RESEARCH - Evidence for coxsackievirus infection in primary Sjogren's syndrome.

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Arthritis Rheum. 2004 Sep;50(9):2897-902.

Evidence for coxsackievirus infection in primary Sjogren's syndrome.

Triantafyllopoulou A, Tapinos N, Moutsopoulos HM.

University of Athens Medical School, Athens, Greece.

OBJECTIVE: Primary Sjogren's syndrome (SS) is an autoimmune disease

characterized by activation of minor salivary gland (MSG) epithelial cells

and B and T lymphocytic infiltrates. These findings have long encouraged the

hypothesis that a persistent viral infection of the MSG epithelial cells may

drive the autoimmune response; however, the identity of that virus has

remained elusive. The aim of this study was to test this hypothesis.

METHODS: We applied the differential display protocol to MSG RNA samples

from patients with primary SS and healthy controls. We then used seminested

reverse transcriptase-polymerase chain reaction to amplify the 5'-noncoding

region (5'-NCR) of the enteroviral genome in 8 patients with primary SS, 9

patients with secondary SS, and 8 control subjects. Immunohistochemistry was

performed to study the expression of the VP1 enteroviral capsid protein in

MSG biopsy samples from 12 patients with primary SS, 8 patients with

secondary SS, and 16 controls. RESULTS: Differential display analysis

yielded a 94-bp fragment of coxsackievirus B4 (CVB4) P2A gene in the primary

SS samples. The 5'-NCR was amplified in 7 samples from patients with primary

SS and in no samples from patients with secondary SS or controls. The 7

amplified products were sequenced; 4 of the sequences were found to be

98-99% identical to the 5'- NCR of CVB4, and 3 were found to be 97-98%

identical to the 5'-NCR of CVA13. Immunohistochemistry for the enteroviral

capsid protein VP1 revealed positive staining in epithelial cells and

lymphocytic infiltrates in 11 primary SS samples, 1 secondary SS sample, and

no control samples.

CONCLUSION: We provide evidence that primary SS may be associated with

coxsackievirus infection of the MSG epithelial cells and focal lymphocytic

infiltrates. Our findings are formulated in a hypothesis concerning the

possible role of coxsackieviruses in the induction and maintenance of

autoimmunity in primary SS.

PMID: 15457458

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5457458 & dopt=Abstract

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