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Multiple Sklerose und Epstein-Barr-Virus

Neue Entwicklungen und Perspektiven

Multiple sclerosis and Epstein-Barr virus

New developments and perspectives

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Zusammenfassung

Zwillings- und Migrationsstudien bei Patienten mit Multipler Sklerose (MS) weisen auf eine Beteiligung von Umweltfaktoren in der Entwicklung der MS hin. Hierbei sprechen zunehmende Evidenzen für eine herausragende Rolle des Epstein-Barr-Virus (EBV) als infektiöser Risikofaktor für die MS. Eine nahezu 100%ige Seroprävalenz von Antikörpern gegen EBV, und bereits Jahre vor klinischer Erstmanifestation nachweisbare erhöhte EBV-Antikörper-Titer bei Patienten mit MS, legen neben einem erhöhtem MS-Risiko nach einer symptomatischen EBV-Primärinfektion (infektiöse Mononukleose) eine Assoziation der MS mit einer vorangegangenen EBV-Infektion nahe. Die genauen Mechanismen, durch die EBV bei der MS beteiligt sein könnte, sind gegenwärtig jedoch unklar. Unterschiedliche aktuell diskutierte potenzielle Mechanismen werden dargestellt. Eine dauerhaft anhaltende (möglicherweise immunologische) Veränderung, die in der Akutphase einer EBV-Primärinfektion entsteht und nachfolgend zu einem anhaltend erhöhten MS-Risiko führt, erscheint mit verschiedenen Aspekten der Assoziation von MS und EBV vereinbar.

Summary

Data from studies of twins and migrants with multiple sclerosis (MS) imply environmental factors in the development of MS. In this respect, increasing evidence indicates that Epstein-Barr virus (EBV) plays a unique role as an infectious risk factor for MS. A nearly 100% seroprevalence of antibodies to EBV in patients with MS, elevated EBV antibody titers years before clinical onset of the disease, and an increased risk for MS after symptomatic primary EBV infection (infectious mononucleosis) suggest an association of MS with a previous infection with EBV. However, the precise mechanisms through which EBV may contribute to MS are still unclear. Currently discussed potential mechanisms are outlined. The notion of a persisting (possibly immunological) change caused during the acute phase of primary EBV infection and subsequently leading to permanently elevated MS risk appears compatible with several aspects of the association found between MS and EBV.

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  1. Institut für Virologie, Haus 47, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland

    K. Ruprecht

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Ruprecht, K. Multiple Sklerose und Epstein-Barr-Virus. Nervenarzt 79, 399–407 (2008). https://doi.org/10.1007/s00115-007-2335-8

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