Epstein-Barr virus flare: A multiple sclerosis attack.

Surgical neurology international Pub Date : 2024-10-04 eCollection Date: 2024-01-01 DOI:10.25259/SNI_457_2024
Ali Naser Msheik, Zeinab Al Mokdad, Faten Hamed, Farah Assi, Ali Jibbawi, Jean-Pierre Saad, Rami Mohanna, Anthony Khoury, Mhamad Farhat, Rami Atat
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Abstract

Background: Multiple sclerosis (MS)-Epstein-Barr virus (EBV) relation is similar to doing a complicated puzzle: it consists of many pieces that become more and more clear as the issue is viewed from different sides. Based on the research findings, there is powerful evidence that EBV and MS have a strong relation where high levels of EBV DNA are able to be shown in all the spinal cord and the blood of the MS patients, but these are shown during disease relapses, and this implies a role in these illnesses. It kind of narrows the choices that you have to look for, just like how gathering evidence can lead to finding the missing person. In the analysis, new ways of EBV participation in MS progression are expected to be installed, and even new therapeutics are expected to be made.

Methods: A comprehensive literature search of PubMed was conducted until November 2023 to identify studies investigating the association between Epstein-Barr virus (EBV) infection and multiple sclerosis (MS). Only articles that met stringent criteria, including validation of EBV infection through laboratory testing, were included in the analysis.

Results: A total of 16 articles were identified as applicable for the background review, and this conformed with the discovery that the initiation of EBV/IM was consistent across various studies, namely, retrospective, cross-sectional, or prospective. The statistics reveal a glimpse into the need for prolonged research in studying the pattern of this link between EBV and MS. Novel treatment approaches targeting EBV, including adoptive T-cell therapy and gene-based immunotherapy, show promise in mitigating MS progression by targeting EBV-infected cells.

Conclusion: Clinical trials investigating antiviral therapies and vaccination strategies are underway, aiming to translate these findings into effective treatments for MS. Despite promising advances, challenges remain in developing EBV-targeted therapies for MS, including safety concerns and the multifactorial nature of MS pathogenesis. Advance treatment options that focus on EBV, such as adoptive T-cell therapy and gene-based immunotherapy, are shown to be effective in the improvement of MS management that targets the viral-infected cell. The clinical trials for antiviral drugs and vaccination tactics are going on to benefit from these findings and eventually to invent effective therapeutics for MS. While these new therapeutic directions may offer great promise, challenges remain in these approaches as safety concerns and complex factors that underlie MS pathology need to be taken care of. The ethical aspects linked to picking the patients and giving informed consent make the progress of EBV-related treatments are even more difficult. Future research is recommended so that the primary mechanisms through which EBV contributes to MS development will be elucidated; in addition, the main MS subtype sources must be addressed. Longitudinal studies and other advanced research technologies will provide hope because they can solve the complicated problems of MS due to viruses and look for new therapeutic targets. The review brings up EBV/IM disease as a vital aspect of MS susceptibility, encouraging research in the field of longitudinal studies. Although we have made advances, we are still far from clear on the labyrinthine pairing between EBV and MS and the development of therapeutic strategies to attack EBV infection in MS patients.

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Epstein-Barr 病毒发作:多发性硬化症发作
背景:多发性硬化症(MS)与天疱疮病毒(EBV)的关系就像做一个复杂的拼图:它由许多部分组成,随着从不同角度看问题,这些部分会变得越来越清晰。根据研究结果,有强有力的证据表明 EBV 与多发性硬化症有着密切的关系,在所有多发性硬化症患者的脊髓和血液中都能发现高水平的 EBV DNA,但这些都是在疾病复发时出现的,这意味着 EBV 在这些疾病中扮演着重要的角色。这就缩小了你必须寻找的范围,就像收集证据可以找到失踪者一样。在分析中,有望找到 EBV 参与多发性硬化症进展的新途径,甚至有望开发出新的疗法:截至 2023 年 11 月,我们在 PubMed 上进行了全面的文献检索,以确定调查 Epstein-Barr 病毒(EBV)感染与多发性硬化症(MS)之间关联的研究。只有符合严格标准(包括通过实验室检测验证 EBV 感染)的文章才被纳入分析:结果:共有 16 篇文章被确定为适用于背景综述,这与各种研究(即回顾性研究、横断面研究或前瞻性研究)发现的 EBV/IM 的起始时间一致。从这些统计数字中可以窥见,在研究 EBV 与多发性硬化症之间的这种联系模式时,需要进行长期的研究。针对EB病毒的新型治疗方法,包括采用性T细胞疗法和基于基因的免疫疗法,有望通过靶向EB病毒感染细胞缓解多发性硬化症的进展:结论:研究抗病毒疗法和疫苗接种策略的临床试验正在进行中,旨在将这些发现转化为治疗多发性硬化症的有效方法。尽管取得了令人鼓舞的进展,但开发多发性硬化症的 EBV 靶向疗法仍面临挑战,包括安全性问题和多发性硬化症发病机制的多因素性质。针对EBV的先进治疗方案,如采用性T细胞疗法和基因免疫疗法,在改善针对病毒感染细胞的多发性硬化症治疗方面已显示出效果。抗病毒药物和疫苗接种策略的临床试验正在进行中,以便从这些发现中获益,最终发明出治疗多发性硬化症的有效疗法。虽然这些新的治疗方向可能会带来巨大的希望,但这些方法仍面临挑战,因为需要考虑安全性问题和多发性硬化症病理的复杂因素。与挑选患者和知情同意相关的伦理问题使 EBV 相关治疗的进展更加困难。建议今后开展研究,以阐明 EBV 促成多发性硬化症发展的主要机制;此外,还必须研究多发性硬化症的主要亚型来源。纵向研究和其他先进的研究技术将带来希望,因为它们可以解决病毒导致的多发性硬化症的复杂问题,并寻找新的治疗靶点。综述将 EBV/IM 疾病作为多发性硬化症易感性的一个重要方面,鼓励在纵向研究领域开展研究。尽管我们已经取得了进展,但对于 EBV 与多发性硬化症之间如迷宫般的配对关系,以及开发治疗策略以攻克多发性硬化症患者的 EBV 感染,我们还远远没有搞清楚。
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