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Epstein-Barr virus and multiple sclerosis: Mechanisms, therapeutic implications, and emerging interventions
Mohamed Reda Fazazi1, Kevin Champagne-Jorgensen2, Tamanna Islam3
1Axe Neurosciences, Centre de recherche du CHU de Québec-Université Laval, 2705 blvd Laurier, Québec, QC G1V 4G2, Canada.
Abstract:
Multiple sclerosis (MS) is a neuroinflammatory disease shaped by genetic and environmental factors, with Epstein-Barr virus (EBV) emerging as the strongest environmental risk. Here, we review current evidence for the involvement of EBV in MS, its impact on existing therapeutics, and strategies for novel therapeutic directions. Compelling evidence indicates EBV infection precedes MS onset, likely contributing to disease initiation, relapses, and possibly progression through mechanisms such as molecular mimicry, B cell immortalization, and viral reactivation. Current MS therapies may indirectly suppress EBV by depleting B cells or restricting lymphocyte CNS entry. Novel strategies, including CAR-T/-NK cells, adoptive T cells, "kick and kill" approaches, and vaccines, aim to directly target EBV and offer promising new avenues for MS therapy.
Insights
Epstein-Barr virus (EBV) is strongly linked to multiple sclerosis (MS) onset and progression. New therapies targeting EBV offer promising treatment avenues for this neuroinflammatory disease.
Area of Science:
- Neuroimmunology
- Virology
- Demyelinating Diseases
Background:
- Multiple sclerosis (MS) is a chronic neuroinflammatory disease.
- Genetic and environmental factors contribute to MS pathogenesis.
- Epstein-Barr virus (EBV) is the leading environmental risk factor for MS.
Purpose of the Study:
- To review the evidence linking EBV to MS.
- To examine EBV's impact on current MS therapies.
- To explore novel EBV-targeted therapeutic strategies for MS.
Main Methods:
- Literature review of current scientific evidence.
- Analysis of EBV's role in MS initiation, relapses, and progression.
- Evaluation of existing MS treatments' effects on EBV.
- Assessment of emerging EBV-specific therapies.
Main Results:
- Strong evidence shows EBV infection precedes MS onset.
- EBV may drive MS through molecular mimicry, B cell immortalization, and reactivation.
- Current MS therapies may indirectly impact EBV by affecting lymphocytes.
- Novel strategies like CAR-T/NK cells and vaccines aim to directly target EBV.
Conclusions:
- EBV plays a significant role in the development and potentially the progression of MS.
- Targeting EBV directly presents a promising therapeutic avenue for MS.
- Further research into EBV-specific interventions is warranted for MS treatment.
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