Epstein-Barr Virus and the Lacrimal Gland Pathology of Sjögren’s Syndrome

Ocular Mucosal Immunity

“…Furthermore, in experimental models of this complex disorder, the generation of autoantibodies (Ohashi et al, 1985) and autoreactive T cells to (Tsubata et al, 1996), and the deposition of IgG, IgA, and complement in ductal epithelial cells of (deLuise et al, 1982), lacrimal tissue may accompany the striking glandular inflammation (Jabs et al, 1985;Jabs and Prendergast, 1988;Tsubata et al, 1996;Takahashi et al, 1996;Robinson et al, 1998;van Blokland and Versnel, 2002). The etiology of Sjögren's syndrome may involve the endocrine system (Ansar et al, 1985;Talal and Ahmed, 1985;Nelson and Steinberg, 1987;Ahmed et al, 1989;Homo-Delarche et al, 1991;Homo-Delarche and Durant, 1994;Sullivan, 1994Sullivan, , 1997, but it may also be due to primary infection by, and reactivation of, EpsteinBarr virus, cytomegalovirus, herpes virus-6, hepatitis C, or retroviruses (Burns, 1983;Fox, 1988;Green et al, 1989;Krueger et al, 1990;Mariette et al, 1991Mariette et al, , 1993Fox et al, 1991;Pflugfelder et al, 1993;Pepose et al, 1996;Sipsas et al, 2011). These viruses have been identified in the lacrimal and/or salivary tissues of Sjögren's patients (Burns, 1983;Fox et al, 1986;Fox, 1988;Krueger et al, 1990;Garry et al, 1990;Mariette et al, 1991;Pflugfelder et al, 1993;Tsubota ...…”

“…The etiology of Sjögren's syndrome may involve the endocrine system (Ansar et al, 1985;Talal and Ahmed, 1985;Nelson and Steinberg, 1987;Ahmed et al, 1989;Homo-Delarche et al, 1991;Homo-Delarche and Durant, 1994;Sullivan, 1994Sullivan, , 1997, but it may also be due to primary infection by, and reactivation of, EpsteinBarr virus, cytomegalovirus, herpes virus-6, hepatitis C, or retroviruses (Burns, 1983;Fox, 1988;Green et al, 1989;Krueger et al, 1990;Mariette et al, 1991Mariette et al, , 1993Fox et al, 1991;Pflugfelder et al, 1993;Pepose et al, 1996;Sipsas et al, 2011). These viruses have been identified in the lacrimal and/or salivary tissues of Sjögren's patients (Burns, 1983;Fox et al, 1986;Fox, 1988;Krueger et al, 1990;Garry et al, 1990;Mariette et al, 1991;Pflugfelder et al, 1993;Tsubota et al, 1995;Pepose et al, 1996) and may possibly stimulate the inappropriate epithelial cell human leukocyte antigen-DR and Toll-like receptor expression, T helper/inducer cell activation, B cell hyperactivity, and autoantibody production evident in these affected tissues (Moutsopoulos and Talal, 1987;Maini, 1987;Fox, 1988;Homma et al, 1994;Berglova et al, 2011;Lambiase et al, 2011). In support of this possibility, certain viral infections in experimental animals exert a striking effect on the lacrimal gland and induce a periductular infiltration of plasma cells, lymphocytes, and macrophages; distinct nonsuppurative periductular inf...…”

Dry eye disease caused by viral infection: review

“…Minor salivary gland shows CD4 T cells infiltration and less severe inflammation. On the other hand, in lacrimal gland biopsies the infiltrating cell type is predominately B-lymphocytes and EBV antigen and EBV DNA are detected in ductal epithelia associated high levels of lymphoproliferation surrounding infected ducts or focci replacing secretory acini (45) .…”

Primary Sjögren’s Syndrome: Current Pathophysiological, Diagnostic and Therapeutic Advances

“…In advanced stages of the disease, following BAFF activation, B-cell proliferation, and aberrant lymphocyte homing favoring diseased gland destruction and the formation of germinal centers and ensuing lymphoma (Figure 1). (Pflugfelder et al, 1993;Green et al, 1989, Haddad et al, 1992Iwakiri et al, 2009). Coxsackie virus was found to be increased in SS salivary glands, but these findings have been the subject of some controversies (Triantafyllopoulou et al, 2004, Gottenberg et al, 2006a.…”