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Many factors are implicated in the etiology of MS, with the relationship between Epstein-Barr Virus (EBV) infection and the development of MS being the subject of extensive research recently. When the human body experiences a decline in immune function, it may trigger reactivation of EBV, and this reactivation is also believed to increase the risk of onset or relapse of MS. Currently, the phenomenon of cross-reactivity resulting from molecular mimicry following EBV infection (including reactivation status) is theorized as a contributing etiology. EBV-mediated abnormalities in T cells and B cells also play a key role in the development of MS. However, the underlying mechanisms have not been thoroughly understood. Meanwhile, the limited availability of effective treatment options for MS, in particular MS progression, underscores the urgent need for novel therapeutic strategies. Here, we discuss the pathophysiological mechanisms underlying MS, specifically emphasizing the relationship between EBV infection and the disease pathology. Furthermore, we introduced relevant pharmacological targets in order to propose a broader range of therapeutic alternatives for individuals diagnosed with MS.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1799161","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:47:19Z","timestamp":1779338839000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epstein-Barr virus-associated multiple sclerosis: recent mechanistic advances and clinical therapeutic perspectives"],"prefix":"10.3389","volume":"17","author":[{"given":"Ruogu","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Neurology, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanfang Hospital, Southern Medical 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