Positive correlation between latent Epstein-Barr virus infection and severity of illness in inflammatory bowel disease patients

Hong-Tao Wei; Xiao-Wei Xue; Qing Ling; Peng-Yan Wang; Wei-Xun Zhou

doi:10.4240/wjgs.v15.i3.420

Positive correlation between latent Epstein-Barr virus infection and severity of illness in inflammatory bowel disease patients

World J Gastrointest Surg. 2023 Mar 27;15(3):420-429. doi: 10.4240/wjgs.v15.i3.420.

Authors

Hong-Tao Wei¹, Xiao-Wei Xue², Qing Ling², Peng-Yan Wang², Wei-Xun Zhou³

Affiliations

¹ Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
² Department of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
³ Department of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China. zweixun@163.com.

Abstract

Background: Emerging studies indicate the critical involvement of microorganisms, such as Epstein-Barr virus (EBV), in the pathogenesis of inflammatory bowel disease (IBD). Immunosuppressive therapies for IBD can reactivate latent EBV, complicating the clinical course of IBD. Moreover, the clinical significance of EBV expression in B lymphocytes derived from IBD patients' intestinal tissues has not been explored in detail.

Aim: To explore the clinical significance of latent EBV infection in IBD patients.

Methods: Latent EBV infection was determined by double staining for EBV encoded RNA and CD20 in colon specimens of 43 IBD patients who underwent bowel resection. Based on the staining results, the patients were divided into two groups, according to their latent EBV infection states - negative (n = 33) and positive (n = 10). Illness severity of IBD were assigned according to Crohn's disease activity index (ulcerative colitis) and Mayo staging system (Crohn's disease). The clinic-pathological data were analyzed between the two different latent EBV groups and also between the mild-to-moderate and severe disease groups.

Results: Systolic pressure (P = 0.005), variety of disease (P = 0.005), the severity of illness (P = 0.002), and pre-op corticosteroids (P = 0.025) were significantly different between the EBV-negative and EBV-positive groups. Systolic pressure (P = 0.001), variety of disease (P = 0.000), pre-op corticosteroids (P = 0.011) and EBV infection (P = 0.003) were significantly different between the mild-to-moderate and severe disease groups.

Conclusion: IBD patients with latent EBV infection may manifest more severe illnesses. It is suggested that the role of EBV in IBD development should be further investigated, latent EBV infection in patients with serious IBD should be closely monitored, and therapeutic course should be optimized.

Keywords: Crohn’s disease; Epstein-Barr virus; Epstein-Barr virus encoded RNA; Inflammatory bowel disease; Ulcerative colitis.