Epstein-Barr virus cause of multiple sclerosis.

PURPOSE OF REVIEW: The cause of multiple sclerosis (MS) has eluded medical science for over a century. Pierre Marie speculated that MS is an infectious disease and this paradigm has had a prominent place in the discussion. A number of candidate pathogens have been proposed, but most have not survived scrutiny. In this review, we summarize the evidence that MS is caused by Epstein-Barr virus (EBV), which has been a prominent candidate for several decades. Although there is much suggestive evidence that EBV is involved in the pathogenesis of MS, the precise effect of EBV is still unclear.

RECENT FINDINGS: EBV is more common in MS patients than in controls. A history of infectious mononucleosis, and high baseline EBV antibody titers are risk factors for MS. More controversial are findings of changes in the reactivity of the T-cell repertoire, presence of EBV antibodies in the cerebrospinal fluid, and presence of EBV in meningeal lymphoid follicles and perivenular infiltrates in the white matter.

SUMMARY: The contribution of EBV to the cause of MS is not yet established, but a relationship is clearly present.