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      What do animal models tell us about the role of EBV in the pathogenesis of multiple sclerosis?

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          Abstract

          Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS), marked primarily by demyelination, inflammation, and neurodegeneration. While the prevalence and incidence rates of MS are on the rise, the etiology of the disease remains enigmatic. Nevertheless, it is widely acknowledged that MS develops in persons who are both genetically predisposed and exposed to a certain set of environmental factors. One of the most plausible environmental culprits is Epstein-Barr virus (EBV), a common herpesvirus asymptomatically carried by more than 90% of the adult population. How EBV induces MS pathogenesis remains unknown. A comprehensive understanding of the biology of EBV infection and how it contributes to dysfunction of the immune system and CNS, requires an appreciation of the viral dynamics within the host. Here, we aim to outline the different animal models, including nonhuman primates (NHP), rodents, and rabbits, that have been used to elucidate the link between EBV and MS. This review particularly focuses on how the disruption in virus-immune interaction plays a role in viral pathogenesis and promotes neuroinflammation. We also summarize the effects of virus titers, age of animals, and route of inoculation on the neuroinvasiveness and neuropathogenic potential of the virus. Reviewing the rich data generated from these animal models could provide directions for future studies aimed to understand the mechanism(s) by which EBV induces MS pathology and insights for the development of prophylactic and therapeutic interventions that could ameliorate the disease.

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          Multiple Sclerosis

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            Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis

            Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system of unknown etiology. We tested the hypothesis that MS is caused by Epstein-Barr virus (EBV) in a cohort comprising more than 10 million young adults on active duty in the US military, 955 of whom were diagnosed with MS during their period of service. Risk of MS increased 32-fold after infection with EBV but was not increased after infection with other viruses, including the similarly transmitted cytomegalovirus. Serum levels of neurofilament light chain, a biomarker of neuroaxonal degeneration, increased only after EBV seroconversion. These findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS.
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              Multiple sclerosis - a review

              Multiple sclerosis (MS) is the commonest non-traumatic disabling disease to affect young adults. The incidence of MS is increasing worldwide, together with the socioeconomic impact of the disease. The underlying cause of MS and mechanisms behind this increase remain opaque, although complex gene-environment interactions almost certainly play a significant role. The epidemiology of MS indicates that low serum levels of vitamin D, smoking, childhood obesity and infection with the Epstein-Barr virus are likely to play a role in disease development. Changes in diagnostic methods and criteria mean that people with MS can be diagnosed increasingly early in their disease trajectory. Alongside this, treatments for MS have increased exponentially in number, efficacy and risk. There is now the possibility of a diagnosis of 'pre-symptomatic MS' being made; as a result potentially preventive strategies could be studied. In this comprehensive review, MS epidemiology, potential aetiological factors and pathology are discussed, before moving on to clinical aspects of MS diagnosis and management.
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                Author and article information

                Contributors
                Journal
                Front Immunol
                Front Immunol
                Front. Immunol.
                Frontiers in Immunology
                Frontiers Media S.A.
                1664-3224
                17 November 2022
                2022
                : 13
                : 1036155
                Affiliations
                [1] 1 Dept of Neurology, Division of Movement Disorders, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA, United States
                [2] 2 Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates
                [3] 3 Zayed Center for Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates
                Author notes

                Edited by: Klemens Ruprecht, Charité Universitätsmedizin Berlin, Germany

                Reviewed by: Shunbin Ning, East Tennessee State University, United States; Marco Salvetti, Sapienza University of Rome, Italy; Gunnar Houen, Statens Serum Institut (SSI), Denmark; John Lindsey, University of Texas Health Science Center at Houston, United States; Christoph Friedli, Bern University Hospital and University of Bern, Switzerland

                *Correspondence: Gulfaraz Khan, g_khan@ 123456uaeu.ac.ae

                This article was submitted to Multiple Sclerosis and Neuroimmunology, a section of the journal Frontiers in Immunology

                Article
                10.3389/fimmu.2022.1036155
                9712437
                53bc9d0b-9973-44c8-b89c-0c12e095482e
                Copyright © 2022 Hassani and Khan

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 04 September 2022
                : 02 November 2022
                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 99, Pages: 11, Words: 5546
                Categories
                Immunology
                Review

                Immunology
                epstein-barr virus,multiple sclerosis,neuroinflammation,animal models,non-human primates (nhp),rodents,rabbits

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