Refractory inflammatory bowel disease: is there a role for Epstein-Barr virus? A case-controlled study using highly sensitive Epstein-Barr virus-encoded small RNA1 in situ hybridization

Autor: Maryam Kherad Pezhouh, James A. Miller, Ogechukwu Eze, Mark Lazarev, Maria Westerhoff, Kevin M. Waters, Lysandra Voltaggio, Rajni Sharma, Alyssa Parian, David Borzik
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Epstein-Barr Virus Infections
Herpesvirus 4
Human
Adolescent
Colon
medicine.medical_treatment
Biopsy
Endometriosis
Drug Resistance
medicine.disease_cause
Inflammatory bowel disease
Gastroenterology
Severity of Illness Index
Pathology and Forensic Medicine
03 medical and health sciences
Young Adult
0302 clinical medicine
Refractory
Crohn Disease
Gastrointestinal Agents
Risk Factors
hemic and lymphatic diseases
Internal medicine
medicine
Humans
Child
Colectomy
In Situ Hybridization
Aged
business.industry
Case-control study
Middle Aged
medicine.disease
Epstein–Barr virus
Ulcerative colitis
digestive system diseases
United States
Dysplasia
030220 oncology & carcinogenesis
Case-Control Studies
RNA
Viral
030211 gastroenterology & hepatology
Colitis
Ulcerative
Female
business
Zdroj: Human pathology. 82
ISSN: 1532-8392
Popis: A potential role for viral infections has been implicated in inflammatory bowel disease (IBD) unresponsive to medical treatment. It is well known that Epstein-Barr virus (EBV) infection can elicit a brisk mononuclear response in the gastrointestinal tract. The aim of this study was to further evaluate the role of EBV in patients with refractory IBD and compare them with nonrefractory IBD cases. Surgically resected colonic specimens from 67 patients with refractory IBD (62 with ulcerative colitis, 3 patients with Crohn disease, and 2 patients with indeterminate colitis) were retrieved. Twelve colectomy specimens from patients with ulcerative colitis who had undergone resections for dysplasia or endometriosis were included as controls. Highly sensitive EBV-encoded small RNA1 (EBER-1) in situ hybridization was performed on a representative block from each specimen. EBER-1 reactivity was graded as absent, focal, or diffuse. EBV was detected in 60% (40/67) of patients with refractory IBD compared with 25% (3/12) of the control group (P < .05). Focal EBER-1 positivity was present in 45% of cases of refractory IBD compared with 25% of controls. Diffuse EBER-1 reactivity was seen in 15% of cases of refractory IBD (10/67); none of the samples from the control group contained diffuse EBER-1 positivity. There was a positive correlation between EBER positivity and depth of inflammation and mucosal ulceration in patients with refractory IBD. Our findings suggest a potential role for EBV infection in patients with refractory IBD.
Databáze: OpenAIRE
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