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Epstein-Barr virus infection and autoimmunity in rheumatoid arthritis.

The Epstein-Barr virus (EBV) is an attractive candidate pathogen for rheumatoid arthritis (RA) because it is persistent, ubiquitous, and has profound effects on the immune system (for review, see Tosato and Blaese'). Its persistence is due to its ability to remain latent in two cell types-the B lymphocyte and the salivary gland epitheliumlboth of which could be envisaged as possible sources for some of the immunological abnormalities in RA. In this review I will examine the link between EBV and RA and attempt to establish whether the link is (a) aetiological, (b) represents an abnormal response to the virus, or (c) whether the serological response to one EBV encoded antigen, which has been termed rheumatoid arthritis nuclear antigen (RANA), gives a clue to the pattern of autoimmunity in RA.