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

Abstract

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.

Relation between Epstein-Barr virus and multiple sclerosis: analytic study of scientific production

“…In three of the studies, the positive proportion of positive cases was less than in controls [17,31,42]. The Myhr et al [34] …”

“…In addition, its weight was the highest among the set. All remaining studies used serum samples [4,10,19,31,42] and the proportion of seropositive patients was also higher in cases than in controls, except for the study by Banwell et al [18], which was carried out in children, and with an OR that failed to indicate any association between the virus and MS. The article with the highest OR was that by Haahr et al [4].…”

Identification of Epstein-Barr virus proteins as putative targets of the immune response in multiple sclerosis

“…Latent proteins have been suggested as bearing primary responsibility for the differences in immunoreacitivty to EBV (38). Recently, an association between EBV reactivation and disease activity was reported whereas no association was found with other herpes viruses (39,40). Another study found elevated EBV DNA levels in the blood of MS patients during relapses (41).…”

Epstein-Barr Virus and Autoimmunity

“…This could result from an increased frequency of circulating EBV-infected B cells or from defective control of outgrowth of EBV-transformed B cells in vitro by EBV-specific cytotoxic T cells. Wandinger et al [23] found EBV DNA in the sera of patients with clinically active MS but not in those with clinically stable disease. They interpreted this as evidence of an association between disease activity and EBV replication, which was supported by the finding of increased IgM and IgA responses to EBV early antigens in the patients with clinically active disease.…”

“…Subsequent studies have shown that patients with MS are almost universally seropositive for EBV, raising the possibility that EBV infection might be a prerequisite for the development of MS. A review of eight published case-control studies comparing EBV serology in MS patients and controls revealed that 99% of MS patients were EBVseropositive compared to 90% of controls; the summary odds ratio of MS comparing EBV-seropositive individuals with EBV-seronegative individuals was 13.5 (95% confidence interval = 6.3-31.4) [22]. This difference does not apply to other herpes viruses [23]. Furthermore, a definite clinical history of infectious mononucleosis, which indicates primary infection with -EBV with a high frequency of infected B cells [11] further increases the risk of MS in EBV-seropositive subjects (eight-fold, if infection occurs before the age of 18 years) [24].…”