Análise do índice de anticorpos IgG do vírus anti-Epstein-Barr líquor/soro e sua associação com doenças desmielinizantes

Abstract

Demyelinating diseases are a group of illnesses with diverse and non-specific triggers, of infectious and/or autoimmune origin, which are based on the inflammatory principle of loss of myelin from neurons, generating a series of signs and symptoms, which require a multifactorial diagnosis. The tests that support the differential diagnosis, as well as signaling the likely investigative paths, involve cerebrospinal fluid (CSF) in routine and assessments to detect intrathecal synthesis. The trigger for demyelinating diseases has always been an enigma, but in mid-2023, Bjornevik and colleagues demonstrated the correlation of this disease with the Epstein-Barr virus (EBV). Thus, this study aimed to determine the concentrations of IgG antibodies specific to EBV VCA, in CSF and serum, and verify the specific antibody index (SAI) in association with other tests such as oligoclonal bands (OCB), the Reiber normogram, and clinical laboratory findings of patients with demyelinating diseases treated at the Hospital Universitario de Santa Maria – RS (HUSM) and at the Instituto Neurológico de Goiania (ING), between March 1, 2022 and March 31, 2024. Sixty-one patients were selected, with ages ranging from 28 days to 84 years, and separated into 2 groups, 34 patients with demyelinating diseases (DESM), and another 27 patients without related demyelinating diseases (NDESM). OCB, antiAQP4 IgG and anti-MOG IgG research, IgG and albumin measurements in serum and CSF, Reiber normograms, measurements of antibody marking activity for EBV VCA IgG were performed, and subsequently, the IAE was calculated. The majority of DESM patients were women in a ratio of 1.6:1, and they had a higher incidence of the presence of EBV VCA IgG antibody activity compared to NDESM patients, both in serum and CSF. Patients between 1 and 18 years old were 100% non-reactive for EBV VCA IgG antibody marking activity. The presence of OCB was detected in 33.3% of DESM patients with MS. Newborn NDESM patients showed high titers of EBV VCA IgG antibodies in CSF. The presence of intrathecal synthesis assessed by reibergram was concordant in 88.9% of patients with the presence of OCB. IAE EBV VCA IgG was lower than 2.5 in 96.9% of DESM patients, even in the presence of OCB and with reibergram showing the presence of intrathecal synthesis. These associations showed that DESM patients, even in the presence of intrathecal synthesis detected by OCB and reibergram being reagents for EBV VCA IgG, both in serum and CSF, in the vast majority of cases presented SAI within normal values.