Epstein–Barr virus and multiple sclerosis. From evidence to therapeutic strategies

• Published in: Journal of the neurological sciences Vol. 361; pp. 213 - 219
• Main Authors: Fernández-Menéndez, Santiago, Fernández-Morán, Marta, Fernández-Vega, Iván, Pérez-Álvarez, Angel, Villafani-Echazú, Javier
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.02.2016
• Subjects: B-cell; Brain - pathology; Brain - virology; CD20; Epstein-Barr virus; Epstein-Barr Virus Infections - complications; Epstein-Barr Virus Infections - pathology; Herpesvirus 4, Human; Human endogenous retroviruses; Humans; Multiple sclerosis; Multiple Sclerosis - pathology; Multiple Sclerosis - virology; Neurology; Risk Factors; RRMS; CD20; W family of human endogenous retroviruses; magnetic resonance imaging; BBB; HERV-W; HERVs; MRI; B-cell; CNS; odds ratio; MSRV; oligoclonal bands; natural killer; blood–brain barrier; CSF; multiple sclerosis associated retrovirus; EBV; Epstein–Barr virus; Relapsing remitting multiple sclerosis; Human endogenous retroviruses; OR; Cerebrospinal Fluid; MS; multiple sclerosis; CIS; central nervous system; OCB; clinically isolated syndrome; NK; Multiple sclerosis
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2016.01.013

Abstract Multiple sclerosis is caused by a complex interaction between genetic predisposition and environmental factors. Epstein–Barr virus (EBV) is an environmental risk factor that is strongly related to multiple sclerosis (MS), since EBV seropositivity is linked to a significant risk of developing MS. EBV may be involved in the pathogenesis of the disease and it is possibly a prerequisite for the development of MS. EBV infection persists in B-cells during the lifetime of the host and can modulate their function. In addition, MS patients might have a deficient capacity to eliminate latent EBV infection in the central nervous system and this would promote the accumulation of infected B cells. Several mechanisms of pathogenesis, including a direct and indirect function of infected B cells, have been postulated in inflammation and neurodegeneration. A relationship between EBV and human endogenous retroviruses in the pathogenesis of MS has also been reported. If EBV is important in the pathogenesis of MS, different therapeutic strategies seem possible for MS treatment.