Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2023; 15(3): 420-429
Published online Mar 27, 2023. doi: 10.4240/wjgs.v15.i3.420
Positive correlation between latent Epstein-Barr virus infection and severity of illness in inflammatory bowel disease patients
Hong-Tao Wei, Xiao-Wei Xue, Qing Ling, Peng-Yan Wang, Wei-Xun Zhou
Hong-Tao Wei, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Xiao-Wei Xue, Qing Ling, Peng-Yan Wang, Wei-Xun Zhou, Department of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
Author contributions: Wei HT made a major contribution to the study design, data analysis, and manuscript writing; Xue XW and Zhou WX had the same contribution to the manuscript by providing advice for the study design and giving suggestions to improve the manuscript writing; Ling Q and Wang PY collected and reviewed the experimental data; and all authors read and approved the final version of the manuscript.
Supported by Clinical and Translational Medicine Research Foundation of Chinese Academy of Medical Sciences, No. 2020-I2M-C&T-B-038; Capital Health Research and Development of Special Project, No. 2022-1-2181; and Group Medical Aid Project of the Tibet Autonomous Region Natural Science Foundation, No. XZ2020ZR-ZY28[Z].
Institutional review board statement: This work was approved by the Institutional Review Board of the Peking Union Medical College Hospital, Chinese Academy of Medical Science (Approval No. JS-2918).
Informed consent statement: This study does not involve patient intervention, information disclosure and long-term follow-up, the informed consent is exempted with the approval of the Institutional Review Board.
Conflict-of-interest statement: All authors declare that there is no conflict of interest.
Data sharing statement: After the paper is published, the corresponding author can be contacted to obtain the data for reasonable reasons.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Xun Zhou, MD, PhD, Chief Physician, Professor, Department of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. zweixun@163.com
Received: January 20, 2023
Peer-review started: January 20, 2023
First decision: February 10, 2023
Revised: February 16, 2023
Accepted: March 3, 2023
Article in press: March 3, 2023
Published online: March 27, 2023
Processing time: 66 Days and 8 Hours
Abstract
BACKGROUND

Emerging studies indicate the critical involvement of microorganisms, such as Epstein-Barr virus (EBV), in the pathogenesis of inflammatory bowel disease (IBD). Immunosuppressive therapies for IBD can reactivate latent EBV, complicating the clinical course of IBD. Moreover, the clinical significance of EBV expression in B lymphocytes derived from IBD patients’ intestinal tissues has not been explored in detail.

AIM

To explore the clinical significance of latent EBV infection in IBD patients.

METHODS

Latent EBV infection was determined by double staining for EBV encoded RNA and CD20 in colon specimens of 43 IBD patients who underwent bowel resection. Based on the staining results, the patients were divided into two groups, according to their latent EBV infection states - negative (n = 33) and positive (n = 10). Illness severity of IBD were assigned according to Crohn’s disease activity index (ulcerative colitis) and Mayo staging system (Crohn’s disease). The clinic-pathological data were analyzed between the two different latent EBV groups and also between the mild-to-moderate and severe disease groups.

RESULTS

Systolic pressure (P = 0.005), variety of disease (P = 0.005), the severity of illness (P = 0.002), and pre-op corticosteroids (P = 0.025) were significantly different between the EBV-negative and EBV-positive groups. Systolic pressure (P = 0.001), variety of disease (P = 0.000), pre-op corticosteroids (P = 0.011) and EBV infection (P = 0.003) were significantly different between the mild-to-moderate and severe disease groups.

CONCLUSION

IBD patients with latent EBV infection may manifest more severe illnesses. It is suggested that the role of EBV in IBD development should be further investigated, latent EBV infection in patients with serious IBD should be closely monitored, and therapeutic course should be optimized.

Keywords: Epstein-Barr virus; Epstein-Barr virus encoded RNA; Inflammatory bowel disease; Crohn’s disease; Ulcerative colitis

Core Tip: Inflammatory bowel disease (IBD) patients with latent Epstein-Barr virus (EBV) infection may manifest more severe illnesses. It is suggested that the role of EBV in IBD development should be further investigated, latent EBV infection in patients with serious IBD should be closely monitored, and therapeutic course should be optimized.