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The High Prevalence of Epstein-Barr Virus in Adults with Bronchiectasis: A Prospective Cohort Study
35 Pages Posted: 18 Sep 2019
More...Abstract
Background: Epstein-Barr virus (EBV) has been implicated in the pathogenesis and progression of chronic obstructive pulmonary disease.
Methods: To determine whether EBV correlates with bronchiectasis severity, exacerbations and progression, we collected induced sputum in healthy controls, and spontaneous sputum at 3-6-month intervals and onset of exacerbations in bronchiectasis patients between March 2017 and October 2018. EBV was detected with quantitative polymerase chain reaction.
We collected 442 sputum samples from 108 bronchiectasis patients and 50 induced sputum samples from 50 healthy controls. When stable, bronchiectasis patients yielded significantly higher detection rate (48.1% vs. 20.0%, P=0.0001), but not viral loads of EBV (mean Log10load: 4.45 vs. 4.76, P=0.266), compared with controls. 64.9% of patients yielded consistent detection status between two consecutive stable visits. Neither the detection rate (40.8% vs. 48.1%, P=0.393) nor load (mean Log10load: 4.34 vs. 4.45, P=0.580) differed between the onset of exacerbations and stable-visits, nor from exacerbations to convalescence. Neither the detection status nor viral loads correlated with bronchiectasis severity. EBV load correlated negatively with sputum interleukin-1β (P=0.002), CXC motif chemokine-8 (P=0.008) and tumor necrosis factor-α levels (P=0.005). Patients initially detected with, or chronically colonized with, EBV had significantly faster lung function decline and shorter time to next exacerbations (both P<0.05) than those without. EBV detection was unrelated to detection of influenza, cytomegalovirus and opportunistic bacteria (all P>0.05). The EBV strains detected in bronchiectasis patients were phylogenetically homologous.
Interpretation: EBV contributes to bronchiectasis progression despite no association with disease severity and onset of exacerbation.
Funding Statement: This work was supported by National Natural Science Foundation No. 81870003, Pearl River S&T Nova Program of Guangzhou No. 201710010097 and Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme 2017 (to Prof. Guan), The Impact and Mechanisms of Physical, Chemical and Biological Interventions on the Development and Outcome of Acute Lung Injury No. 81490534, National Key Technology R&D Program No. 2018YFC1311902, Guangdong Science and Technology Foundation No. 2019B030316028 (to Prof. Zhong).
Declaration of Interests: All authors have no potential conflicts of interest with any companies/organizations whose products or services may be discussed in this article.
Ethics Approval Statement: The Ethics Committee of The First Affiliated Hospital of Guangzhou Medical University gave approval [Medical Ethics 2012 (The 29th 165 )]. All participants provided written informed consent.
Keywords: Chronic airway disease, human herpes virus-4, chronic viral infection, exacerbation, airway inflammation, lung function
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