ArticleNeurology(R) neuroimmunology & neuroinflammation2017
Time correlation between mononucleosis and initial symptoms of MS.
Article in Neurology(R) neuroimmunology & neuroinflammation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Repurposing Licensed Drugs with Activity Against Epstein-Barr Virus for Treatment of Multiple Sclerosis: A Systematic Approach.CNS drugs · 2025Pooled it
- Why Is MS a More Frequent Complication of EBV Infection in Females?Immunological reviews · 2026Review
- The CNS Meninges and the Synovial Joint: Parallel Immunological Structures in Autoimmune Disease.BioEssays : news and reviews in molecular, cellular and developmental biology · 2026Review
- Sex-Related Differences in Lifestyle Factors Affecting Multiple Sclerosis Susceptibility and Disease Progression.Brain sciences · 2025Review
- Article
- Sex differences in postacute infection syndromes.Science translational medicine · 2024Article
- Seroreactivity against lytic, latent and possible cross-reactive EBV antigens appears on average 10 years before MS induced preclinical neuroaxonal damage.Journal of neurology, neurosurgery, and psychiatry · 2024Article
- Markers of Epstein-Barr Virus Infection in Patients with Multiple Sclerosis.Microorganisms · 2023Review
- Epstein-Barr virus and multiple sclerosis: moving from questions of association to questions of mechanism.Clinical & translational immunology · 2023Review
- Comprehensive Investigations Relationship Between Viral Infections and Multiple Sclerosis Pathogenesis.Current microbiology · 2022Review
- The immunology of multiple sclerosis.Nature reviews. Immunology · 2022Review
- Altered Immune Response to the Epstein-Barr Virus as a Prerequisite for Multiple Sclerosis.Cells · 2022Review
- Focus on the Role of the NLRP3 Inflammasome in Multiple Sclerosis: Pathogenesis, Diagnosis, and Therapeutics.Frontiers in molecular neuroscience · 2022Review
- Rituximab for the treatment of multiple sclerosis: a review.Journal of neurology · 2022Review
- Epstein-Barr virus, interleukin-10 and multiple sclerosis: A ménage à trois.Frontiers in immunology · 2022Article
- The CD8 T Cell-Epstein-Barr Virus-B Cell Trialogue: A Central Issue in Multiple Sclerosis Pathogenesis.Frontiers in immunology · 2021Review
- Gender and the Sex Hormone Estradiol Affect Multiple Sclerosis Risk Gene Expression in Epstein-Barr Virus-Infected B Cells.Frontiers in immunology · 2021Article
- Epstein-Barr Virus in Multiple Sclerosis: Theory and Emerging Immunotherapies.Trends in molecular medicine · 2020Review
- Hospital diagnosed pneumonia before age 20 years and multiple sclerosis risk.BMJ neurology open · 2020Article
- Epstein-Barr virus and its association with disease - a review of relevance to general practice.BMC family practice · 2019Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the average age of MS onset vs the age at which Epstein-Barr infection has previously occurred and stratify this analysis by sex and the blood level of Epstein-Barr nuclear antigen 1 (EBNA1) antibody.
methodsUsing infectious mononucleosis (IM) as a temporal marker in data from the Swedish epidemiologic investigation of MS, 259 adult IM/MS cases were identified and then augmented to account for "missing" childhood data so that the average age of MS onset could be determined for cases binned by age of IM (as stratified by sex and EBNA1 titer level).
resultsMean age of IM vs mean age of MS reveals a positive time correlation for all IM ages (from ∼5 to ∼30 years), with IM-to-MS delay decreasing with increased age. When bifurcated by sex or EBNA1 blood titer levels, males and high-titer subpopulations show even stronger positive time correlation, while females and low-titer populations show negative time correlation in early childhood (long IM/MS delay). The correlation becomes positive in females beyond puberty.
conclusionsIM/MS time correlation implies causality if IM is time random. Alternative confounding models seem implausible, in light of constraints imposed by time-invariant delay observed here. Childhood infection with Epstein-Barr virus (EBV) in females and/or those genetically prone to low EBNA1 blood titers will develop MS slowly. Males and/or high EBNA1-prone develop MS more rapidly following IM infection at all ages. For all, postpubescent EBV infection is critical for the initiation and rapid development of MS.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.