Human Parvovirus B19 Infection in Multiple Sclerosis

Abstract

The association of human parvovirus B19 (PVB19) infection with the development of several systemic autoimmune diseases has been confirmed in other studies. To determine if there is any association of PVB19 infection with multiple sclerosis (MS), we studied the prevalence of serum anti-PVB19 IgG and IgM by an enzyme-linked immunosorbent assay and PVB19-specific DNA in the cerebrospinal fluid (CSF) by the polymerase chain reaction method in a total of 46 patients during exacerbation or remission of MS. Anti-PVB19 IgG was detected in 65.8% of the patients’ sera. The percentage was significantly higher than that in age-matched healthy control subjects (40%; p = 0.019), but was not higher in patients with other neurological diseases (50%; p = 0.16). There was no correlation between serum anti-PVB19 IgG status and antinuclear antibodies or oligoclonal IgG bands in CSF. Serum anti-PVB19 IgM and PVB19 DNA in CSF were consistently negative in the patients during exacerbation of MS. Although MS patients may be commonly infected with PVB19, our results suggest that there is no active PVB19 infection during exacerbation of MS.

Parvovirus B19 and mumps virus antibodies are major constituents of the intrathecal immune response in European patients with MS and increase the diagnostic sensitivity and discriminatory power of the MRZ reaction

“…The latter notion is in accordance with the fact that antibodies to M, R and Z account only for a proportion of intrathecally produced CSF IgG [7] and are not accountable for the majority of CSF oligoclonal IgG bands in MS [31]. However, it should be underlined that there is currently no evidence that any of the viruses that form part of the MRZB or MRZBU reaction is actively involved in the aetiopathogenesis of MS. PCR studies did not demonstrate reactivation of measles virus, rubella virus, zoster virus, parvovirus B19 or mumps virus during acute attacks [6,19]. This is consistent with the concept that the MRZ reaction represents non-specific ('nonsense') B-cell activation.…”

Parvovirus B19 nonstructural (NS1) protein as a transactivator of interleukin‐6 synthesis: Common pathway in inflammatory sequelae of human parvovirus infections?

“…Case reports have linked acute and recurrent B19 infection or viral persistence with neurologic disorders such as neuralgic amyotrophy [Puechal et al, 1998], acute cerebellar ataxia [Shimizu et al, 1999], encephalopathy [Watanabe et al, 1994], meningitis [Okumura and Ichikawa, 1993], paresthesia [Faden et al, 1992], transverse myelitis, vertigo, and seizures [Torok, 1997], whereas Nakashima et al [1999] failed to find associations of B19 infection with multiple sclerosis. Both preand post-natal parvovirus B19 infections have been associated with cardiopulmonary disorders including: fetal myocardial necrosis [Lambot et al, 1999]; neonatal and adult cardiomyopathy [Heegaard et al, 1998;Barton, 1999]; severe interstitial lung disease associated with hepatitis and myositis [Bousvaros et al, 1998]; and pneumonia [Wardeh and Marik, 1998].…”

Autoantibody Reaction to Myelin Basic Protein by Plasma Parvovirus B19 IgG in MS Patients

“…Binding studies have illustrated that the majority of antigen specific antibodies found in the serum and CSF of MS patients have relatively low binding affinities [12]. While Nakashima et al [2] found that MS patients had a higher prevalence of serum anti-B19 IgG (66% as compared to 40% in healthy controls) they found no correlation between IgG titers and exacerbations. They also could not detect anti-B19 IgG in the CSF of the MS patients included in their study.…”

“…In a small number of cases, neurological diseases of the CNS such as encephalitis, meningitis, and transverse myelitis have been reported in which antibody and viral DNA have been detected in CSF [1]. Infectious links between B19 and other viral agents and multiple sclerosis (MS), a demyelinating disease of the CNS, have been investigated but a definitive association has yet to be established [2][3][4][5].…”

“…During acute infection, IgM can be detected in the blood followed by persistent IgG and most individuals will be seropositive as adults [8]. MS patients have been shown to have a higher prevalence of anti-B19 IgG in serum [2]. To examine a possible relationship between anti-B19 …”