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The role of Epstein-Barr virus in multiple sclerosis: From pathogenesis to therapeutic potential

G Bellucci1, R Mechelli2, R Bigi3

  • 1Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome, 00189 Rome, Italy; Department of Neurology, University of California, San Francisco, CA, United States.

Revue Neurologique
|April 23, 2026
PubMed

Insights

Epstein-Barr virus (EBV) infection is a necessary precursor to multiple sclerosis (MS) development. This review synthesizes evidence to model EBV

Area of Science:

  • Neuroimmunology
  • Virology
  • Epidemiology

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease with complex etiology.
  • Epstein-Barr virus (EBV) infection is increasingly implicated in MS pathogenesis.
  • The link between EBV and MS requires further elucidation.

Purpose of the Study:

  • To synthesize current evidence on the role of EBV in multiple sclerosis.
  • To construct a model of EBV-driven MS pathogenesis.
  • To explore therapeutic strategies targeting EBV for MS prevention and treatment.

Main Methods:

  • Review of epidemiological, pathological, and immunogenetic studies.
  • Analysis of clinical-therapeutic data.
  • Synthesis of evidence to propose a pathogenetic model.

Main Results:

  • EBV infection precedes MS onset and is a necessary precondition.
  • EBV-infected B cells are found in CNS lesions.
  • EBV reshapes B cell function, promotes molecular mimicry, and drives neuroinflammation.

Conclusions:

  • EBV is a central factor in MS pathogenesis.
  • Current MS therapies have varying interactions with EBV biology.
  • EBV-targeted strategies, including vaccines and antivirals, offer potential for MS prevention and early intervention.
Keywords:
Epstein-Barr virusEtiologyMultiple sclerosisTherapiesVaccines

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