The EBV-MS connection: the enigma remains
Year: 2024
Type: article
Abstract: IntroductionIn multiple sclerosis (MS) patients, the central nervous system (CNS) is affected by the infiltration of inflammatory immune cells, resulting in demyelination and axonal loss.Although the exact trigger for the activation of autoimmune responses against the CNS has not been elucidated yet, a genetic predisposition in combination with environmental factors seems essential to develop MS.Therefore, MS is considered to be a multifactorial disease.The main environmental factors increasing the risk of MS are obesity, smoking, low vitamin D levels, and Epstein-Barr virus (EBV) infection (1).EBV is a human gammaherpesvirus and its life cycle starts after infection of epithelial cells where it replicates and then spreads to B cells to establish lifelong latency.Latent EBV can be reactivated in memory B cells.EBV was first linked to MS almost 40 years ago.The first hypothesis was developed after identifying many similarities between the occurrence and latitude gradient of MS and infectious mononucleosis (IM) caused by EBV, and therefore MS was proposed to be a complication of an EBV infection (2).EBV is also reported to be associated with MS relapses (3), however, here we emphasize the involvement in MS etiology rather than in disease progression and we highlight the progress made in the field and provide suggestions for future research. Epidemiological evidenceA lot of epidemiological evidence is available that shows the association between EBV and MS.For example, anti-EBV antibodies are elevated 5 or more years before the onset of MS symptoms, and the most consistent observations are found for antibodies against EBV nuclear antigens (e.g.EBNA-1 and EBNA-2) which are expressed during a latent infection (4).Besides antibodies against the latent-expressed EBNA, also antibodies against the lyticexpressed viral capsid antigen (VCA) are elevated in MS patients (5) and correlates with disease activity (6).Also, the risk of MS can be neglected in individuals who are seronegative for EBV (7).In immunocompetent individuals, an EBV infection is often mild and self- Frontiers in Immunology frontiersin.org01
Source: Frontiers in Immunology
Authors: A. van de Waterweg Berends, B. Broux, B. Machiels, L. Gillet, N. Hellings
Institutions: University of Liège, Hasselt University
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,295
OpenAlex ID: W4402017407