Clinical Neurology and Neurosurgery 99 Suppl. 2 (1997) S225–S228
Studies on cytomegalovirus and Epstein-Barr virus infection in
Moyamoya disease
Tetsuya Tanigawara *, Hiromu Yamada, Noboru Sakai, Takashi Andoh, Kazuki Deguchi,
Makoto Iwamura
Department of Neurosurgery, Gifu Uni6ersity School of Medicine,
40
Tsukasa-machi, Gifu
500
, Japan
Abstract
In this study, measurement of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) viral antibody titers and analysis of
both viral genomic sequences using polymerase chain reaction (PCR) were performed to clarify the correlation of viral
infection and Moyamoya disease. Serum samples were obtained from 64 patients with Moyamoya disease. The ages ranged
from 5 to 66 years, with a mean age of 35.1 years. There were 23 males and 41 females. The serum antibody titers to
CMV and EBV were measured by means of compliment fixation test and fluorescent antibody method respectively. Those
titers of the patients were compared with those of 13 patients of atherosclerotic internal carotid occlusion and 34 normal
volunteers. On the other hand, CMV and EBV genomic sequence using PCR, which was utilized with specific primer pairs,
were performed in 22 patients of Moyamoya disease and ten normal volunteers. The following results were obtained; The
antibody titer of EBV in Moyamoya disease was significantly higher than that in controls. However, no significant differ-
ence of antibody titer against CMV was detected. In EBV DNA analysis by use of PCR, EBV DNA was proved in 15
out of 20 patients with Moyamoya disease and four out of nine normal controls. Namely, EBV DNA was seen more
frequently in patients with Moyamoya disease, compared with normal controls. In inverse, CMV DNA was not seen in
patients with Moyamoya disease nor normal controls. In conclusion, the antibody titer of EBV revealed high levels in
Moyamoya disease and EBV DNA was also detected more frequently in patients with Moyamoya disease. These results
suggested a possibility that EBV infection might be involved in the pathogenesis of Moyamoya disease. © 1997 Elsevier
Science B.V.
Keywords
:
Moyamoya disease; Epstein-Barr virus; Cytomegalovirus; Antibody titer; Polymerase chain reaction
1. Introduction
Moyamoya disease, although an unusual disease, is
characterized by progressive cerebrovascular occlusion
at the peripheral internal carotid artery and develop-
ment of abnormal collateral circulation at the cere-
bral basal region [1,2]. Several investigators have
postulated that abnormal thrombogenesis, inflamma-
tory process and autoimmune process are responsible
for the pathogenesis, however the etiology of this dis-
ease is still obscure. Recently, the Research Commit-
tee on Spontaneous Occlusion of the Circle of the
Willis of Ministry of Health and Welfare in Japan
revealed viral infection as a possible etiology. There-
fore, viral antibody titers with the patients of this
disease were investigated, in which the antibody titer
of Epstein-Barr virus (EBV) in Moyamoya disease
was found out significantly to be higher than that in
control. On the other hand, cytomegalovirus (CMV)
has been pointed out as one of the pathogenesis of
the atherosclerosis [3–5]. Thus, in order to clarify the
correlation of viral infection and this disease, the
* Corresponding author. Tel.: +81 58 2672348; fax: + 81 58
2659025.
0303-8467/97/$17.00 © 1997 Elsevier Science B.V. All rights reserved.
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