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Targeting Epstein-Barr virus infection as an intervention against multiple sclerosis

Journal article
Authors Daniel Jons
Peter Sundström
Oluf Andersen
Published in Acta Neurologica Scandinavica
Volume 131
Issue 2
Pages 69–79
ISSN 0001-6314
Publication year 2015
Published at Institute of Neuroscience and Physiology
Pages 69–79
Language en
Links dx.doi.org/10.1111/ane.12294
Keywords Epstein-Barr virus, multipel skleros
Subject categories Clinical Medicine, Neurology

Abstract

We here review contemporary data on genetic and environmental risk factors, particularly Epstein-Barr virus infection, for multiple sclerosis. There is an important immunogenetic etiological factor for multiple sclerosis. However, a general assumption is that immune defense genes are activated by the environment, basically by infections. We contend that the relationship between infectious mononucleosis and multiple sclerosis cannot be completely explained by genetics and inverse causality. Epstein-Barr infection as indicated by positive serology is an obligatory precondition for multiple sclerosis, which is a stronger attribute than a risk factor only. Data on events in the early pathogenesis of multiple sclerosis are cumulating from bio-banks with presymptomatic specimens, but there is only little information from the critical age when Epstein-Barr infection including infectious mononucleosis is acquired, nor on the detailed immunological consequences of this infection in individuals with and without multiple sclerosis. We discuss how focused bio-banking may elaborate a rationale for the development of treatment or vaccination against Epstein-Barr virus infection. A cohort in which intervention against Epstein-Barr infections was performed should be the object of neurological follow-up.

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