The role of Epstein-Barr virus in multiple sclerosis: From pathogenesis to therapeutic potential.

IF 2.3 4区医学 Q2 CLINICAL NEUROLOGY

Revue neurologique Pub Date : 2026-04-22 DOI:10.1016/j.neurol.2026.04.002

G Bellucci, R Mechelli, R Bigi, G Ristori, M Salvetti

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Abstract

A growing body of evidence positions Epstein-Barr virus (EBV) as a central agent in the etiopathogenesis of multiple sclerosis (MS). Compelling epidemiological studies now demonstrate that EBV infection precedes MS onset and is a necessary precondition for disease development. This is supported by pathology findings revealing EBV-infected B cells within CNS lesions and immunogenetic data linking viral and human genetic susceptibility to MS risk. Mechanistically, EBV appears to act as an upstream trigger that reshapes B cell function, promotes molecular mimicry with CNS antigens, and drives compartmentalized neuroinflammation. In this Review, we synthesize epidemiological, pathological, immunogenetic, and clinical-therapeutic evidence to construct a coherent model of EBV-driven MS pathogenesis. We examine how current MS therapies intersect with EBV biology and discuss the challenges and opportunities in developing EBV-targeted strategies, including vaccines and antivirals, for disease prevention and early intervention. Finally, we highlight key unresolved questions and outline a translational research agenda aimed at intercepting MS through virologically informed approaches.

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eb病毒在多发性硬化症中的作用：从发病机制到治疗潜力。

越来越多的证据表明，eb病毒（EBV）在多发性硬化症（MS）的发病机制中起着中心作用。令人信服的流行病学研究现在表明，EBV感染先于MS发病，是疾病发展的必要先决条件。病理结果显示，中枢神经系统病变内ebv感染的B细胞和免疫遗传学数据将病毒和人类遗传易感性与多发性硬化症风险联系起来，支持了这一点。从机制上讲，EBV似乎是重塑B细胞功能的上游触发器，促进与中枢神经系统抗原的分子模仿，并驱动区隔性神经炎症。在这篇综述中，我们综合流行病学、病理学、免疫遗传学和临床治疗证据来构建ebv驱动的MS发病机制的连贯模型。我们研究了当前的MS治疗如何与EBV生物学交叉，并讨论了开发EBV靶向策略的挑战和机遇，包括疫苗和抗病毒药物，用于疾病预防和早期干预。最后，我们强调了关键的未解决的问题，并概述了旨在通过病毒学方法拦截MS的转化研究议程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revue neurologique 医学-临床神经学

CiteScore

4.80

自引率

0.00%

发文量

598

审稿时长

55 days

期刊介绍： The first issue of the Revue Neurologique, featuring an original article by Jean-Martin Charcot, was published on February 28th, 1893. Six years later, the French Society of Neurology (SFN) adopted this journal as its official publication in the year of its foundation, 1899. The Revue Neurologique was published throughout the 20th century without interruption and is indexed in all international databases (including Current Contents, Pubmed, Scopus). Ten annual issues provide original peer-reviewed clinical and research articles, and review articles giving up-to-date insights in all areas of neurology. The Revue Neurologique also publishes guidelines and recommendations. The Revue Neurologique publishes original articles, brief reports, general reviews, editorials, and letters to the editor as well as correspondence concerning articles previously published in the journal in the correspondence column.