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Chronic fatigue syndrome, depression, and anxiety symptoms due to relapsing-remitting multiple sclerosis are associated with reactivation of Epstein-Barr virus and Human Herpesvirus 6.
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  • Michael Maes,
  • Abbas F. Almulla,
  • Elroy Vojdani,
  • Elizabet Dzhambazova,
  • Drozdstoj Stoyanov,
  • Yingqian Zhang,
  • Aristo Vojdani
Michael Maes
Sichuan Academy of Medical Sciences and Sichuan People's Hospital

Corresponding Author:[email protected]

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Abbas F. Almulla
Sichuan Academy of Medical Sciences and Sichuan People's Hospital
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Elroy Vojdani
Regenera Medical
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Elizabet Dzhambazova
Medical University of Plovdiv
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Drozdstoj Stoyanov
Medical University of Plovdiv
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Yingqian Zhang
Sichuan Academy of Medical Sciences and Sichuan People's Hospital
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Aristo Vojdani
Immunosciences Lab Inc
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Abstract

Relapsing-remitting multiple sclerosis (RRMS) is defined by elevated IgG/IgA/IgM responses targeting Epstein-Barr Virus (EBV) nuclear antigen 1 (EBNA) and deoxyuridine-triphosphatases (dUTPases) of Human herpsesvirus-6 (HHV-6) and EBV. These responses suggest that the viruses are being replicated and reactivated. An increased prevalence of chronic fatigue syndrome, depression, and anxiety is associated with signs of immune activation in RRMS. Nevertheless, there is a lack of data regarding the association between viral reactivation and neuropsychiatric symptoms of RRMS. This study investigated the IgG/IgA/IgM responses to EBNA, and EBV and HHV-6-dUTPases, in 58 remitted RRMS patients and 63 normal controls. The McDonald criteria were employed to establish the diagnosis of MS. The Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Severity Score were employed to evaluate disabilities caused by RRMS. We evaluated the scores of the Hamilton Depression (HAMD) and Anxiety (HAMA) Rating Scales, and Fibro-Fatigue (FF) scale. One latent construct was extracted from the EDSS, MSSS, FF, HAMD, and HAMA scores. We discovered that the combined effects of IgG and IgM-HHV-6-dUTPAses accounted for 63.7% of the variance in this construct. Furthermore, the total FF, HAMA, and HAMD scores were substantially associated with the IgG and IgM-HHV-6-dUTPAses, accounting for approximately 38.7% to 51.0% of the variance. The three neuropsychiatric rating scale scores were also significantly correlated with IgA reactivity directed to both dUTPases and IgG/IgA/IgM to EBNA. In conclusion, the reactivation and replication of HHV-6 and EBV significantly contributes to chronic fatigue syndrome, as well as symptoms of depression and anxiety due to RRMS.
12 Oct 2024Submitted to Journal of Medical Virology
14 Oct 2024Submission Checks Completed
14 Oct 2024Assigned to Editor
14 Oct 2024Review(s) Completed, Editorial Evaluation Pending
31 Oct 2024Reviewer(s) Assigned