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Cited by 246Multiple Sclerosis Research StudiesViral-associated cancers and disordersCytomegalovirus and herpesvirus research

Epstein–Barr virus as a leading cause of multiple sclerosis: mechanisms and implications

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Bjornevik, Kjetil, Münz, Christian, Cohen, Jeffrey I., Ascherio, Alberto·2023·Nature Reviews Neurology
DOI 10.1038/s41582-023-00775-5
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Abstract

Epidemiological studies have provided compelling evidence that multiple sclerosis (MS) is a rare complication of infection with the Epstein-Barr virus (EBV), a herpesvirus that infects more than 90% of the global population. This link was long suspected because the risk of MS increases markedly after infectious mononucleosis (symptomatic primary EBV infection) and with high titres of antibodies to specific EBV antigens. However, it was not until 2022 that a longitudinal study demonstrated that MS risk is minimal in individuals who are not infected with EBV and that it increases over 30-fold following EBV infection. Over the past few years, a number of studies have provided clues on the underlying mechanisms, which might help us to develop more targeted treatments for MS. In this Review, we discuss the evidence linking EBV to the development of MS and the mechanisms by which the virus is thought to cause the disease. Furthermore, we discuss implications for the treatment and prevention of MS, including the use of antivirals and vaccines.

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  • Several exogenous and endogenous viruses have been considered in MS pathogenesis, with the most compelling evidence implicating EBV and HERV-W.

    “Several exogenous and endogenous viruses have been considered in MS pathogenesis, with the most compelling evidence implicating respectively Epstein-Barr virus (EBV)40 and human endogenous retrovirus type-W (HERV-W)41.”

    From Locus for severity implicates CNS resilience in progression of multiple sclerosis (2023) · cites this paper as [40]

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Cited by

Sorted by citations

Authors
Bjornevik, K., Münz, C., Cohen, J. I., & Ascherio, A.
Affiliations
  • University of Zurich (CH)
  • National Institutes of Health (US)
  • Brigham and Women's Hospital (US)
Corresponding author
Ascherio, Alberto
ORCID
Venue
Nature Reviews Neurology
Publisher
Springer Science and Business Media LLC
Published
2023-02-09
Volume
19
Issue
3
Pages
160-171
ISSN
  • 1759-4758 (ISSN-L)
  • 1759-4766
DOI
10.1038/s41582-023-00775-5
OpenAlex
W4319662009
Cited by
246
References
6
Citations by year
2026: 42 · 2025: 91 · 2024: 77 · 2023: 35 · 2022: 1
FWCI
11.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Nature Reviews Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
  • Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
Keywords
Epstein-Barr virus, multiple sclerosis, infectious mononucleosis, viral etiology of multiple sclerosis, EBV antibodies, post-infectious autoimmunity, antiviral therapy, EBV vaccine
MeSH terms
Antibodies, Viral, Herpesvirus 4, Human, Humans, Longitudinal Studies, Multiple Sclerosis, Epstein-Barr Virus Infections

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