Relationship between Epstein-Barr virus and inflammatory bowel disease

Epstein-Barr virus (EBV), a linear double-stranded DNA herpesvirus, is universally prevalent in humans. Infection is mostly invisible in early childhood, subsequently leading to a latent infection in the B-lymphatic system that persists throughout life. However, in immunocompromised hosts, it may infect more cell types, especially epithelial cells. Furthermore, EBV can reactivate and employ multiple mechanisms to evade the immune system, and it can also induce host immune dysfunction, leading to exacerbation or triggering of the inflammatory process. Inflammatory bowel disease (IBD), an immune-mediated gastrointestinal inflammatory, is increasingly recognized as having multiple stages of development, similar to other inflammatory diseases (systemic lupus erythematosus and rheumatoid arthritis). EBV, a commonly encountered opportunistic infection in IBD, can cause rapid disease progression loss of response to drug treatment, and induction of lymphoid tissue proliferative diseases or EBV-associated lymphomas, and may even lead to death in affected patients. To comprehend the complex interactions between EBV and the different stages of IBD disease progression, we comprehensively review the current evidence of the relevance of EBV to the clinical stages of IBD, including the risk, initiation, and development stages, with the aim of developing a more comprehensive predictive and therapeutic strategy for IBD.