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The Potential for EBV Vaccines to Prevent Multiple Sclerosis

There is increasing evidence suggesting that Epstein-Barr virus infection is a causative factor of multiple sclerosis (MS). Epstein-Barr virus (EBV) is a human herpesvirus, Human Gammaherpesvirus 4. EBV infection shows two peaks: firstly, during early childhood and, secondly during the teenage years...

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Autores principales: Maple, Peter A., Ascherio, Alberto, Cohen, Jeffrey I., Cutter, Gary, Giovannoni, Gavin, Shannon-Lowe, Claire, Tanasescu, Radu, Gran, Bruno
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9263514/
https://www.ncbi.nlm.nih.gov/pubmed/35812097
http://dx.doi.org/10.3389/fneur.2022.887794
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author Maple, Peter A.
Ascherio, Alberto
Cohen, Jeffrey I.
Cutter, Gary
Giovannoni, Gavin
Shannon-Lowe, Claire
Tanasescu, Radu
Gran, Bruno
author_facet Maple, Peter A.
Ascherio, Alberto
Cohen, Jeffrey I.
Cutter, Gary
Giovannoni, Gavin
Shannon-Lowe, Claire
Tanasescu, Radu
Gran, Bruno
author_sort Maple, Peter A.
collection PubMed
description There is increasing evidence suggesting that Epstein-Barr virus infection is a causative factor of multiple sclerosis (MS). Epstein-Barr virus (EBV) is a human herpesvirus, Human Gammaherpesvirus 4. EBV infection shows two peaks: firstly, during early childhood and, secondly during the teenage years. Approximately, 90–95% of adults have been infected with EBV and for many this will have been a subclinical event. EBV infection can be associated with significant morbidity and mortality; for example, primary infection in older children or adults is the leading cause of infectious mononucleosis (IM). A disrupted immune response either iatrogenically induced or through genetic defects can result in lymphoproliferative disease. Finally, EBV is oncogenic and is associated with several malignancies. For these reasons, vaccination to prevent the damaging aspects of EBV infection is an attractive intervention. No EBV vaccines have been licensed and the prophylactic vaccine furthest along in clinical trials contains the major virus glycoprotein gp350. In a phase 2 study, the vaccine reduced the rate of IM by 78% but did not prevent EBV infection. An EBV vaccine to prevent IM in adolescence or young adulthood is the most likely population-based vaccine strategy to be tested and adopted. National registry studies will need to be done to track the incidence of MS in EBV-vaccinated and unvaccinated people to see an effect of the vaccine on MS. Assessment of vaccine efficacy with MS being a delayed consequence of EBV infection with the average age of onset being approximately 30 years of age represents multiple challenges.
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spelling pubmed-92635142022-07-09 The Potential for EBV Vaccines to Prevent Multiple Sclerosis Maple, Peter A. Ascherio, Alberto Cohen, Jeffrey I. Cutter, Gary Giovannoni, Gavin Shannon-Lowe, Claire Tanasescu, Radu Gran, Bruno Front Neurol Neurology There is increasing evidence suggesting that Epstein-Barr virus infection is a causative factor of multiple sclerosis (MS). Epstein-Barr virus (EBV) is a human herpesvirus, Human Gammaherpesvirus 4. EBV infection shows two peaks: firstly, during early childhood and, secondly during the teenage years. Approximately, 90–95% of adults have been infected with EBV and for many this will have been a subclinical event. EBV infection can be associated with significant morbidity and mortality; for example, primary infection in older children or adults is the leading cause of infectious mononucleosis (IM). A disrupted immune response either iatrogenically induced or through genetic defects can result in lymphoproliferative disease. Finally, EBV is oncogenic and is associated with several malignancies. For these reasons, vaccination to prevent the damaging aspects of EBV infection is an attractive intervention. No EBV vaccines have been licensed and the prophylactic vaccine furthest along in clinical trials contains the major virus glycoprotein gp350. In a phase 2 study, the vaccine reduced the rate of IM by 78% but did not prevent EBV infection. An EBV vaccine to prevent IM in adolescence or young adulthood is the most likely population-based vaccine strategy to be tested and adopted. National registry studies will need to be done to track the incidence of MS in EBV-vaccinated and unvaccinated people to see an effect of the vaccine on MS. Assessment of vaccine efficacy with MS being a delayed consequence of EBV infection with the average age of onset being approximately 30 years of age represents multiple challenges. Frontiers Media S.A. 2022-06-24 /pmc/articles/PMC9263514/ /pubmed/35812097 http://dx.doi.org/10.3389/fneur.2022.887794 Text en Copyright © 2022 Maple, Ascherio, Cohen, Cutter, Giovannoni, Shannon-Lowe, Tanasescu and Gran. https://creativecommons.org/licenses/by/4.0/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.
spellingShingle Neurology
Maple, Peter A.
Ascherio, Alberto
Cohen, Jeffrey I.
Cutter, Gary
Giovannoni, Gavin
Shannon-Lowe, Claire
Tanasescu, Radu
Gran, Bruno
The Potential for EBV Vaccines to Prevent Multiple Sclerosis
title The Potential for EBV Vaccines to Prevent Multiple Sclerosis
title_full The Potential for EBV Vaccines to Prevent Multiple Sclerosis
title_fullStr The Potential for EBV Vaccines to Prevent Multiple Sclerosis
title_full_unstemmed The Potential for EBV Vaccines to Prevent Multiple Sclerosis
title_short The Potential for EBV Vaccines to Prevent Multiple Sclerosis
title_sort potential for ebv vaccines to prevent multiple sclerosis
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9263514/
https://www.ncbi.nlm.nih.gov/pubmed/35812097
http://dx.doi.org/10.3389/fneur.2022.887794
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