Deficient EBV-specific B- and T-cell response in patients with chronic fatigue syndrome

• Published in: PloS one 2014-01, Vol.9 (1), p.e85387-e85387
• Main Authors: Loebel, Madlen, Strohschein, Kristin, Giannini, Carolin, Koelsch, Uwe, Bauer, Sandra, Doebis, Cornelia, Thomas, Sybill, Unterwalder, Nadine, von Baehr, Volker, Reinke, Petra, Knops, Michael, Hanitsch, Leif G, Meisel, Christian, Volk, Hans-Dieter, Scheibenbogen, Carmen
• Format: Article
• Language: English
• Subjects: Activation; Adult; Aged; Antibodies; Antibodies, Viral - blood; B cells; B-Lymphocytes - immunology; Base Sequence; Biology; Care and treatment; CD4 antigen; CD8 antigen; Chronic fatigue syndrome; Cytometry; Deoxyribonucleic acid; Diagnostic systems; DNA; DNA Primers; EBNA-1 protein; Enzyme-Linked Immunosorbent Assay; Epstein-Barr virus; Fatigue; Fatigue Syndrome, Chronic - immunology; Fatigue Syndrome, Chronic - virology; Female; Flow Cytometry; Herpesvirus 4, Human - immunology; Herpesvirus 4, Human - physiology; Humans; Immune system; Immunoglobulin G; Immunologic Memory; Immunological memory; Infectious mononucleosis; Interferon; Interleukin 2; Lupus; Lymphocytes B; Lymphocytes T; Male; Medicine; Middle Aged; Mononucleosis; Patients; Real-Time Polymerase Chain Reaction; Ribonucleic acid; RNA; Stability; T cell receptors; T cells; T-Lymphocyte Subsets; T-Lymphocytes - immunology; Tumor necrosis factor-α; Virus Replication; Viruses; γ-Interferon
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0085387

Epstein-Barr virus (EBV) has long been discussed as a possible cause or trigger of Chronic Fatigue Syndrome (CFS). In a subset of patients the disease starts with infectious mononucleosis and both enhanced and diminished EBV-specific antibody titers have been reported. In this study, we comprehensively analyzed the EBV-specific memory B- and T-cell response in patients with CFS. While we observed no difference in viral capsid antigen (VCA)-IgG antibodies, EBV nuclear antigen (EBNA)-IgG titers were low or absent in 10% of CFS patients. Remarkably, when analyzing the EBV-specific memory B-cell reservoir in vitro a diminished or absent number of EBNA-1- and VCA-antibody secreting cells was found in up to 76% of patients. Moreover, the ex vivo EBV-induced secretion of TNF-α and IFN-γ was significantly lower in patients. Multicolor flow cytometry revealed that the frequencies of EBNA-1-specific triple TNF-α/IFN-γ/IL-2 producing CD4(+) and CD8(+) T-cell subsets were significantly diminished whereas no difference could be detected for HCMV-specific T-cell responses. When comparing EBV load in blood immune cells, we found more frequently EBER-DNA but not BZLF-1 RNA in CFS patients compared to healthy controls suggesting more frequent latent replication. Taken together, our findings give evidence for a deficient EBV-specific B- and T-cell memory response in CFS patients and suggest an impaired ability to control early steps of EBV reactivation. In addition the diminished EBV response might be suitable to develop diagnostic marker in CFS.