Epstein-Barr virus and rheumatoid arthritis: cellular and molecular aspects.

Several lines of research have indicated a possible association of the Epstein-Barr virus and rheumatoid arthritis (RA). The earliest evidence suggested that RA patients develop a stronger humoral immune response to EBV nuclear antigens (EBNA) which may in part account for the increased titers of antibody to the RA nuclear antigen (RANA). It was then pointed out that mononuclear cells from RA patients may be impaired in their capacity to control EBV infection. This may be related to a decrease in the production of IFN gamma and a consequence of monocyte-derived inhibitory activities. These cellular defects, however, are not specific for RA and may rather be the result of chronic inflammatory responses. These findings and the lack of increased virus presence in RA tissues did not provide a strong basis for a possible association of EBV and RA. A new concept for this association is now being tested on the basis of the sequence homology between the genetic RA susceptibility determinant HLA DR4 and the EBV glycoprotein 110.