The role of Epstein-Barr virus in multiple sclerosis:from molecular pathophysiology to in vivo imaging

作     者：Yi Guan Dejan Jakimovski Murali Ramanathan Bianca Weinstock-Guttman Robert Zivadinov 

作者机构：Buffalo Neuroimaging Analysis Center Department of Neurology Jacobs School of Medicine and Biomedical Sciences University at BuffaloState University of New York Jacobs Comprehensive MS Treatment and Research Center Department of Neurology Jacobs School of Medicine and Biomedical SciencesUniversity at Buffalo State University of New York Department of Pharmaceutical Sciences State University of New York Center for Biomedical Imaging at Clinical Translational Science Institute University at Buffalo State University of New York 

出 版 物：《Neural Regeneration Research》 (中国神经再生研究（英文版）)

年 卷 期：2019年第14卷第3期

页      面：373-386页

核心收录：

学科分类：10[医学] 

主　　题：Epstein-Barr virus multiple sclerosis meningeal inflammation magnetic resonance imaging leptomeningeal contrast enhancement mononucleosis human endogeneous retrovirus-W B-cells 

摘      要：Multiple sclerosis(MS) is a disease of the central nervous system characterized by inflammation, demyelination, and neuronal damage. Environmental and genetic factors are associated with the risk of developing MS, but the exact cause still remains unidentified. Epstein-Barr virus(EBV), vitamin D, and smoking are among the most well-established environmental risk factors in MS. Infectious mononucleosis, which is caused by delayed primary EBV infection, increases the risk of developing MS. EBV may also contribute to MS pathogenesis indirectly by activating silent human endogenous retrovirus-W. The emerging B-cell depleting therapies, particularly anti-CD20 agents such as rituximab, ocrelizumab, as well as the fully human ofatumumab, have shown promising clinical and magnetic resonance imaging benefit. One potential effect of these therapies is the depletion of memory B-cells, the primary reservoir site where EBV latency occurs. In addition, EBV potentially interacts with both genetic and other environmental factors to increase susceptibility and disease severity of MS. This review examines the role of EBV in MS pathophysiology and summarizes the recent clinical and radiological findings, with a focus on B-cells and in vivo imaging. Addressing the potential link between EBV and MS allows the better understanding of MS pathogenesis and helps to identify additional disease biomarkers that may be responsive to B-cell depleting intervention.