In 2022, a study published in Science presented the hitherto strongest evidence that the development of multiple sclerosis (MS) depends on infection with the Epstein–Barr virus (EBV).1 Based on serological analyses of prospective samples from the American Department of Defense Serum Repository (DoDSR), the study demonstrated that among uninfected individuals, subsequent infection with EBV was associated with a 32-fold increased risk of MS.1
Meanwhile infection with other viruses was not associated with MS risk in the study. Also, serum levels of neurofilament light chain, which is a marker of neuroaxonal degeneration, began to increase only after infection with EBV, further strengthening the case against the virus.1
The association between EBV and MS is interesting and important for several reasons. First, it may pave the way for a more detailed understanding of MS pathogenesis (e.g. Vietzen et al.2) and inspire the design of novel treatments.3,4 Second, it implies that MS may one day be preventable, for example, through vaccinations against EBV, encouraging efforts to develop such.