Epstein-Barr virus in the multiple sclerosis brain: a controversial issue--report on a focused workshop held in the Centre for Brain Research of the Medical University of Vienna, Austria

Brain. 2011 Sep;134(Pt 9):2772-86. doi: 10.1093/brain/awr197. Epub 2011 Aug 16.


Recent epidemiological and immunological studies provide evidence for an association between Epstein-Barr virus infection and multiple sclerosis, suggesting a role of Epstein-Barr virus infection in disease induction and pathogenesis. A key question in this context is whether Epstein-Barr virus-infected B lymphocytes are present within the central nervous system and the lesions of patients with multiple sclerosis. Previous studies on this topic provided highly controversial results, showing Epstein-Barr virus reactivity in B cells in the vast majority of multiple sclerosis cases and lesions, or only exceptional Epstein-Barr virus-positive B cells in rare cases. In an attempt to explain the reasons for these divergent results, a workshop was organized under the umbrella of the European Union FP6 NeuroproMiSe project, the outcome of which is presented here. This report summarizes the current knowledge of Epstein-Barr virus biology and shows that Epstein-Barr virus infection is highly complex. There are still major controversies, how to unequivocally identify Epstein-Barr virus infection in pathological tissues, particularly in situations other than Epstein-Barr virus-driven lymphomas or acute Epstein-Barr virus infections. It further highlights that unequivocal proof of Epstein-Barr virus infection in multiple sclerosis lesions is still lacking, due to issues related to the sensitivity and specificity of the detection methods.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Austria
  • B-Lymphocytes / immunology
  • Brain / immunology
  • Brain / pathology*
  • Brain / virology*
  • Diagnosis, Differential
  • Education*
  • Epstein-Barr Virus Infections / immunology*
  • Epstein-Barr Virus Infections / pathology
  • Epstein-Barr Virus Infections / physiopathology
  • Gene Expression
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / immunology*
  • Humans
  • Multiple Sclerosis / immunology*
  • Multiple Sclerosis / pathology
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / virology*
  • RNA, Viral
  • Sensitivity and Specificity


  • RNA, Viral