EBV-driven Gate–License–Amplify circuit in multiple sclerosis pathogenesis

Abstract

Five recent publications establish a “Gate–License–Amplify” circuit that mechanistically links Epstein–Barr virus (EBV) infection and genetic risk (HLA-DR15) to the pathogenesis of multiple sclerosis (MS). 1 , 2 , 3 , 4 , 5 This new model reveals how EBV reprograms immunopeptidomes to trigger CNS autoimmunity, providing a molecular rationale for the efficacy of B-cell depletion and supporting EBV-directed prevention as a realistic goal.