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Published online before print February 20, 2008
Eur Respir J 2008, doi:10.1183/09031936.00107507
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ORIGINAL ARTICLE

High levels of Epstein Barr Virus in COPD

T.E. McManus 1*, A-M. Marley 2, N. Baxter 2, S.N. Christie 3, J.S. Elborn 4, H.J. O'Neill 5, P.V. Coyle 5, J.C. Kidney 2

1 Dept of Respiratory Medicine, Mater Hospital, Belfast, N. Ireland BT14 6AB; and Regional Virus Laboratory, Kelvin Building, Royal Victoria Hospital, Belfast, N. Ireland BT12 6BA
2 Dept of Respiratory Medicine, Mater Hospital, Belfast, N. Ireland BT14 6AB
3 Regional Virus Laboratory, Kelvin Building, Royal Victoria Hospital, Belfast, N. Ireland BT12 6BA; and Royal Belfast Hospital for Sick Children, Belfast, N. Ireland BT12 6BA
4 Dept of Respiratory Medicine, Belfast City Hospital, Belfast, N. Ireland BT9 7AB
5 Regional Virus Laboratory, Kelvin Building, Royal Victoria Hospital, Belfast, N. Ireland BT12 6BA


  Abstract

Latent viral infection has been implicated in the pathophysiology of COPD. Epstein Barr Virus (EBV) is known to be important in pulmonary fibrosis. We hypothesized that EBV is associated with the pathogenesis of COPD.

Sputum samples were collected from patients during exacerbations of COPD and when stable. A control group of smokers who do not have airways obstruction also had their sputum examined. The presence of EBV DNA was established and quantified using a real-time nucleic acid amplification assay.

One hundred and thirty six patients with COPD were recruited during an acute exacerbation and 68 when stable. EBV was detected in 65 (48%) of exacerbation cases and 31 (46%) of stable patients. In the comparison group of 16 non-obstructed smokers EBV was demonstrated in only 1 case (6%); p<0.05. Risk of COPD in patients with EBV and are smokers confers an odds ratio of 12.6.

EBV DNA is more frequently identified in the respiratory tract of COPD patients in comparison to unaffected smokers. It is present in exacerbation and when stable, suggesting infection is persistent. Smokers who do not develop COPD, rarely have EBV in their sputum. This finding may be of importance in the pathogenesis of COPD.

Keywords:  Chronic obstructive pulmonary disease, epstein barr virus, latent viral infection, pathogenesis, real-time polymerase chain reaction




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A. W. J. Bossink, M. Deege, and S. F. T. Thijsen
A possible role for Epstein-Barr virus infection in COPD?
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W. B. Grant
To the Editors
Eur. Respir. J., November 1, 2008; 32(5): 1412 - 1413.
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T. E. McManus, S. Elborn, H. J. O'Neill, P. V. Coyle, and J. Kidney
From the authors
Eur. Respir. J., November 1, 2008; 32(5): 1413 - 1413.
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