Risk of Multiple Sclerosis in Epstein–Barr Virus Infection

Ahmed, Syed Ijlal; Aziz, Kashif; Gul, Amna; Samar, Syeda Sana; Bareeqa, Syeda Beenish

doi:10.7759/cureus.5699

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…The first evidence correlating EBV infection and MS was the fact that MS patients' B lymphocytes carry and transport EBV antigens [140]. Subsequently, other evidence was suggested, such as genetic susceptibility and EBV infection, as a higher risk of MS was found in individuals with infectious mononucleosis (IM) [141,142]. The indirect effect of EBV on MS onset may be related to the activation of silent human endogenous retrovirus W (HERV-W) [143].…”

Section: Multiple Sclerosis (Ms)mentioning

confidence: 99%

Viral infections and their relationship to neurological disorders

et al. 2021

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The chronic dysfunction of neuronal cells, both central and peripheral, a characteristic of neurological disorders, may be caused by irreversible damage and cell death. In 2016, more than 276 million cases of neurological disorders were reported worldwide. Moreover, neurological disorders are the second leading cause of death. Generally, the etiology of neurological diseases is not fully understood. Recent studies have related the onset of neurological disorders to viral infections, which may cause neurological symptoms or lead to immune responses that trigger these pathological signs. Currently, this relationship is mostly based on epidemiological data on infections and seroprevalence of patients who present with neurological disorders. The number of studies aiming to elucidate the mechanism of action by which viral infections may directly or indirectly contribute to the development of neurological disorders has been increasing over the years but these studies are still scarce. Comprehending the pathogenesis of these diseases and exploring novel theories may favor the development of new strategies for diagnosis and therapy in the future. Therefore, the objective of the present study was to review the main pieces of evidence for the relationship between viral infection and neurological disorders such as Alzheimer's disease, Parkinson's disease, Guillain-Barré syndrome, multiple sclerosis, and epilepsy. Viruses belonging to the families Herpesviridae, Orthomyxoviridae, Flaviviridae, and Retroviridae have been reported to be involved in one or more of these conditions. Also, neurological symptoms and the future impact of infection with SARS-CoV-2, a member of the family Coronaviridae that is responsible for the COVID-19 pandemic that started in late 2019, are reported and discussed.

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Section: Multiple Sclerosis (Ms)mentioning

confidence: 99%

Viral infections and their relationship to neurological disorders

et al. 2021

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“…Virus infections have for long been suspected to be involved in MS development (29)(30)(31)(32)(54)(55)(56). Most investigations have focused on EBV, which remains the most likely candidate for a causative virus, but other viruses may also play a role as discussed below.…”

Section: Ms Etiology and Epidemiologymentioning

confidence: 99%

Epstein-Barr Virus and Multiple Sclerosis

2020

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Multiple sclerosis (MS) is a neurologic disease affecting myelinated nerves in the central nervous system (CNS). The disease often debuts as a clinically isolated syndrome, e.g., optic neuritis (ON), which later develops into relapsing-remitting (RR) MS, with temporal attacks or primary progressive (PP) MS. Characteristic features of MS are inflammatory foci in the CNS and intrathecal synthesis of immunoglobulins (Igs), measured as an IgG index, oligoclonal bands (OCBs), or specific antibody indexes. Major predisposing factors for MS are certain tissue types (e.g., HLA DRB1*15:01), vitamin D deficiency, smoking, obesity, and infection with Epstein-Barr virus (EBV). Many of the clinical signs of MS described above can be explained by chronic/recurrent EBV infection and current models of EBV involvement suggest that RRMS may be caused by repeated entry of EBV-transformed B cells to the CNS in connection with attacks, while PPMS may be caused by more chronic activity of EBV-transformed B cells in the CNS. In line with the model of EBV’s role in MS, new treatments based on monoclonal antibodies (MAbs) targeting B cells have shown good efficacy in clinical trials both for RRMS and PPMS, while MAbs inhibiting B cell mobilization and entry to the CNS have shown efficacy in RRMS. Thus, these agents, which are now first line therapy in many patients, may be hypothesized to function by counteracting a chronic EBV infection.

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“…In the adult population it has been shown that there is an increased risk of MS in those who smoke cigarettes, and coinciding with this, children who are exposed to smoking in the home have been shown to be more likely to develop pediatric MS than a control population [16,17]. Epstein-Barr virus (EBV) may play a role in pathogenesis and risk of MS and pediatric MS, although the mechanism remains unclear at this time [15,18]. Historically, a correlation between EBV and MS was proposed due to the similarities in the epidemiology of the diseases, and studies have shown a strong correlation in support of this [19].…”

Section: Epidemiologymentioning

confidence: 99%

Current Advances in Pediatric Onset Multiple Sclerosis

et al. 2020

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Multiple sclerosis (MS) is an autoimmune inflammatory disease affecting the central nervous system leading to demyelination. MS in the pediatric population is rare, but has been shown to lead to significant disability over the duration of the disease. As we have learned more about pediatric MS, there has been a development of improved diagnostic criteria leading to earlier diagnosis, earlier initiation of disease-modifying therapies (DMT), and an increasing number of DMT used in the treatment of pediatric MS. Over time, treatment with DMT has trended towards the initiation of higher efficacy treatment at time of diagnosis to help prevent further disease progression and accrual of disability over time, and there is evidence in current literature that supports this change in treatment patterns. In this review, we discuss the current knowledge in diagnosis, treatment, and clinical outcomes in pediatric MS.

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Risk of Multiple Sclerosis in Epstein–Barr Virus Infection

Cited by 10 publications

References 21 publications

Viral infections and their relationship to neurological disorders

Viral infections and their relationship to neurological disorders

Epstein-Barr Virus and Multiple Sclerosis

Current Advances in Pediatric Onset Multiple Sclerosis

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