Groundbreaking medical research has uncovered that a common childhood virus serves as the primary trigger for the autoimmune condition lupus, potentially revolutionising treatment approaches for the approximately 69,000 people affected in the UK.
The Viral Connection to Autoimmune Disease
Scientists from Stanford University have demonstrated that Epstein-Barr virus (EBV), which infects about 95% of adults, can cause immune cells to malfunction and attack the body's own tissues. The study, published in Science Translational Medicine, provides the first cellular-level explanation for how this near-ubiquitous virus initiates the autoimmune response characteristic of lupus.
Professor William Robinson, the study's senior author and a professor of immunology and rheumatology at Stanford, stated emphatically: "We think it applies to 100% of lupus cases. I think it really sets the stage for a new generation of therapies that could fundamentally treat and thereby provide benefit to lupus patients."
How EBV Hijacks the Immune System
The research team employed high-precision genetic sequencing to analyse B cells in 11 lupus patients compared to 10 healthy individuals. They discovered striking differences in how EBV interacts with the immune system.
In healthy control subjects, fewer than 1 in 10,000 B cells hosted the dormant virus. However, in lupus patients, the virus was present in approximately 1 in 400 B cells – representing a 25-fold increase. Crucially, EBV was found more frequently in autoreactive B cells, which have the potential to attack the body's own tissues.
First author Shady Younis described the significance: "This study resolves a decades-old mystery" about what triggers lupus.
Implications for Treatment and Prevention
The findings explain how EBV flips these B cells into a hyperactive state where they not only target the body's own antigens but also recruit other immune cells, including killer T-cells, to join the destructive attack.
Professor Robinson noted the surprising nature of the discovery: "The reason why this is so surprising is because this is a common virus that most of us get from our brother or sister at the kitchen table when we're growing up. Practically the only way to not get EBV is to live in a bubble."
The research adds significant momentum to ongoing clinical trials for an EBV vaccine and could lead to repurposing existing cancer treatments designed to eliminate problematic B cells for severe lupus cases.
Independent expert Professor Guy Gorochov from Sorbonne University praised the work as "impressive" and acknowledged that while it's not the final paper on lupus, the team has "developed an interesting concept" that could transform understanding of autoimmune diseases.
The study also helps explain why lupus disproportionately affects women and people of African, Caribbean or Asian background, with hormonal factors and genetic susceptibility potentially amplifying the EBV-triggered autoimmune response.
