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Neurology. 2013 Oct 15;81(16):1392-9. doi: 10.1212/WNL.0b013e3182a841e4. Epub 2013 Sep 6.

Epstein-Barr virus in oral shedding of children with multiple sclerosis.

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From Neuroscience and Mental Health, Research Institute (C.Y.), The Hospital for Sick Children, Toronto; the Department of Microbiology, Immunology, and Infectious Diseases (R.T.), University of Calgary; the Provincial Public Health Laboratory of Alberta (R.T.), Calgary; the National Microbiology Laboratory (P.C., G.W.), Public Health Agency of Canada, Winnipeg; the Department of Internal Medicine (R.A.M.), University of Manitoba, Winnipeg; the Experimental Therapeutics Program (A.B.-O.), Montreal Neurological Institute, McGill University, Montreal, Canada; and the Division of Neurology (B.B.), The Children's Hospital of Philadelphia, PA.



To investigate Epstein-Barr virus (EBV) oral shedding frequency and EBV genetic diversity in pediatric patients with multiple sclerosis (MS).


This was a prospective case-control study. We used PCR-based assays to detect viral DNA in the monthly mouth swabs of 22 pediatric patients with MS and 77 age- and sex-matched healthy controls. EBV-positive samples were further analyzed for sequence variation in the EBV BCRF1 (ebvIL-10) gene using direct DNA sequencing methods, and in the EBV LMP1 gene by mass spectrometry.


Nineteen of the 22 (86.4%) children with MS were seropositive for remote EBV infection compared to 35 out of 77 (45.5%) healthy controls (p = 0.008). Baseline analysis of mouth swabs revealed a higher proportion of EBV-positive samples from EBV-seropositive patients with MS compared to EBV-seropositive healthy controls (52.6% vs 20%, p = 0.007). Longitudinal analysis of monthly swabs revealed average EBV detection rates of 50.6% in patients with MS and 20.4% in controls (p = 0.01). The oral shedding frequencies of Herpesviruses herpes simplex virus-1, cytomegalovirus, human herpesvirus (HHV)-6, and HHV-7 did not differ between groups. Changes in the predominant EBV genetic variants were detected more frequently in patients with MS; however, no specific EBV genetic variant was preferentially associated with MS.


Children with MS demonstrate abnormally increased rates of EBV viral reactivation and a broader range of genetic variants, suggesting a selective impairment in their immunologic control of EBV.

[Indexed for MEDLINE]
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