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. Hum Pathol 2018 Dec;82:187-192
Date
08/19/2018Pubmed ID
30120969DOI
10.1016/j.humpath.2018.08.001Scopus ID
2-s2.0-85055707695 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
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.
Author List
Pezhouh MK, Miller JA, Sharma R, Borzik D, Eze O, Waters K, Westerhoff MA, Parian AM, Lazarev MG, Voltaggio LAuthor
James Adam Miller MD, MPH Assistant Professor in the Pathology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Biopsy
Case-Control Studies
Child
Colectomy
Colitis, Ulcerative
Colon
Crohn Disease
Drug Resistance
Epstein-Barr Virus Infections
Female
Gastrointestinal Agents
Herpesvirus 4, Human
Humans
In Situ Hybridization
Male
Middle Aged
RNA, Viral
Risk Factors
Severity of Illness Index
United States
Young Adult
