Targeting Epstein-Barr virus (EBV) for treatment of multiple sclerosis

Epstein-Barr Virus (EBV) is now recognized as an essential causal agent in the development of Multiple Sclerosis (MS). MS is a chronic autoimmune disease resulting in demyelination and neurodegeneration in the central nervous system (CNS). EBV is a ubiquitous human γ-herpesvirus that establishes long-term latent infection in a small subpopulation of memory B-lymphocytes. While EBV and B-lymphocytes are known to be drivers of MS autoimmune disease, it remains enigmatic how a small population of EBV-infected cells trigger and drive MS pathogenesis in some individuals. In this review, we discuss the known biology of EBV and its role in MS and other disease, including cancers, where EBV is an essential driving factor in disease progression. We review some of the conditions and cofactors that increase the risk of EBV infection leading to MS and the potential of pharmacological, biologic and vaccine approaches to more selectively target EBV to treat MS.