4.3 Letter

EBV as the 'gluten of MS' hypothesis: Bypassing autoimmunity

Journal

MULTIPLE SCLEROSIS AND RELATED DISORDERS
Volume 66, Issue -, Pages -

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.msard.2022.104069

Keywords

Multiple sclerosis; Celiac disease; Exogenous antigens; Epstein-barr virus; Immunopathogenesis

Funding

  1. Istituto Superiore di Sanita [BFC2]

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The article discusses the hypothesis of EBV as the "gluten of MS" and suggests that EBV may act as the driver of multiple sclerosis without involving autoimmunity.
The EBV as the 'gluten of MS' hypothesis discussed by Drosu et al. in a recent Editorial envisages the existence of similar mechanisms leading to celiac disease and multiple sclerosis, such as induction of immunity against an ubiquitous exogenous antigen - gluten and EBV, respectively - and subsequent development of autoimmunity that is maintained by persistence of the initial trigger. While this hypothesis provides the rationale for treating MS with antivirals to lower EBV load, it can be misleading when trying to translate concepts of T cell-B cell interaction and autoimmunity development in celiac disease to multiple sclerosis. Here, we propose that EBV might act as the driver of multiple sclerosis without involving autoimmunity.

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