‘Mono’ Virus May Also Cause Lupus
Early findings indicate that Epstein-Barr Virus may also cause the autoimmune disease lupus
The Epstein-Barr virus, which causes mononucleosis, may also drive the autoimmune disorder lupus.
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For years scientists have suspected that the Epstein-Barr virus (EBV)—a type of herpesvirus that infects 94 percent of the global population by adulthood and causes mononucleosis (aka “mono”)—might be one cause of lupus, an autoimmune disorder. But these assumptions were based mostly on anecdotal reports.
Now researchers at Stanford University and their colleagues have confirmed that the virus can “reprogram” immune cells that produce antibodies in a way that triggers and sustains lupus. Their small study, published today in Science Translational Medicine, provides the first evidence of this virus-disease link, the authors say.
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Lupus is a chronic autoimmune disease in which the body’s immune system mistakenly attacks its own healthy tissues and organs. It can affect the joints, skin, kidneys, heart, lungs, blood, brain and other parts of the body. Although at least five million people worldwide live with lupus, its cause has remained a mystery.
Recently, EBV was found to cause another autoimmune disease—multiple sclerosis. A 2022 paper co-authored by Robinson showed that EBV triggers multiple sclerosis by priming the immune system to attack the body’s own nervous system—a process similar to what happens in lupus.
EBV has also been linked to nasopharyngeal and stomach cancer. Scientists have found that billions of B cells—a type of white blood cell that produces antibodies to fight pathogens—are affected when a person is infected with the virus. But studying B cells’ role in autoimmune diseases such as lupus has been much harder because only about one in 1,000—or even one in 10,000—of these cells is infected, Robinson says.
In their study, Robinson and his colleagues developed a new, EBV-specific single-cell sequencing technique that was capable of detecting the B cells that were infected by the virus. They isolated individual B cells from the blood samples of 11 people with lupus and 10 without the disease. The team found that EBV-infected B cells were about 25 times as abundant in people with lupus than they were in healthy control participants.
The researchers found that EBV infects and reprograms B cells to drive autoimmune attacks. Instead of defending the body, these infected cells begin presenting the body’s own molecules, triggering a chain reaction that fuels the chronic inflammation that is characteristic of lupus.
Each B cell recognizes a specific cellular flag through unique receptors on its surface and can later secrete antibodies. The researchers tested the antibodies produced by these EBV-infected cells and found that many of the antibodies mistakenly recognized cellular components that were known to cause tissue damage in lupus.
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