Abstract
We sought to evaluate a possible link between parvovirus B19 infection and the clinical and laboratory expression of systemic lupus erythematosus (SLE). SLE patients were examined to evaluate their clinical status and disease activity. A complete Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score was obtained for each patient. In addition, we determined the level of systemic involvement throughout the course of the disease. Blood levels of IgM and IgG antibodies to parvovirus B19, levels of anti-dsDNA, C3, and C4 were measured. A PCR real-time assay was used to determine the presence of parvovirus B19 genetic material. The viral genome was found in sera of 2 of 51(3.9%) patients with SLE. There was no correlation between viral serology and the clinical and serological parameters of the disease. More SLE patients with secondary antiphospholipid syndrome (APS) had IgG and IgM antibodies to the virus (p < 0.029 and p < 0.018, respectively). These patients also had a higher titer of IgG antibodies to parvovirus B19 compared to SLE patients without APS. In this group of SLE patients, no association was found between parvovirus infection and the presence or activity of SLE. The results of the study suggest an association between parvovirus infection and antibody production directed against phospholipids.
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References
Meyer O. Parvovirus B19 and autoimmune diseases. Joint Bone Spine. 2003;70:6–11.
Lehmann HW, von Landenberg P, Modrow S. Parvovirus B19 infection and autoimmune disease. Autoimmun Rev. 2003;2:218–23.
Hsu TC, Tsay GJ. Human parvovirus B19 infection in patients with SLE. Rheumatology. 2001;40:152–7.
Young N, Brown KE. Parvovirus B19. NEJM. 2004;350:586–97.
Severin MC, Levy Y, Shoenfeld Y. SLE and parvovirus B19: causal coincidence or causative culprit? Clin Rev Allergy Immunol. 2003;25:41–8.
Lehmann HW, Knoll A, Küster RM, Modrow S. Frequent infection with a viral pathogen, parvovirus B19, in rheumatic diseases of childhood. Arthritis Rheum. 2003;48:1631–8.
von Landenberg P, Lehmann HW, Knöll A, Dorsch S, Modrow S. Antiphospholipid antibodies in pediatric and adult patients with rheumatic disease are associated with parvovirus B19 infection. Arthritis Rheum. 2003;48:1939–47.
Kurtzman G, Frickhofen N, Kimball J, Jenkins DW, Nienhuis AW, Young NS. Pure red cell aplasia of 10 years duration due to persistent parvovirus B19 infection and its cure with immunoglobulin therapy. NEJM. 1989;321:519–23.
Dorsch S, Liebisch G, Kaufmann B, von Landenberg P, Hoffmann JH, Drobnik W, et al. The VP1 unique region of parvovirus B19 and its constituent phospholipase A2-like activity. J Virol. 2002;76:2014–8.
Soderlund-Venermo M, Hokynar K, Nieminen J, Rautakorpi H, Hedman K. Persistence of human parvovirus B19 in human tissues. Pathol Biol. 2002;50:307–16.
Lunardi C, Tinazzi E, Bason C, Dolcino M, Corrocher R, Puccetti A. Human parvovirus B19 infection and autoimmunity. Autoimmun Rev. 2008;8:116–20.
von Landenberg P, Lehmann HW, Modrow S. Human parvovirus B19 infection and antiphospholipid antibodies. Autoimmun Rev. 2007;6:278–85.
Aslanidis S, Pyrpasopoulou A, Kontotasios K, Doumas S, Zamboulis C. Parvovirus B19 infection and systemic lupus erythematosus: activation of an aberrant pathway? Eur J Intern Med. 2008;19:314–8.
Moffatt S, Tanaka N, Tada K, Nose M, Nakamura M, Muraoka O. A cytotoxic nonstructural protein, NS1, of human parvovirus B19 induces activation of interlukin-6 gene expression. J Virol. 1996;70:8485–91.
Ramos-Casals M, Cuadrado MJ, Alba P, Sanna G, Brito-Zerón P, Bertolaccini L, et al. Acute viral infections in patients with systemic lupus erythematosus. Medicine. 2008;87:311–8.
Suzuki T, Saito S, Hirabayashi Y, Harigae H, Ishii T, Kodera T, et al. Human parvovirus infection during the inactive stage of SLE. Intern Med. 2003;42:538–40.
Tóvári E, Mezey I, Hedman K, Czirják L. Self limiting lupus-like symptoms in patients with parvovirus B19 infection. Ann Rheum Dis. 2002;61:662–3.
Díaz F, Collazos J, Mendoza F, De La Viuda JM, Cazallas J, Urkijo JC. Systemic lupus erythematosus associated with acute parvovirus B19 infection. Clin Microbiol Infect. 2002;8:115–7.
Sugimoto T, Tsuda A, Uzu T, Kashiwagi A. Emerging lupus-like manifestations in acute parvovirus B19 infection. Clin Rheumatol. 2008;27:119–20.
Narváez Garcia FJ, Domingo-Domènech E, Castro-Bohorquez FJ, Biosca M, Garcia-Quintana A, Perez-Vega C. Lupus-like presentation of parvovirus B19 infection. Am J Med. 2001;111:573–5.
Hemauer A, Beckenlehner K, Wolf H, Lang B, Modrow S. Acute parvovirus B19 infection in connection with a flare of SLE in a female patient. J Clin Virol. 1999;4:73–7.
Sève P, Ferry T, Koenig M, Cathebras P, Rousset H, Broussolle C. Lupus-like presentation of parvovirus B19 infection. Semin Arthritis Rheum. 2004;34:642–8.
Bengtsson A, Widell A, Elmstâhl S, Sturfelt G. No serological indications that SLE is linked to exposure to human parvovirus B19. Ann Rheum Dis. 2000;59:64–6.
Kurtzman GJ, Cohen BJ, Field AM, Oseas R, Blaese RM, Young NS. Immune response to parvovirus B19 and an antibody defect in persistent viral infection. J Clin Invest. 1989;84:1114–23.
Tzang BS, Lee YJ, Yang TP, Tsay GJ, Shi JY, Tsai CC, et al. Induction of antiphospholipid antibodies and antiphospholipid syndrome-like autoimmunity in naive mice with antibody against human parvovirus B19 VP1 unique region protein. Clin Chim Acta. 2007;382(1–2):31–6.
Tzang BS, Tsay GJ, Lee YJ, Li C, Sun YS, Hsu TC. The association of VP1 unique region protein in acute parvovirus B19 infection and anti-phospholipid antibody production. Clin Chim Acta. 2007;378:59–65.
Chou TN, Hsu TC, Chen RM, Lin LI, Tsay GJ. Parvovirus B19 infection associated with the production of anti-neutrophil cytoplasmic antibody (ANCA) and anticardiolipin antibody (aCL). Lupus. 2000;9:551–4.
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Hod, T., Zandman-Goddard, G., Langevitz, P. et al. Does parvovirus infection have a role in systemic lupus erythematosus?. Immunol Res 65, 447–453 (2017). https://doi.org/10.1007/s12026-017-8896-0
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DOI: https://doi.org/10.1007/s12026-017-8896-0