The essential role of Epstein-Barr virus in the pathogenesis of multiple sclerosis.

The essential role of Epstein-Barr virus in the pathogenesis of multiple sclerosis.
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爱泼斯坦 - 巴尔病毒在多发性硬化症的发病机理中的重要作用。

DOI:
10.1177/1073858410381531
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发表时间:
2011-08
期刊:
The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry
影响因子:
--
通讯作者:
Pender MP
Pender MP
中科院分区:
其他
文献类型:
--
作者:
Pender MP

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越来越多的证据表明,EB 病毒 (EBV) 感染在多发性硬化症 (MS)(一种中枢神经系统慢性炎症性脱髓鞘疾病)的发展中发挥作用。本文提供了一个四层假设,提出 (1) EBV 感染对于 MS 的发展至关重要; (2) EBV 通过感染自身反应性 B 细胞在遗传易感个体中引起多发性硬化症,这些细胞在中枢神经系统中产生致病性自身抗体,并向自身反应性 T 细胞提供共刺激生存信号,否则这些细胞会在中枢神经系统中因细胞凋亡而死亡; (3) EBV 感染后发生 MS 的易感性取决于基因决定的细胞毒性 CD8+ T 细胞的数量缺乏,而细胞毒性 CD8+ T 细胞通常使 EBV 感染处于严格控制之下; (4) 阳光和维生素 D 通过增加可用于控制 EBV 感染的 CD8+ T 细胞数量来预防多发性硬化症。该假设做出了可以检验的预测,包括通过控制 EBV 感染来预防和成功治疗多发性硬化症。
There is increasing evidence that infection with the Epstein-Barr virus (EBV) plays a role in the development of multiple sclerosis (MS), a chronic inflammatory demyelinating disease of the CNS. This article provides a four-tier hypothesis proposing (1) EBV infection is essential for the development of MS; (2) EBV causes MS in genetically susceptible individuals by infecting autoreactive B cells, which seed the CNS where they produce pathogenic autoantibodies and provide costimulatory survival signals to autoreactive T cells that would otherwise die in the CNS by apoptosis; (3) the susceptibility to develop MS after EBV infection is dependent on a genetically determined quantitative deficiency of the cytotoxic CD8+ T cells that normally keep EBV infection under tight control; and (4) sunlight and vitamin D protect against MS by increasing the number of CD8+ T cells available to control EBV infection. The hypothesis makes predictions that can be tested, including the prevention and successful treatment of MS by controlling EBV infection.
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