CRYPTOGENIC FIBROSING ALVEOLITIS - LACK OF ASSOCIATION WITH EPSTEIN-BARR-VIRUS INFECTION

Background - Cryptogenic fibrosing alveolitis (CFA) is a well defined clinical entity of unknown aetiology. An association between CFA and t he presence of protein indicating Epstein-Barr virus (EBV) replication within epithelial cells of the respiratory tract has recently been su ggested, leading to speculation for a role for EBV in the pathogenesis of CFA. Methods - Lung tissue was obtained from patients in three gro ups: those with cryptogenic fibrosing alveolitis, either lone or assoc iated with systemic sclerosis; patients with other pulmonary disorders ; and patients with normal lung. Paraffin blocks were stained using th ree antibodies raised against well defined EBV antigens. In addition, EBER-1 and EBER-2 antisense nucleotide probes were used in an attempt to identify EBV RNA. DNA was also extracted from the tissue sections a nd evaluated for evidence of EBV DNA using the polymerase chain reacti on. Results - Immunohistochemistry showed inconsistent focal positive staining with anti-EBV antibodies in all three,Groups, but there was n o evidence of EBV RNA using in situ hybridisation. None of the samples from patients with pulmonary fibrotic disorders was found to contain EBV DNA following gene amplification. Conclusion - Contrary to an earl ier report, these results do not support the hypothesis that EBV has a role in the pathogenesis of CFA.