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CD8 T cell deficiency impairs control of Epstein–Barr virus and worsens with age in multiple sclerosis
  1. Michael P Pender1,2,
  2. Peter A Csurhes1,3,
  3. Casey M M Pfluger1,3,
  4. Scott R Burrows4
  1. 1The University of Queensland, School of Medicine, Brisbane, Queensland, Australia
  2. 2Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
  3. 3The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
  4. 4Queensland Institute of Medical Research, Brisbane, Queensland, Australia
  1. Correspondence to Professor Michael P Pender, Level 9, Health Sciences Building, Royal Brisbane and Women's Hospital, Queensland 4029, Australia; m.pender{at}

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A large body of evidence indicates that infection with the Epstein–Barr virus (EBV) has a role in the pathogenesis of multiple sclerosis (MS).1 We have previously hypothesised that a genetically determined defect in the elimination of EBV-infected B cells by cytotoxic CD8 T cells might predispose to the development of MS by allowing EBV-infected autoreactive B cells to accumulate in the central nervous system (CNS).1 2 Recently, we have shown that patients with MS have a decreased frequency of CD8 T cells reactive to their own EBV-infected B cells.3 Since 1980, it has been recognised that MS patients have a decreased proportion and number of CD8 T cells in peripheral blood.4 This was initially interpreted as a decrease in CD8 suppressor T cells leading to disinhibition of autoimmune responses but was later attributed to sequestration of CD8 T cells in the CNS. An alternative explanation is that the CD8 T cell deficiency is genetically determined and causes the decreased CD8 T cell response to EBV,3 which allows the accumulation of EBV-infected B cells in the CNS and the consequent development of MS. In the present study, we have used flow cytometry to determine the frequency of CD8 T cells in the blood and its relationship to the EBV-specific T cell response and clinical features of MS.

Patients and methods

Blood was collected from 64 MS patients and 68 age- and sex-matched healthy subjects after obtaining informed consent. This study was approved by the Royal Brisbane & Women's Hospital …

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