Epstein–Barr Virus Infection and Multiple Sclerosis: A Review

  title={Epstein–Barr Virus Infection and Multiple Sclerosis: A Review},
  author={Alberto Ascherio and Kassandra L. Munger},
  journal={Journal of Neuroimmune Pharmacology},
Epstein–Barr virus (EBV) infection results in a life-long persistence of the virus in the host’s B-lymphocytes and has been associated with numerous cancers including Burkitt’s lymphoma, Hodgkin lymphoma, and nasopharyngeal carcinoma. There is considerable evidence that EBV infection is a strong risk factor for the development of multiple sclerosis. Early age at primary EBV infection is typically asymptomatic, but primary infection during adolescence or adulthood often manifests as infectious… 

Epstein–Barr virus and multiple sclerosis

There is strong evidence however that people with MS are more likely to report a past history of infectious mononucleosis (thought to represent initial EBV infection at an older age), and higher titres of EBV specific antibodies are associated with an increased risk of developing MS.

Risk of Multiple Sclerosis in Epstein–Barr Virus Infection

Several ecological studies, co-occurring pathologies, and experimental laboratory-based research provide evidence to support the relationship between EBV and MS.

Epstein-barr virus in the central nervous system and cervical lymph node of a patient with primary progressive multiple sclerosis.

Using in situ hybridization and immunohistochemistry, EBV is analyzed for the first time in both postmortem CNS and lymph nodes from a patient with primary progressive MS.

Epstein Barr Virus: Development of Vaccines and Immune Cell Therapy for EBV-Associated Diseases

The inclusion of gH/gL and gB in a vaccine formulation with gp350 represents a promising approach of EBV prophylactic vaccine development, and has the potential to increase the efficacy of a therapeutic EBV vaccine.

Epstein-Barr Virus Infection in the Development of Neurological Disorders.

Investigating the role of Epstein-Barr virus in the pathogenesis of Multiple Sclerosis

This research investigates the significance of EBV immune responses, including those targeting the novel epitope EBNA-1(398-413), previously associated with MS risk in disease-discordant identical twins, and identifies novel and statistically powerful relationships between environmental and genetic MS risk factors.

Epstein-Barr virus in the multiple sclerosis brain - An evasive culprit.

  • M. Pender
  • Biology, Medicine
    Multiple sclerosis and related disorders
  • 2012

The Role of Latently Infected B Cells in CNS Autoimmunity

Animal models, such as experimental autoimmune encephalomyelitis and murine gammaherpesvirus-68 (γHV-68), can be used as powerful tools in the study of the relationship between EBV, MS, and B cells.

The role of Epstein-Barr virus in the etiology of multiple sclerosis: a current review

  • K. Ruprecht
  • Biology
    Expert review of clinical immunology
  • 2020
The mechanism of EBV in MS is a pressing question, whose clarification may substantially advance the pathophysiological understanding, rational therapies, and prevention of MS.

The role of the Epstein-Barr virus in the pathogenesis of some autoimmune disorders - Similarities and differences.

  • G. Füst
  • Medicine, Biology
    European journal of microbiology & immunology
  • 2011
After a brief summary on the properties of the Epstein-Barr virus (EBV), the course and latency stages of the infection, the characteristics of infectious mononucleosis (IM), and other disorders



Epstein-Barr virus infection is not a characteristic feature of multiple sclerosis brain.

The finding that CNS Epstein-Barr virus infection was rare in multiple sclerosis brain indicates that EBV infection is unlikely to contribute directly tomultiple sclerosis brain pathology in the vast majority of cases.

Dysregulated Epstein-Barr virus infection in the multiple sclerosis brain

Findings from this study are interpreted as evidence that EBV persistence and reactivation in the CNS play an important role in MS immunopathology.

Epstein-Barr virus in pediatric multiple sclerosis.

Serological evidence for remote EBV infection was present in 83% of pediatric MS patients compared with 42% of emergency department and healthy controls, and results suggest an association betweenEBV infection and pediatric MS.

Strong EBV-specific CD8+ T-cell response in patients with early multiple sclerosis.

The data show high levels of CD8+ T-cell activation against EBV--but not CMV--early in the course of MS, which support the hypothesis that EBV might be associated with the onset of this disease.

Absence of Epstein-Barr virus in the brain and CSF of patients with multiple sclerosis

Application of real-time PCR to multiple sclerosis brain and single B-lymphocytes in CSF did not reveal any evidence of active Epstein-Barr virus infection.

Epstein-Barr virus and disease activity in multiple sclerosis

There was no evidence for increased clinical disease activity in the subgroup of MS patients with serological signs of EBV reactivation, however, the observation that chronic EBv reactivation may be associated with increased inflammatory activity as assessed by gadolinium enhanced MRI lesions should be reproduced in a larger and independent dataset.

Association between clinical disease activity and Epstein–Barr virus reactivation in MS

The results demonstrate an association between EBV reactivation and disease activity in MS patients over time, and suggest that EBV might play an indirect role in MS as an activator of the underlying disease process.

Epstein Barr virus is not a characteristic feature in the central nervous system in established multiple sclerosis.

It is shown that there is little evidence for the presence of EBV in the central nervous system of people with multiple sclerosis, and the studies reveal the vagaries of pathological detection methods for infectious agents such as EBV.

An altered immune response to Epstein-Barr virus in multiple sclerosis

Individuals who will develop MS exhibit an altered immune response against the EBV virus characterized by a high IgG activity to EBNA-1 in the absence of high activity to VCA, this being most pronounced in the 5-year period preceding MS onset.

Epstein-Barr virus and multiple sclerosis: evidence of association from a prospective study with long-term follow-up.

Elevations of antibody titers to the EBNA complex and EBNA-1 among MS cases first occurred between 15 to 20 years before the onset of symptoms and persisted thereafter, probably an early event in the pathogenesis of MS.