We are excited to announce a new publication by Dr. Anna Onisiforou, head of our AI and Systems Bioinformatics Unit Cyprus, published in Open Forum Infectious Diseases. This review paper, titled “The Immunosuppression Paradox in Multiple Sclerosis: Are We Fueling the Fire by Suppressing Immunity in an Epstein–Barr Virus–Linked Disease?”, raises a fundamental question about how we treat one of the most common neurological diseases in young adults.

Multiple sclerosis has long been treated as an autoimmune condition, with therapies designed to suppress or modulate the immune system. Yet a growing body of evidence, including a landmark study showing that Epstein–Barr virus (EBV) seroconversion raises MS risk over thirtyfold, points to EBV as a necessary, if not sufficient, trigger for the disease. Dr. Onisiforou’s review asks whether broadly suppressing the immune system may inadvertently compromise the very antiviral surveillance needed to keep latent EBV in check, potentially worsening the underlying disease process rather than addressing it.

The paper systematically examines how current MS therapies interact with EBV biology, showing that not all treatments carry equal risk. Therapies such as alemtuzumab, fingolimod, and natalizumab have been linked to EBV reactivation or expansion of the viral reservoir, while B-cell–depleting agents like ocrelizumab and rituximab may actually reduce EBV burden by targeting infected memory B cells, an alignment with the viral model that may help explain their strong clinical efficacy. Looking ahead, the review argues for integrating EBV-targeted strategies into MS management, including adoptive T-cell immunotherapies, therapeutic vaccines, and precision biomarker tools such as the VirTarget framework developed in our lab.

The full article is open access and available at doi.org/10.1093/ofid/ofag097.