
EBV reactivation in the peripheral immune system heralds MS relapse
A time-resolved study of relapsing–remitting MS patients identifies reproducible immune changes in monocytes and CD11c+ atypical B cells up to three months before relapse, enriched for genes responsive to Epstein–Barr virus (EBV) lytic reactivation. Elevated EBV LMP-1 transcripts in pre-relapse B cells and expansion of gp350-expressing atypical B cells were observed, with pre-relapse transcriptional modules overlapping MS risk loci and EBNA-2–bound enhancers. The findings suggest EBV reactivation in a genetically susceptible peripheral immune environment may be a proximal precursor to relapse, though causality remains unestablished and the link to central nervous system lesion formation needs further study.













