炎症与 EBV 在多发性硬化症及 COVID-19 感染后急性后遗症中的关系
Inflammation and Epstein-Barr Virus at the Crossroads of Multiple Sclerosis and Post-Acute Sequelae of COVID-19 Infection.
机构信息
Division of Infectious Diseases, Department of Pediatrics, University of Florida, Gainesville, FL 32610, USA.
Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL 32610, USA.
出版信息
Viruses. 2023 Apr 12;15(4):949. doi: 10.3390/v15040949.
Recent studies have strengthened the evidence for Epstein-Barr Virus (EBV) as an important contributing factor in the development of multiple sclerosis (MS). Chronic inflammation is a key feature of MS. EBV B cells can express cytokines and exosomes that promote inflammation, and EBV is known to be reactivated through the upregulation of cellular inflammasomes. Inflammation is a possible cause of the breakdown of the blood-brain barrier (BBB), which allows the infiltration of lymphocytes into the central nervous system. Once resident, EBV or EBV-specific B cells could both plausibly exacerbate MS plaques through continued inflammatory processes, EBV reactivation, T cell exhaustion, and/or molecular mimicry. Another virus, SARS-CoV-2, the cause of COVID-19, is known to elicit a strong inflammatory response in infected and immune cells. COVID-19 is also associated with EBV reactivation, particularly in severely ill patients. Following viral clearance, continued inflammation may be a contributor to post-acute sequelae of COVID-19 infection (PASC). Evidence of aberrant cytokine activation in patients with PASC supports this hypothesis. If unaddressed, long-term inflammation could put patients at risk for reactivation of EBV. Determining mechanisms by which viruses can cause inflammation and finding treatments for reducing that inflammation may help reduce the disease burden for patients suffering from PASC, MS, and EBV diseases.
最近的研究加强了证据表明 Epstein-Barr 病毒(EBV)是多发性硬化症(MS)发展的一个重要因素。慢性炎症是 MS 的一个关键特征。EBV B 细胞可以表达细胞因子和外泌体,促进炎症,并且已知 EBV 通过细胞焦亡体的上调而被重新激活。炎症是血脑屏障(BBB)破裂的一个可能原因,允许淋巴细胞渗透到中枢神经系统。一旦定居,EBV 或 EBV 特异性 B 细胞都可能通过持续的炎症过程、EBV 再激活、T 细胞耗竭和/或分子模拟来加剧 MS 斑块。另一种病毒,SARS-CoV-2,是 COVID-19 的病因,已知在感染和免疫细胞中引起强烈的炎症反应。COVID-19 也与 EBV 再激活有关,特别是在重症患者中。在病毒清除后,持续的炎症可能是 COVID-19 感染后急性后遗症(PASC)的一个促成因素。PASC 患者异常细胞因子激活的证据支持这一假设。如果不加以解决,长期炎症可能使患者面临 EBV 再激活的风险。确定病毒引起炎症的机制,并寻找减少炎症的治疗方法,可能有助于减轻 PASC、MS 和 EBV 疾病患者的疾病负担。