Cytomegalovirus seropositivity is associated with reduced risk of multiple sclerosis—a presymptomatic case–control study
(2021) In European Journal of Neurology 28(9). p.3072-3079- Abstract
Background and purpose: Epstein–Barr virus (EBV) and human herpesvirus 6A (HHV-6A) are associated with increased risk of multiple sclerosis (MS). Conversely, infection with cytomegalovirus (CMV) has been suggested to reduce the risk of MS but supporting data from presymptomatic studies are lacking. Here, it was sought to increase the understanding of CMV in MS aetiology. Methods: A nested case–control study was performed with presymptomatically collected blood samples identified through crosslinkage of MS registries and Swedish biobanks. Serological antibody response against CMV, EBV and HHV-6A was determined using a bead-based multiplex assay. Odds ratio (OR) with 95% confidence interval (CI) for CMV seropositivity as a risk factor for... (More)
Background and purpose: Epstein–Barr virus (EBV) and human herpesvirus 6A (HHV-6A) are associated with increased risk of multiple sclerosis (MS). Conversely, infection with cytomegalovirus (CMV) has been suggested to reduce the risk of MS but supporting data from presymptomatic studies are lacking. Here, it was sought to increase the understanding of CMV in MS aetiology. Methods: A nested case–control study was performed with presymptomatically collected blood samples identified through crosslinkage of MS registries and Swedish biobanks. Serological antibody response against CMV, EBV and HHV-6A was determined using a bead-based multiplex assay. Odds ratio (OR) with 95% confidence interval (CI) for CMV seropositivity as a risk factor for MS was calculated by conditional logistic regression and adjusted for EBV and HHV-6A seropositivity. Potential interactions on the additive scale were analysed by calculating the attributable proportion due to interaction (AP). Results: Serum samples from 670 pairs of matched cases and controls were included. CMV seropositivity was associated with a reduced risk for MS (OR = 0.70, 95% CI 0.56–0.88, p = 0.003). Statistical interactions on the additive scale were observed between seronegativity for CMV and seropositivity against HHV-6A (AP 0.34, 95% CI 0.06–0.61) and EBV antigen EBNA-1 (amino acid 385–420) at age 20–39 years (AP 0.37, 95% CI 0.09–0.65). Conclusions: Cytomegalovirus seropositivity is associated with a decreased risk for MS. The protective role for CMV infection in MS aetiology is further supported by the interactions between CMV seronegativity and EBV and HHV-6A seropositivity.
(Less)
- author
- organization
- publishing date
- 2021-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- case–control studies, cytomegalovirus, herpesviruses, multiple sclerosis, serology
- in
- European Journal of Neurology
- volume
- 28
- issue
- 9
- pages
- 8 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:34107122
- scopus:85112301681
- ISSN
- 1351-5101
- DOI
- 10.1111/ene.14961
- language
- English
- LU publication?
- yes
- id
- a6b061f0-edbb-4d74-8efc-c0138887fc8c
- date added to LUP
- 2021-09-08 13:50:56
- date last changed
- 2024-04-06 08:27:58
@article{a6b061f0-edbb-4d74-8efc-c0138887fc8c,
abstract = {{<p>Background and purpose: Epstein–Barr virus (EBV) and human herpesvirus 6A (HHV-6A) are associated with increased risk of multiple sclerosis (MS). Conversely, infection with cytomegalovirus (CMV) has been suggested to reduce the risk of MS but supporting data from presymptomatic studies are lacking. Here, it was sought to increase the understanding of CMV in MS aetiology. Methods: A nested case–control study was performed with presymptomatically collected blood samples identified through crosslinkage of MS registries and Swedish biobanks. Serological antibody response against CMV, EBV and HHV-6A was determined using a bead-based multiplex assay. Odds ratio (OR) with 95% confidence interval (CI) for CMV seropositivity as a risk factor for MS was calculated by conditional logistic regression and adjusted for EBV and HHV-6A seropositivity. Potential interactions on the additive scale were analysed by calculating the attributable proportion due to interaction (AP). Results: Serum samples from 670 pairs of matched cases and controls were included. CMV seropositivity was associated with a reduced risk for MS (OR = 0.70, 95% CI 0.56–0.88, p = 0.003). Statistical interactions on the additive scale were observed between seronegativity for CMV and seropositivity against HHV-6A (AP 0.34, 95% CI 0.06–0.61) and EBV antigen EBNA-1 (amino acid 385–420) at age 20–39 years (AP 0.37, 95% CI 0.09–0.65). Conclusions: Cytomegalovirus seropositivity is associated with a decreased risk for MS. The protective role for CMV infection in MS aetiology is further supported by the interactions between CMV seronegativity and EBV and HHV-6A seropositivity.</p>}},
author = {{Grut, Viktor and Biström, Martin and Salzer, Jonatan and Stridh, Pernilla and Jons, Daniel and Gustafsson, Rasmus and Fogdell-Hahn, Anna and Huang, Jesse and Brenner, Nicole and Butt, Julia and Bender, Noemi and Lindam, Anna and Alonso-Magdalena, Lucia and Gunnarsson, Martin and Vrethem, Magnus and Bergström, Tomas and Andersen, Oluf and Kockum, Ingrid and Waterboer, Tim and Olsson, Tomas and Sundström, Peter}},
issn = {{1351-5101}},
keywords = {{case–control studies; cytomegalovirus; herpesviruses; multiple sclerosis; serology}},
language = {{eng}},
number = {{9}},
pages = {{3072--3079}},
publisher = {{Wiley-Blackwell}},
series = {{European Journal of Neurology}},
title = {{Cytomegalovirus seropositivity is associated with reduced risk of multiple sclerosis—a presymptomatic case–control study}},
url = {{http://dx.doi.org/10.1111/ene.14961}},
doi = {{10.1111/ene.14961}},
volume = {{28}},
year = {{2021}},
}