Multiple sclerosis – is a dysregulated immune response the route to illness via Epstein-Barr virus reactivation?

Abstract: Background: Throughout human history infectious agents such as viruses have been one of the biggest threats to public health. One example of infectious agents that can cause severe malignant conditions in humans is the Epstein-Barr virus (EBV). This virus has been researched for decades but still a lot of its potential malignant functions remain to be elucidated. Autoimmunity, and especially multiple sclerosis (MS), has been strongly associated to EBV infection for a long time but the exact mechanisms behind this relationship are still largely unknown. Aim: The main aim of this study was to investigate the evidence connecting an EBV-specific dysregulated immune response to MS. Methods: This paper is written as a systematic review examining the latest science within the studied field. PubMed was searched for articles published between 2010-2020. Results: In total 15 studies were reviewed. Five out of seven studies found an altered antibody response towards EBV in patients with MS, while one demonstrated somewhat mixed results and one could not support such a pattern. Seven out of eight studies found an altered T cell response towards EBV in MS patients, while one could only support such a trend. Conclusions: This review confirms that there is strong evidence for a dysregulated EBV-specific immune response in MS patients. Evidence for a causal relationship between the failure to control a reactivated EBV infection and the progression of disease is suggestive, but this needs to be confirmed by further studies.