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Effect of methotrexate and anti-TNF on Epstein-Barr virus T-cell response and viral load in patients with rheumatoid arthritis or spondylarthropathies.
- Source :
-
Arthritis research & therapy [Arthritis Res Ther] 2009; Vol. 11 (3), pp. R77. Date of Electronic Publication: 2009 May 26. - Publication Year :
- 2009
-
Abstract
- Introduction: There is a suspicion of increased risk of Epstein-Barr virus (EBV)-associated lymphoproliferations in patients with inflammatory arthritides receiving immunosuppressive drugs. We investigated the EBV load and EBV-specific T-cell response in patients treated with methotrexate (MTX) or anti-TNF therapy.<br />Methods: Data for patients with rheumatoid arthritis (RA) (n = 58) or spondylarthropathy (SpA) (n = 28) were analyzed at baseline in comparison with controls (n = 22) and after 3 months of MTX or anti-TNF therapy for EBV load and EBV-specific IFNgamma-producing T cells in response to EBV latent-cycle and lytic-cycle peptides.<br />Results: The EBV load and the number of IFNgamma-producing T-cells after peptide stimulation were not significantly different between groups at baseline (P = 0.61 and P = 0.89, respectively). The EBV load was not significantly modified by treatment, for RA with MTX (P = 0.74) or anti-TNF therapy (P = 0.94) or for SpA with anti-TNF therapy (P = 1.00). The number of EBV-specific T cells was not significantly modified by treatment, for RA with MTX (P = 0.58) or anti-TNF drugs (P = 0.19) or for SpA with anti-TNF therapy (P = 0.39). For all patients, the EBV load and EBV-specific T cells were significantly correlated (P = 0.017; R = 0.21). For most patients, short-term exposure (3 months) to MTX or anti-TNF did not alter the EBV load or EBV-specific T-cell response but two patients had discordant evolution.<br />Conclusions: These data are reassuring and suggest there is no short-term defect in EBV-immune surveillance in patients receiving MTX or anti-TNF drugs. However, in these patients, long term follow-up of EBV-specific T-cell response is necessary and the role of non-EBV-related mechanisms of lymphomagenesis is not excluded.
- Subjects :
- Adult
Aged
Antirheumatic Agents pharmacology
Antirheumatic Agents therapeutic use
Arthritis, Rheumatoid immunology
Arthritis, Rheumatoid virology
Cross-Sectional Studies
Humans
Longitudinal Studies
Methotrexate pharmacology
Middle Aged
Spondylarthropathies immunology
Spondylarthropathies virology
T-Lymphocytes drug effects
T-Lymphocytes immunology
T-Lymphocytes virology
Tumor Necrosis Factor-alpha immunology
Arthritis, Rheumatoid blood
Herpesvirus 4, Human drug effects
Herpesvirus 4, Human immunology
Methotrexate therapeutic use
Spondylarthropathies blood
Tumor Necrosis Factor-alpha antagonists & inhibitors
Viral Load methods
Subjects
Details
- Language :
- English
- ISSN :
- 1478-6362
- Volume :
- 11
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Arthritis research & therapy
- Publication Type :
- Academic Journal
- Accession number :
- 19470150
- Full Text :
- https://doi.org/10.1186/ar2708