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J Neurol Neurosurg Psychiatry 2009;80:469 doi:10.1136/jnnp.2008.165217
  • Editorial commentary

Epstein–Barr virus (EBV) and multiple sclerosis association: EBV has a primary or secondary role?

  1. Maria Trojano1,
  2. Carlo Avolio2
  1. 1
    Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
  2. 2
    Department of Medical and Occupational Sciences and Research Centre BIOAGROMED, University of Foggia, Foggia, Italy
  1. Professor Maria Trojano, Department of Neurological and Psychiatric Sciences, University of Bari, Policlinico, Piazza Giulio Cesare, 70124, Bari, Italy; mtrojano{at}neurol.uniba.it
  • Received 2 December 2008
  • Accepted 3 December 2008

Multiple sclerosis (MS) is a complex pathology of the CNS in which genetic and environmental factors, such as viral infections, act together to cause disease. Epstein–Barr virus (EBV) represents one of the leading candidates among the infectious agents for which there is the most relevant evidence for an association with MS. Epidemiological studies have demonstrated a correlation between MS and EBV infection.1 There is a broadened and elevated systemic humoral and cellular immune response to EBV nuclear antigen 1 (EBNA1) in adults2 and in children with MS.3 EBNA1 specific antibodies are not only systemically elevated in MS but also enriched in the CSF.4 Demonstration of the presence of EBV infected B cells in tertiary lymphoid tissues in postmortem brain samples from patients with MS, but not …

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