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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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.887794/full |
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| author | Peter A. Maple Peter A. Maple Alberto Ascherio Alberto Ascherio Jeffrey I. Cohen Gary Cutter Gavin Giovannoni Claire Shannon-Lowe Radu Tanasescu Radu Tanasescu Bruno Gran Bruno Gran |
| author_facet | Peter A. Maple Peter A. Maple Alberto Ascherio Alberto Ascherio Jeffrey I. Cohen Gary Cutter Gavin Giovannoni Claire Shannon-Lowe Radu Tanasescu Radu Tanasescu Bruno Gran Bruno Gran |
| author_sort | Peter A. Maple |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-12T15:22:11Z |
| format | Article |
| id | doaj.art-6b50fe4423184bb68556c574e5765230 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-12T15:22:11Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-6b50fe4423184bb68556c574e57652302022-12-22T00:20:21ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-06-011310.3389/fneur.2022.887794887794The Potential for EBV Vaccines to Prevent Multiple SclerosisPeter A. Maple0Peter A. Maple1Alberto Ascherio2Alberto Ascherio3Jeffrey I. Cohen4Gary Cutter5Gavin Giovannoni6Claire Shannon-Lowe7Radu Tanasescu8Radu Tanasescu9Bruno Gran10Bruno Gran11Division of Clinical Neuroscience, Section of Clinical Neurology, University of Nottingham, Nottingham, United KingdomDepartment of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, United KingdomDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United StatesChanning Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United StatesLaboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United StatesSchool of Public Health, University of Alabama at Birmingham, Birmingham, AL, United StatesBlizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United KingdomInstitute of Immunology and Immunotherapy, The University of Birmingham, Birmingham, United KingdomDepartment of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, United KingdomMental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, United KingdomDepartment of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, United KingdomMental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, United KingdomThere 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.https://www.frontiersin.org/articles/10.3389/fneur.2022.887794/fullEpstein-Barr virus (EBV)prophylactic vaccinationepidemiological evidencevaccine evaluationmultiple sclerosis |
| spellingShingle | Peter A. Maple Peter A. Maple Alberto Ascherio Alberto Ascherio Jeffrey I. Cohen Gary Cutter Gavin Giovannoni Claire Shannon-Lowe Radu Tanasescu Radu Tanasescu Bruno Gran Bruno Gran The Potential for EBV Vaccines to Prevent Multiple Sclerosis Frontiers in Neurology Epstein-Barr virus (EBV) prophylactic vaccination epidemiological evidence vaccine evaluation 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 | Epstein-Barr virus (EBV) prophylactic vaccination epidemiological evidence vaccine evaluation multiple sclerosis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.887794/full |
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