ABSTRACT

Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. While its exact etiology is unknown, it is generally believed that MS is caused by environmental triggers in genetically predisposed individuals. Strong and consistent evidence suggests a key role of Epstein-Barr virus (EBV), a B lymphotropic human gammaherpesvirus, in the etiology of MS.

Areas covered: This review summarizes recent developments in the field of EBV and MS with a focus on potential mechanisms underlying the role of EBV in MS. PubMed was searched for the terms ‘Epstein-Barr virus’ and ‘multiple sclerosis’.

Expert opinion: The current evidence is compatible with the working hypothesis that MS is a rare complication of EBV infection. Under the premise of a causative role of EBV in MS, it needs to be postulated that EBV causes a specific, and likely persistent, change(s) that is necessarily required for the development of MS. However, although progress has been made, the nature of that change and thus the precise mechanism explaining the role of EBV in MS remain elusive. The mechanism of EBV in MS therefore is a pressing question, whose clarification may substantially advance the pathophysiological understanding, rational therapies, and prevention of MS.

摘要

简介：多发性硬化症（MS）是一种中枢神经系统慢性炎症性脱髓鞘疾病。虽然其确切病因尚不清楚，但普遍认为 MS 是由遗传易感个体的环境触发因素引起的。强有力且一致的证据表明 Epstein-Barr 病毒 (EBV)，一种嗜 B 淋巴细胞的人类伽马疱疹病毒，在 MS 的病因学中起关键作用。

涵盖的领域：这篇综述总结了 EBV 和 MS 领域的最新发展，重点是 EBV 在 MS 中的作用的潜在机制。在 PubMed 中搜索了术语“Epstein-Barr 病毒”和“多发性硬化症”。

专家意见：目前的证据与 MS 是 EBV 感染的罕见并发症的工作假设一致。在 EBV 在 MS 中起致病作用的前提下，需要假设 EBV 会导致 MS 发展所必需的特定且可能持续的变化。然而，尽管取得了进展，但这种变化的性质以及解释 EBV 在 MS 中作用的精确机制仍然难以捉摸。因此，EBV 在 MS 中的机制是一个紧迫的问题，其澄清可能会大大促进 MS 的病理生理学理解、合理治疗和预防。