Epstein-Barr virus is related with 5-aminosalicylic acid, tonsillectomy, and CD19(+) cells in Crohn's disease

World J Gastroenterol. 2015 Apr 21;21(15):4666-72. doi: 10.3748/wjg.v21.i15.4666.

Abstract

Aim: To study anti-Epstein-Barr virus (EBV) IgG antibodies in Crohn's disease in relation to treatment, immune cells, and prior tonsillectomy/appendectomy.

Methods: This study included 36 CD patients and 36 healthy individuals (controls), and evaluated different clinical scenarios (new patient, remission and active disease), previous mucosa-associated lymphoid tissue removal (tonsillectomy and appendectomy) and therapeutic regimens (5-aminosalicylic acid, azathioprine, anti-tumor necrosis factor, antibiotics, and corticosteroids). T and B cells subsets in peripheral blood were analyzed by flow cytometry (markers included: CD45, CD4, CD8, CD3, CD19, CD56, CD2, CD3, TCRαβ and TCRγδ) to relate with the levels of anti-EBV IgG antibodies, determined by enzyme-linked immunosorbent assay.

Results: The lowest anti-EBV IgG levels were observed in the group of patients that were not in a specific treatment (95.4 ± 53.9 U/mL vs 131.5 ± 46.2 U/mL, P = 0.038). The patients that were treated with 5-aminosalicylic acid showed the highest anti-EBV IgG values (144.3 U/mL vs 102.6 U/mL, P = 0.045). CD19(+) cells had the largest decrease in the group of CD patients that received treatment (138.6 vs 223.9, P = 0.022). The analysis of anti-EBV IgG with respect to the presence or absence of tonsillectomy showed the highest values in the tonsillectomy group of CD patients (169.2 ± 20.7 U/mL vs 106.1 ± 50.3 U/mL, P = 0.002). However, in the group of healthy controls, no differences were seen between those who had been tonsillectomized and subjects who had not been operated on (134.0 ± 52.5 U/mL vs 127.7 ± 48.1 U/mL, P = 0.523).

Conclusion: High anti-EBV IgG levels in CD are associated with 5-aminosalicylic acid treatment, tonsillectomy, and decrease of CD19(+) cells.

Keywords: 5-aminosalicylic acid; B cells; Crohn’s disease; Epstein-Barr virus; Tonsillectomy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology*
  • Antigens, CD19 / blood
  • Antigens, CD19 / immunology*
  • Biomarkers / blood
  • Crohn Disease / blood
  • Crohn Disease / diagnosis
  • Crohn Disease / drug therapy*
  • Crohn Disease / immunology
  • Female
  • Herpesvirus 4, Human / immunology*
  • Humans
  • Immunoglobulin M / blood
  • Immunoglobulin M / immunology*
  • Lymphocytes / drug effects*
  • Lymphocytes / immunology
  • Lymphocytes / metabolism
  • Lymphocytes / virology
  • Male
  • Mesalamine / therapeutic use*
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Tonsillectomy*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Viral
  • Antigens, CD19
  • Biomarkers
  • Immunoglobulin M
  • Mesalamine