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Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective
Article

An Absence of Epstein–Barr Virus Reactivation and Associations with Disease Activity in People with Multiple Sclerosis Undergoing Therapeutic Hookworm Vaccination

1
Clinical Neurology Research Group, Division of Clinical Neuroscience, University of Nottingham School of Medicine; Queen’s Medical Centre, Nottingham NG7 2UH, UK
2
Department of Neurology, Nottingham University Hospitals NHS Trust; Queen’s Medical Centre, Nottingham NG7 2UH, UK
3
Department of Neurosciences, University of Medicine and Pharmacy Carol Davila, 021172 Bucharest, Romania
4
Department of Neurology, Colentina Hospital, 021172 Bucharest, Romania
5
Immune Regulation Research Group (D.P.), University of Nottingham, Nottingham NG7 2UH, UK
*
Author to whom correspondence should be addressed.
Received: 30 July 2020 / Revised: 23 August 2020 / Accepted: 24 August 2020 / Published: 28 August 2020
(This article belongs to the Special Issue Multiple Sclerosis and Its Complications: Clinical Trials)
Background: Epstein–Barr virus (EBV) infection is strongly associated with multiple sclerosis (MS). Helminth infection can downregulate antiviral immune responses, potentially protecting against MS, but with a theoretical risk for reactivating latent EBV infection. Objective: To investigate parameters of EBV infection and their relationship with disease activity in people with MS (PwMS) therapeutically vaccinated with Necator americanus (hookworm). Methods: Sequential serum samples from 51 PwMS; 26 therapeutically infected (25 larvae) with N. americanus and 25 controls were tested for EBV virus capsid antigen (VCA) IgG and IgM, EBV nuclear antigen-1 (EBNA-1) IgG, and EBV early antigen (EA) IgG. Disease activity was assessed by periodic MRI. Significance was set at p < 0.05. Results: All PwMS were EBV VCA IgG and EBNA-1 IgG positive, and 35.2% were EBV EA IgG positive. EBV antibody levels were generally stable, and EBV reactivation in PwMS was not demonstrated by significant increases in IgG titre over 12 months. Disease activity was most frequent in PwMS possessing high levels of EBV VCA IgG (>600 units/mL) or EBNA-1 IgG (>150 units/mL); however, there was no association with hookworm treatment. Interpretation: Therapeutic hookworm vaccination was not associated with EBV reactivation. Multiple sclerosis disease activity was associated with high levels of EBV VCA IgG or EBNA-1 IgG. View Full-Text
Keywords: multiple sclerosis; Epstein–Barr virus; therapeutic hookworm vaccination; disease activity multiple sclerosis; Epstein–Barr virus; therapeutic hookworm vaccination; disease activity
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MDPI and ACS Style

Maple, P.A.C.; Gran, B.; Tanasescu, R.; Pritchard, D.I.; Constantinescu, C.S. An Absence of Epstein–Barr Virus Reactivation and Associations with Disease Activity in People with Multiple Sclerosis Undergoing Therapeutic Hookworm Vaccination. Vaccines 2020, 8, 487. https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8030487

AMA Style

Maple PAC, Gran B, Tanasescu R, Pritchard DI, Constantinescu CS. An Absence of Epstein–Barr Virus Reactivation and Associations with Disease Activity in People with Multiple Sclerosis Undergoing Therapeutic Hookworm Vaccination. Vaccines. 2020; 8(3):487. https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8030487

Chicago/Turabian Style

Maple, Peter A.C., Bruno Gran, Radu Tanasescu, David I. Pritchard, and Cris S. Constantinescu. 2020. "An Absence of Epstein–Barr Virus Reactivation and Associations with Disease Activity in People with Multiple Sclerosis Undergoing Therapeutic Hookworm Vaccination" Vaccines 8, no. 3: 487. https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines8030487

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