Epstein-Barr Virus in Multiple Sclerosis: Theory and Emerging Immunotherapies

Amit Bar-Or; Michael P Pender; Rajiv Khanna; Lawrence Steinman; Hans-Peter Hartung; Tap Maniar; Ed Croze; Blake T Aftab; Gavin Giovannoni; Manher A Joshi

doi:10.1016/j.molmed.2019.11.003

Epstein-Barr Virus in Multiple Sclerosis: Theory and Emerging Immunotherapies

Trends Mol Med. 2020 Mar;26(3):296-310. doi: 10.1016/j.molmed.2019.11.003. Epub 2019 Dec 17.

Authors

Affiliations

¹ Center for Neuroinflammation and Experimental Therapeutics, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
² Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
³ Centre for Immunotherapy and Vaccine Development, Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Brisbane, QLD, Australia.
⁴ Department of Neurology and Neurological Sciences, Beckman Center for Molecular Medicine, Stanford University Medical Center, Stanford, CA, USA.
⁵ Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
⁶ Clinical Development, Torque Therapeutics, Boston, MA, USA.
⁷ IRIS-Bay, San Francisco, CA, USA. Electronic address: ed.croze@iris-bay.com.
⁸ Preclinical Science and Translational Medicine, Atara Biotherapeutics, South San Francisco, CA, USA.
⁹ Blizard Institute, Queen Mary University London, Barts and the London School of Medicine, London, UK.
¹⁰ Medical Affairs, Atara Biotherapeutics, South San Francisco, CA, USA.

Abstract

New treatments for multiple sclerosis (MS) focused on B cells have created an atmosphere of excitement in the MS community. B cells are now known to play a major role in disease, demonstrated by the highly impactful effect of a B cell-depleting antibody on controlling MS. The idea that a virus may play a role in the development of MS has a long history and is supported mostly by studies demonstrating a link between B cell-tropic Epstein-Barr virus (EBV) and disease onset. Efforts to develop antiviral strategies for treating MS are underway. Although gaps remain in our understanding of the etiology of MS, the role, if any, of viruses in propagating pathogenic immune responses deserves attention.

Keywords: Epstein–Barr virus; cell-based therapies; immune evasion; multiple sclerosis; ocrelizumab; vaccination.

Publication types

Review

MeSH terms

Animals
B-Lymphocytes / immunology
Epstein-Barr Virus Infections / immunology*
Epstein-Barr Virus Infections / virology
Herpesvirus 4, Human / immunology*
Humans
Immunotherapy / methods
Multiple Sclerosis / immunology*
Multiple Sclerosis / virology*