytes, white blood cells that help fight infections.
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Even in healthy people, the Epstein-Barr virus remains latent in a small proportion of B cells. However, these virus-containing B cells are much more common in lupus patients, who have a proportion 25 times higher, according to the new research.
The study also highlights a type of protein called antinuclear antibodies, which bind to the nucleus of cells and are one of the hallmarks of lupus. Researchers discovered that the Epstein-Barr virus infects and reprograms B lymphocytes to produce antinuclear antibodies that attack the body’s own tissues, thereby causing lupus.
Robinson said these findings are consistent with other theories about the causes of lupus. For example, scientists suspect that a person’s genetics or hormones may also predispose them to the disease.
A study published last year in the journal Nature also revealed that people with lupus have an excess of a specific type of T lymphocyte – another type of white blood cell – associated with cellular damage and a deficiency of another T lymphocyte related to repair. Robinson stated that the pathway described in his study could activate this T lymphocyte response.
According to Robinson, co-founder of two drug development companies researching treatments for autoimmune diseases, the new research points to some potential options for treating lupus.
Many of the current medications given to relieve lupus symptoms, such as corticosteroids, focus primarily on reducing inflammation. Robinson said future therapies could specifically target B cells infected with Epstein-Barr virus.
However, a vaccine against Epstein-Barr virus—several of which are in clinical trials—could one day prevent infections at their source.
“Vaccination to protect people against Epstein-Barr virus infection would be the definitive and fundamental solution,” Robinson concluded.
