Wahbeh Farah, Sabatino Joseph J
Weill Cornell Medicine-Qatar, Cornell University, Qatar.
Department of Neurology, University of California Davis; and.
Neurol Neuroimmunol Neuroinflamm. 2025 Nov;12(6):e200460. doi: 10.1212/NXI.0000000000200460. Epub 2025 Sep 15.
Epstein-Barr virus (EBV) is a very common herpesvirus that infects more than 90% of the general population. Epidemiologic data indicate that EBV is a requisite risk factor for the development of multiple sclerosis (MS); however, the mechanisms by which EBV contributes to MS pathogenesis are unclear. In this review, we discuss how EBV alters the functions of B cells, its primary cellular reservoir, and the associated dysregulation of anti-EBV immunity in patients with MS. We comprehensively explore the evidence for different potential mechanisms by which EBV may lead to the development of MS, including the so-called driver and hit-and-run models. Finally, we discuss key outstanding scientific questions that must be addressed to advance not only our understanding of the role of EBV in MS pathology but also the development of novel disease therapies.
爱泼斯坦-巴尔病毒（EBV）是一种非常常见的疱疹病毒，感染了超过90%的普通人群。流行病学数据表明，EBV是多发性硬化症（MS）发病的必要风险因素；然而，EBV促成MS发病机制尚不清楚。在本综述中，我们讨论了EBV如何改变其主要细胞储存库B细胞的功能，以及MS患者中抗EBV免疫的相关失调。我们全面探讨了EBV可能导致MS发生的不同潜在机制的证据，包括所谓的驱动模型和肇事逃逸模型。最后，我们讨论了一些关键的悬而未决的科学问题，这些问题不仅必须得到解决，以增进我们对EBV在MS病理中作用的理解，而且还要推动新型疾病疗法的发展。
