Epstein-Barr virus (EBV) has been implicated in the pathogenesis of multiple sclerosis (MS). Recent reports proposed an increased
EBV-targeted humoral immune response in MS, which appears to be more pronounced in pediatric patients. However, little is
known about the CNS-derived antibody production against EBV in patients with MS. The objective of this study was to assess
the frequency and intensity of intrathecal antibody production against EBV as compared to other neurotropic viruses in pediatric
and adult onset MS. In cohorts of 43 childhood, 50 adult onset MS patients, 20 children and 12 adults with other CNS disorders,
paired CSF and serum samples were studied. Frequency and intensity of intrathecal antibody production against EBV as compared
to measles, rubella, varicella zoster (VZV) and herpes simplex virus (HSV) were analyzed by determination of virus-specific
CSF-to-serum Antibody Indices (AI). Intrathecally synthesized EBV antibodies were detectable in 26% pediatric and 10% adult
onset MS patients, compared to frequencies ranging in both groups from 10 to 60% for the other viruses. Median AIs for EBV
were lower than those for all other viruses, with more than twofold higher median AI for measles, rubella and VZV. The EBV-targeted
humoral immune response in the CNS is only part of the intrathecal polyspecific antibody production in MS, directed against
various neurotropic viruses. Our results do not rule out the possibility that EBV is involved in the pathogenesis of MS by
triggering diverse cellular immune mechanisms, but they argue against a direct pathogenic role of EBV-targeted humoral immune
response within the CNS.
Keywords Multiple sclerosis - Epstein-Barr virus - Intrathecal immunoglobulin production - Neurotropic viruses - CNS humoral immune response