Epstein-Barr virus vaccine
The Epstein-Barr virus (EBV) is a member of the herpesvirus family and is commonly spread through saliva exchange. Currently, there is no commercially available vaccine for EBV, despite its widespread prevalence, with estimates suggesting that up to 95% of adults between the ages of 25 and 40 may be infected. Although many infections are asymptomatic, some individuals may develop infectious mononucleosis, characterized by symptoms such as fever, sore throat, and swollen lymph glands, alongside persistent fatigue. Notably, EBV can enter a dormant state in the body, potentially leading to an increased risk of certain cancers, including Burkitt's lymphoma and nasopharyngeal carcinoma, later in life.
Research into an EBV vaccine is ongoing, with glycoprotein 350 (gp350) identified as a promising target. This glycoprotein plays a critical role in the virus's ability to enter human cells and elicits a significant immune response. Current studies are also exploring treatments related to EBV for various cancers and conditions associated with the virus. The development of a vaccine is deemed crucial given EBV's high infection rates and its potential long-term health implications.
Epstein-Barr virus vaccine
Definition
No commercially available vaccine exists for the Epstein-Barr virus (EBV), a common virus that is spread through the exchange of saliva. EBV is a member of the herpes family of viruses. Other notable herpesviruses include herpes simplex-1, herpes simplex-2, varicella zoster virus, and cytomegalovirus.
EBV can cause infectious mononucleosis, although most infections are asymptomatic, with fewer than one-half of infected persons developing the disease. Mononucleosis initially manifests with general symptoms that may include fever, sore throat, and swollen lymph glands. Fatigue is a common sequela and can persist for months. Regardless of the presence or absence of an initial infection, EBV remains in the host in a dormant state in some immune cells.
Research suggests that although rare, persons infected with EBV have an increased likelihood of developing Epstein-Barr-related cancers, including Burkitt’s lymphoma and nasopharyngeal carcinoma, later in life.
Glycoprotein 350
Glycoprotein 350 (gp350) is a promising target for an EBV vaccine and has progressed through phase 1 and 2 studies for use in healthy adults and young adults for the prevention of mononucleosis. GP350 is an envelope glycoprotein that facilitates entry of EBV into human cells through interactions with the CD21 antigen receptors, and it is an important target of the host’s antibody immune response. Additional research has indicated that gp350 may also be a target for antibody-dependent cellular cytotoxicity and cytotoxic T-lymphocyte-mediated cytotoxicity.
Ongoing Research
Ongoing studies are investigating EBV for the treatments of nasopharyngeal cancer and for EBV-positive persons with gastric, head and neck cancer; lymphoma; lymphoproliferative disorder; and nonneoplastic conditions.
Impact
The Centers for Disease Control and Prevention estimates that among adults between the ages of twenty-five and forty years, up to 95 percent may be infected with EBV. When the virus infects hosts at a younger age (childhood through adolescence), infected persons are more apt to develop mononucleosis. Clinical presentation may include nonspecific symptoms such as fever, sore throat, and cervical lymphadenopathy. The resulting illness can leave the infected person feeling fatigued and generally unwell for up to four months or longer. The need to develop an EBV vaccine is evident because of the high rate of EBV infection in the general population and because of the increased likelihood of developing certain EBV-associated cancers later in life.
Bibliography
“About Epstein-Barr Virus (EBV).” Centers for Disease Control and Prevention (CDC), 9 May 2024, www.cdc.gov/epstein-barr/about/index.html. Accessed 3 Feb. 2025.
Cohen, J. I. “Epstein-Barr Virus Infections, Including Infectious Mononucleosis.” In Harrison’s Principles of Internal Medicine, edited by Joan Butterton. 17th ed. New York: McGraw-Hill, 2008.
Moutschen, Michael, et al. “Phase I/II Studies to Evaluate Safety and Immunogenicity of a Recombinant gp350 Epstein-Barr Virus Vaccine in Healthy Adults.” Vaccine 25 (2007): 4697-4705.
Sokal, Etienne, et al. “Recombinant gp350 Vaccine for Infectious Mononucleosis: A Phase 2, Randomized, Double-Blind Placebo-Controlled Trial to Evaluate the Safety, Immunogenicity, and Efficacy of an Epstein-Barr Virus Vaccine in Healthy Young Adults.” Journal of Infectious Diseases 196 (2007): 1749-1753.