Epstein-Barr Virus Infection in Childhood May Precipitate Atopic Diseases

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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 10⁶ 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.