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Epstein-Barr Virus and Multiple Sclerosis.

Gunnar Houen1,2, Nicole Hartwig Trier2, Jette Lautrup Frederiksen2,3

  • 1Institute of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark.

Frontiers in Immunology
|January 4, 2021
PubMed
Summary

Multiple sclerosis (MS) is a neurologic condition linked to Epstein-Barr virus (EBV) infection. Treatments targeting B cells, potentially counteracting chronic EBV, show promise for both relapsing-remitting MS and primary progressive MS.

Keywords:
Epstein-Barr viruscentral nervous systemchronic infectionimmune evasionmultiple sclerosisrelapsing-remitting

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Area of Science:

  • Neurology
  • Immunology
  • Virology

Background:

  • Multiple sclerosis (MS) is a central nervous system (CNS) disease impacting myelinated nerves, often starting as optic neuritis (ON) and progressing to relapsing-remitting (RRMS) or primary progressive (PPMS) forms.
  • Key MS characteristics include CNS inflammation and intrathecal immunoglobulin synthesis (IgG index, OCBs).
  • Predisposing factors include HLA DRB1*15:01, vitamin D deficiency, smoking, obesity, and Epstein-Barr virus (EBV) infection.

Purpose of the Study:

  • To explore the role of chronic Epstein-Barr virus (EBV) infection in the pathogenesis of multiple sclerosis (MS).
  • To investigate the potential mechanisms by which EBV contributes to different MS subtypes (RRMS and PPMS).
  • To evaluate the efficacy of B cell-targeting therapies in the context of EBV's role in MS.

Main Methods:

  • Review of existing literature on MS pathogenesis, EBV infection, and B cell biology.
  • Analysis of clinical trial data for monoclonal antibody (MAb) therapies in RRMS and PPMS.
  • Correlation of clinical signs and disease progression with proposed EBV involvement models.

Main Results:

  • Clinical signs of MS can be explained by chronic/recurrent EBV infection.
  • Models suggest EBV-transformed B cells entering the CNS cause RRMS attacks, while chronic activity causes PPMS.
  • B cell-targeting MAbs demonstrate efficacy in both RRMS and PPMS, supporting the EBV hypothesis.

Conclusions:

  • Chronic EBV infection is a significant factor in MS development and progression.
  • B cell-targeting therapies may counteract EBV's role in MS pathogenesis.
  • Monoclonal antibodies targeting B cells represent a promising therapeutic strategy for MS, potentially by addressing underlying EBV activity.