Epstein-Barr virus and multiple sclerosis: A mechanism comes into focus, 2026, J W Lindsey

[Mij]

Highlights
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EBV infection is necessary to develop MS.
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EBV infected cells can enter the CNS.
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EBV specific cytotoxic T cells are abundant in the CSF and are likely pathogenic.
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Depletion and reconstitution of the immune repertoire can halt MS, but EBV infection and EBV reactive T cells remain.
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We propose that MS is caused by cytotoxic CD8 T cells that are activated by EBV antigens but also recognize CNS antigens.

Abstract
Infection with Epstein-Barr virus (EBV) is associated with multiple sclerosis (MS) but the role that the virus plays in MS is not clear. Recent publications, new findings presented at the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis, and findings from my research now suggest a pathogenic mechanism. I will review the relevant results and combine them into a suggested mechanism.
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[Jonathan Edwards]

The problem for me with this sort of model (which is decades old in one form or another) is that it does not appear to provide any explanation for the focal relapsing nature of muost MS. If there are pathogenic CD8 T cells around, why don't they go around damaging the whole brain all the time?

And why doesn't CAMPATH cure MS since it can produce profound long term T cell depletion?