Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2015; 21(15): 4666-4672
Published online Apr 21, 2015. doi: 10.3748/wjg.v21.i15.4666
Epstein-Barr virus is related with 5-aminosalicylic acid, tonsillectomy, and CD19+ cells in Crohn’s disease
Juan C Andreu-Ballester, Rafael Gil-Borrás, Carlos García-Ballesteros, Ignacio Catalán-Serra, Victoria Amigo, Virgina Fernández-Fígares, Carmen Cuéllar
Juan C Andreu-Ballester, Carlos García-Ballesteros, Research Department, Arnau de Vilanova Hospital, 46015 Valencia, Spain
Rafael Gil-Borrás, Ignacio Catalán-Serra, Digestive Department, Arnau de Vilanova Hospital, 46015 Valencia, Spain
Carlos García-Ballesteros, Victoria Amigo, Hematology Department, Arnau de Vilanova Hospital, 46015 Valencia, Spain
Virgina Fernández-Fígares, Carmen Cuéllar, Department of Parasitology, Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain
Author contributions: Cuéllar C and Andreu-Ballester JC were involved with conception and design of the study; Gil-Borrás R and Catalán-Serra I contributed to acquisition of data and patients; Cuéllar C and Fernández-Fígares V were involved with determination of IgG antibodies against Epstein-Barr virus; Amigo V and García-Ballesteros C contributed to flow cytometry analysis; Cuéllar C and Andreu-Ballester JC were involved with analysis and interpretation of data, drafting and revising the article, and final approval of the version to be submitted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Juan C Andreu-Ballester, MD, PhD, Research Department, Arnau de Vilanova Hospital, c/San Clemente 12, 46015 Valencia, Spain. jcandreu@ono.com
Telephone: +34-963-868784 Fax: +34-963-868580
Received: May 20, 2014
Peer-review started: May 21, 2014
First decision: July 8, 2014
Revised: July 24, 2014
Accepted: October 15, 2014
Article in press: October 15, 2014
Published online: April 21, 2015
Abstract

AIM: To study anti-Epstein-Barr virus (EBV) IgG antibodies in Crohn´s disease in relation to treatment, immune cells, and prior tonsillectomy/appendectomy.

METHODS: This study included 36 CD patients and 36 healthy individuals (controls), and evaluated different clinical scenarios (new patient, remission and active disease), previous mucosa-associated lymphoid tissue removal (tonsillectomy and appendectomy) and therapeutic regimens (5-aminosalicylic acid, azathioprine, anti-tumor necrosis factor, antibiotics, and corticosteroids). T and B cells subsets in peripheral blood were analyzed by flow cytometry (markers included: CD45, CD4, CD8, CD3, CD19, CD56, CD2, CD3, TCRαβ and TCRγδ) to relate with the levels of anti-EBV IgG antibodies, determined by enzyme-linked immunosorbent assay.

RESULTS: The lowest anti-EBV IgG levels were observed in the group of patients that were not in a specific treatment (95.4 ± 53.9 U/mL vs 131.5 ± 46.2 U/mL, P = 0.038). The patients that were treated with 5-aminosalicylic acid showed the highest anti-EBV IgG values (144.3 U/mL vs 102.6 U/mL, P = 0.045). CD19+ cells had the largest decrease in the group of CD patients that received treatment (138.6 vs 223.9, P = 0.022). The analysis of anti-EBV IgG with respect to the presence or absence of tonsillectomy showed the highest values in the tonsillectomy group of CD patients (169.2 ± 20.7 U/mL vs 106.1 ± 50.3 U/mL, P = 0.002). However, in the group of healthy controls, no differences were seen between those who had been tonsillectomized and subjects who had not been operated on (134.0 ± 52.5 U/mL vs 127.7 ± 48.1 U/mL, P = 0.523).

CONCLUSION: High anti-EBV IgG levels in CD are associated with 5-aminosalicylic acid treatment, tonsillectomy, and decrease of CD19+ cells.

Keywords: B cells, Crohn’s disease, Epstein-Barr virus, Tonsillectomy, 5-aminosalicylic acid

Core tip: The prevalence of anti-Epstein-Barr virus (EBV) IgG antibodies was studied in patients with Crohn’s disease. The lowest anti-EBV IgG levels were observed in the patients without specific treatment. 5-aminosalicylic acid treatment showed the highest anti-EBV IgG values. CD19+ cells had the largest decrease in Crohn’s disease patients that had received treatment. Crohn’s disease patients had the highest values of anti-EBV IgG.