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J Neurol Sci. 2014 Apr 15;339(1-2):26-31. doi: 10.1016/j.jns.2014.02.003. Epub 2014 Feb 11.

HLA-DRB1 15:01 and Epstein-Barr virus in a multiple sclerosis patient with psoriasis, nasopharyngeal and breast cancers. Lessons for possible hidden links for autoimmunity and cancer.

Author information

1
Dept of Neurology, Medical School, National and Kapodistrian University, Aeginition Hospital, Athens, Greece; Immunogenetics Lab., Dept of Neurology, Aeginition Hospital, Athens, Greece. Electronic address: managnost@med.uoa.gr.
2
Intensive Care Unit, "Henry Dunant" Hospital, Athens, Greece.
3
Dept of Neurology, Medical School, National and Kapodistrian University, Aeginition Hospital, Athens, Greece; Immunogenetics Lab., Dept of Neurology, Aeginition Hospital, Athens, Greece.
4
Dept of Neurology, Medical School, National and Kapodistrian University, Aeginition Hospital, Athens, Greece.

Abstract

BACKGROUND:

Multiple sclerosis (MS) patients have a low general cancer risk and cases of neoplastic comorbidity are attributed by many researchers in chance, or therapeutical side-effects. Human leucocyte antigen (HLA) class II allele DRB1 15:01 is considered the main genetic factor independently associated with increased susceptibility for MS in Caucasians. Epstein-Barr virus (EBV) has also been proven to be a core triggering factor in MS initiation and progress, mainly in HLA-DRB1 15:01 positive MS patients.

CASE REPORT:

We present an exceptional case of a Greek-origin woman, carrying a distinct immunogenetic profile (HLA-A 26:01-Cw 06:02-DRB1 15:01), which gradually developed psoriasis, nasopharyngeal carcinoma (NPC), MS, breast cancer, uterine leiomyoma and other neoplasms.

DISCUSSION:

EBV plays a fundamental role in the pathogenesis of both autoimmunity (i.e. MS) and cancer (i.e. NPC). Our patient's immunogenetic profile included HLA alleles which are associated with psoriasis (Cw 06:02), NPC (A 26:01), MS (DRB1 15:01) and increased risk of MS, in patients carrying EBV (DRB1 15:01). We made a targeted review of the literature finding data supporting an EBV-HLA interaction mechanism behind our patient's unique combination of disorders, suggesting that beyond the standard role of each factor, their combination could act as the hidden link, in initiation or/and comorbidity of autoimmunity and cancer.

KEYWORDS:

Breast cancer; Epstein–Barr Virus; Human leucocyte antigens; Multiple sclerosis; Nasopharyngeal carcinoma; Psoriasis

PMID:
24576802
DOI:
10.1016/j.jns.2014.02.003
[Indexed for MEDLINE]
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