Pathogenesis, treatment and prevention of diseases caused by Epstein–Barr virus

Abstract

Studying diseases associated with viruses belonging to the family of Herpesviridae is an important challenge for medical researchers and clinicians because of the specific tropism of herpesviruses for immune cells, life-long persistence in human target cells, the ability to reactivate and the potential to cause a wide variety of clinical manifestations. Unlike other members of Herpesviridae, Epstein–Barr virus (EBV), also known as human herpes 4, displays tropism for B cells and mucosal epithelial cells, has the capacity to cause not only productive infection (infectious mononucleosis), but also establish various types of latency in cells, causes benign and malignant transformation of immune system cells (hemoblastoses) and mucosal epithelial cells (oral cavity cancer and gastric cancer). EBV causes 200 000 deaths worldwide every year, the majority of which are attributable to cancers associated with EBV persistence. Moreover, EBV is associated with a group of autoimmune disorders, such as multiple sclerosis, and secondary immunodeficiencies occurring in patients with infection of immune system cells. Mechanisms of the interaction between EBV and human cells implicated in cancer induction should be a focus of further research in fundamental virology, oncology and medicine as a whole. The interactions between EBV and target cells in mother-fetus-child system appear to be the most complicated. The inevitability of facing the virus and associated long-term consequences is determined by the time and mode of mother-to-child transmission of EBV, the presence of innate immune defense factors, genetics and molecular mechanisms of EBV latency. Recent scientific insights allow us to establish control over the evolution of EBV interactions with its host and to identify promising approaches to the prevention and treatment of previously incurable diseases associated with EBV.