Cytomegalovirus Infection May Trigger Adult-Onset Still's Disease Onset or Relapses

Abstract

Previous studies have revealed that several micro-organisms, especially DNA viruses, have been associated with adult-onset Still's disease (AOSD). However, there are no studies on the relationship between the presence of viral infections in AOSD patients with disease occurrence and reactivation. In the present study, we aimed to investigate the presence of antibodies against virus, virus DNA load and nucleic acid sensors in AOSD patients. Anti-viral antibodies were measured by enzyme-linked immunosorbent assay (ELISA) in plasma samples from 100 AOSD patients and 70 healthy controls (HCs). The copy number of cytomegalovirus (CMV) DNA in 100 AOSD patients was detected by PCR. The expression levels of nucleic acid sensors interferon gamma-inducible protein 16 (IFI16) and absent in melanoma 2 (AIM2) in peripheral blood mononuclear cell (PBMC) and skin from AOSD patients and HCs were analyzed by PCR and immunohistochemistry. The levels of antibodies against CMV were significantly higher in AOSD patients compared to HCs. Moreover, the level of anti-CMV IgM antibody was significantly increased in patients with fever, sore throat, arthralgia and rash. CMV DNA was found in plasma of AOSD patients with disease new-onset and relapse. Furthermore, the copy number of CMV DNA significantly increased in patients with fever, sore throat, arthralgia and rash. And the significant associations of the CMV DNA level with the levels of leukocytes, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were observed. Moreover, we found an upregulation of cytoplasmic DNA-sensing receptor IFI16 and AIM2 in PBMC and skin from AOSD patients. In conclusion, our results showed that CMV infection may play a role in the initiation or amplification of inflammatory responses in AOSD.

Adult-Onset Still’s Disease: Clinical Aspects and Therapeutic Approach

“…[ 4 ]. We now know that cytomegalovirus may also trigger a relapse of AoSD [ 14 ]. Blood cultures and polymerase chain reaction (PCR) tests may, therefore, be useful for a differential diagnosis, although no specific diagnostic algorithms exist to date.…”

Adult-onset Still’s disease in Poland – a nationwide population-based study

“…Significant associations between AOSD and the HLA DQB1*06:02 allele, as well as between the DRB1*1501-DQB1*06:02 haplotype and AOSD susceptibility have also been observed [10]. Additionally, in recent decades, many cases of an infection with pathogens have been reported in AOSD patients [11,12,13].…”

Intracellular virus sensor MDA5 exacerbates vitiligo by inducing the secretion of chemokines in keratinocytes under virus invasion

“…The expression of MDA5 and anti-CMV IgM is higher in some progressive vitiligo patients Previous study has established that the detective rate of CMV DNA in vitiligo paraffin-embedded vitiligo tissues is up to 38% 14 . To further confirm the link between virus infection and vitiligo, in the serum of progressive vitiligo we first used ELISA to detect anti-CMV IgM, symbolizing acute CMV infection 46 . We found that the positive rate of anti-CMV IgM was 8.92% in 56 progressive vitiligo patients, while that in 26 healthy controls was 3.84%, and the anti-CMV IgM levels were significantly higher in vitiligo patients than that in healthy controls ( Fig.…”