Association between Autophagy-Related Protein-5 and Epstein-Barr Virus Infection in Multiple Sclerosis Patients

Background: Epstein-Barr virus (EBV), a common human lymphotropic herpes virus infecting over 95% of the overall individuals. Strong evidence from recent research that EBV is a contributing factor in multiple sclerosis (MS). The exact mechanism by which EBV might exacerbate MS in risk groups is unknown. Objectives: To determine plasma levels of Autophagy-related proteins 5 (ATG5) and Epstein-Barr virus nuclear antigen1 (EBNA1) IgG. Additionally, assessing EBV DNA load in MS patients in relation to disease activity. Also, studying the relation between EBV DNA burden and the plasma levels of ATG5 and EBNA1 IgG in MS patients. Methodology: The study was conducted on 23 relapsing remitting MS (RRMS) patients in active attack, 23 RRMS patients' in-between attacks and 23 healthy controls. Enzyme-linked immunosorbent assay (ELISA) method was used to measure the amount of ATG5 and EBNA1 IgG in plasma. Real-time polymerase chain reaction (real-time PCR) was used to assess the EBV DNA load in peripheral blood mononuclear cells (PBMCs). Results: No statistically significant difference in ATG5 or EBNA1 IgG level between MS patients and healthy controls. However, all MS patients (100%) were EBNA1 IgG positive while 91.3% of the control group were EBNA1 IgG positive. EBV DNA load did not show statistically significant difference between MS patients and healthy controls. Significant positive correlation between EBV DNA load and ATG5 plasma level in MS patients in between attacks, P value =0.019. Conclusion: ATG5 levels and EBV DNA load could be utilized to predict disease-related activities in predisposed individuals or MS patients.