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Epstein-Barr virus in multiple sclerosis

Bridget A Bagert1

  • 1Department of Neurology, 1542 Tulane Avenue, Room 718B, Louisiana State University Health Science Center, New Orleans, LA 70112, USA. bbager@lsuhsc.edu

Current Neurology and Neuroscience Reports
|August 12, 2009
PubMed

Insights

Prior Epstein-Barr virus (EBV) infection is strongly linked to developing multiple sclerosis (MS). Most people get EBV, but 99% of MS patients show evidence of prior EBV infection, suggesting a necessary role.

Area of Science:

  • Neuroimmunology
  • Virology
  • Epidemiology

Background:

  • Epstein-Barr virus (EBV) infects over 90% of the global population, typically remaining latent.
  • A high prevalence of prior EBV infection is observed in multiple sclerosis (MS) patients (99%) compared to the general population.
  • EBV establishes lifelong infection in memory B lymphocytes, evading immune detection.

Purpose of the Study:

  • To review the evidence linking Epstein-Barr virus (EBV) to the pathogenesis of multiple sclerosis (MS).
  • To explore potential mechanisms by which EBV may contribute to MS development.
  • To consider the therapeutic implications of the EBV-MS relationship.

Main Methods:

  • Review of seroepidemiologic studies correlating EBV infection rates with MS.
  • Analysis of pathologic findings in postmortem MS brain tissue.
  • Examination of proposed pathogenetic theories including antigenic mimicry and B-cell dysregulation.

Main Results:

  • Elevated EBV antibody titers are detected in MS patients years preceding neurological symptoms.
  • Postmortem analyses reveal widespread EBV-associated B-cell abnormalities in all forms of MS.
  • Strong correlation between prior EBV infection and MS development.

Conclusions:

  • Prior Epstein-Barr virus infection is strongly suggested as a necessary factor in multiple sclerosis development.
  • EBV-associated B-cell immortalization and immune dysregulation are key proposed mechanisms.
  • Understanding the EBV-MS link offers potential avenues for novel MS therapies.

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