Role of Epstein-Barr Virus in Multiple Sclerosis

Multiple sclerosis (MS) is a progressive neuroinflammatory disease marked by concentrated areas of demyelinated lesions that are disseminated in space and time in the central nervous system (CNS). MS is currently the most prevalent cause of atraumatic neurologic disability in the United States and is estimated to affect more than 2.8 million individuals worldwide. Neuroinflammatory diseases, including MS, often have multifactorial etiologies that make them difficult to understand and treat. We propose that the onset of MS occurs in individuals of a particular genetic background who encounter an environmental trigger. This dual-hit hypothesis leads to a dysregulation of the immune system that is characteristic of MS. Epstein-Barr virus (EBV) is of prominent interest in the research for a virus that could be one of many environmental triggers of MS. Recently, there has been a significant re-emergent interest in the role of EBV in MS pathogenesis. This spans hypotheses that suggest EBV may be a necessary but insufficient trigger of the disease to a causative role for EBV in MS. It is still unclear as to which, if any, of these assumptions may be true. In this chapter, we review MS and EBV independently before citing various forms of research that provide evidence for and against the link between MS and EBV. Ultimately, we believe that in order to claim that EBV is a primary environmental trigger for MS, researchers must conduct more clinical trials to understand and support the role played by EBV in the progression of MS.