PT  - JOURNAL ARTICLE
AU  - Berthelot, Jean-Marie
AU  - Saulquin, Xavier
AU  - Coste-Burel, Marianne
AU  - Peyrat, Marie A
AU  - Echasserieau, Klara
AU  - Bonneville, Marc
AU  - Houssaint, Elisabeth
TI  - Search for correlation of CD8 T cell response to Epstein-Barr virus with clinical status in rheumatoid arthritis: a 15 month followup pilot study.
DP  - 2003 Aug 01
TA  - The Journal of Rheumatology
PG  - 1673--1679
VI  - 30
IP  - 8
4099  - http://www.jrheum.org/content/30/8/1673.short
4100  - http://www.jrheum.org/content/30/8/1673.full
SO  - J Rheumatol2003 Aug 01; 30
AB  - OBJECTIVE: To assess in a longitudinal 15 month followup study the CD8 T cell response to immunodominant Epstein-Barr virus (EBV) antigens of 17 patients with rheumatoid arthritis (RA); and to seek an association between these responses and both clinical activity/severity of RA and a qualitative PCR for EBV in peripheral blood. METHODS: At each patient's visit every 3 months: (1) RA activity was assessed for Disease Activity Score (DAS-28); (2) a qualitative PCR for EBV was performed; (3) CD8 T cell response to EBV epitopes was screened in peripheral blood, using an autopresentation assay of 13 EBV peptides previously identified as immunodominant targets in RA synovia. Activation of anti-EBV CD8 T cells was evaluated by measuring the release of tumor necrosis factor-a. RESULTS: The semiquantitative CD8 T cell response to EBV roughly paralleled RA clinical activity in only 4/17 patients. No clear association could be found between positive PCR for EBV (performed at least once in 10/17 patients) and RA activity/severity or fatigue. Reactivity was not qualitatively broader in samples where PCR for EBV proved positive, and most often focused on one or 2 EBV antigens. However, these antigens differed between patients, as did the magnitude of CD8 T cell response to immunodominant antigens at different timepoints for the same patient. CONCLUSION: The CD8 T cell response to EBV paralleled clinical activity in only 4/17 patients. Our pilot study does not support the hypothesis that this CD8 response contributes to RA activity/flares, although the quantitative variations in the pattern of this reactivity over time confirmed that control of EBV manifestations was difficult in most patients with RA.