Predicting MS

P
Strautins K, Tschochner M, James I, Choo L, Dunn D, Pedrini M, Kermode A, Carroll W, Nolan D. Combining HLA-DR risk alleles and anti-Epstein-Barr virus antibody profiles to stratify multiple sclerosis risk. Mult Scler. 2013  [Epub ahead of print]

BACKGROUND:Risk factors for multiple sclerosis (MS) include human leucocyte antigen (HLA)-DR and Epstein-Barr virus (EBV)-specific antibody responses, including an epitope within EBV nuclear antigen 1 (EBNA-1) that is of recent interest.

OBJECTIVE:The objective of this paper is to assess case-control associations between MS risk and anti-EBV antibody levels as well as HLA-DR profiles, gender and age in a population-based cohort.



METHODS:Serological responses to EBV were measured in 426 MS patients and 186 healthy controls. HLA-DR typing was performed using sequence-based methods.



RESULTS:MS patients had significantly higher levels of antibodies against epitope-specific and polyspecific EBNA-1 and viral capsid antigen (VCA), compared with controls (all p < 10-15). In regression analyses, anti-EBNA-1 and anti-VCA antibody levels, protective HLA-DR*04/07/09 alleles and gender (all p < 0.003) contributed independently to a model that classified cases and controls with an odds ratio > 20 (sensitivity 92%, specificity 64%). Notably, the strong influence of high-risk HLA-DR alleles was abrogated after inclusion of EBV serology results.


CONCLUSIONS:The ability to discriminate MS cases and controls can be substantially enhanced by including anti-EBV serology as well as HLA-DR risk profiles. These findings support the relevance of EBV-specific immunity in MS pathogenesis, and implicate both HLA-dependent and HLA-independent immune responses against EBNA-1 as prominent disease risk factors.






MSers have evidence of EBV infection and are more likely to have antibodies to EBV, as a measure of infection than people without EBV, in fact there is a thousand million, million to 1 chance that this effect occurred by chance. So I think we can safety say that MSers have EBV. This study tried to look at the DR types (Transplantation antigen, what makes you different in DNA fingerprinting) to see if that can assess you chance of developing MS as certain types are associated with MS others are not. However there is only 64% specificity and so it gets things wrong when you do this, so maybe not that useful. Maybe we need to add more things in the equation to get the specificity up.

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