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L’EBV e il paradosso dell’infezione precoce: protezione o rischio?
EBV and the paradox OF early infettino: protection or risk?
Tommasini A.
Aprile 2026 - pagg. 225 -230 | DOI: 10.53126/MEB45225
Abstract
The Epstein-Barr virus (EBV) is one of the most fascinating paradoxes of modern medicine: a nearly ubiquitous pathogen that in most cases causes benign infections, but it may be lethal in individuals with specific genetic vulnerabilities and, in a fraction of apparently healthy subjects, may trigger devastating autoimmune diseases many years later. In recent years, epidemiological studies of extraordinary scope and mechanistic research of great elegance have revolutionised the understanding of how, when and why EBV becomes pathogenic. The article reviews the classical knowledge about infectious mononucleosis and integrates it with the most recent discoveries, which tell a story of timing, genetics and immunological misfortune that culminates in an apparently paradoxical provocation: in the absence of vaccines, might it be better for children to encounter this virus when they are ‘young’ rather than when they are ‘older’?
Riassunto
Il virus di Epstein-Barr (EBV) rappresenta uno dei più affascinanti paradossi della medicina moderna: un patogeno quasi ubiquitario che nella maggior parte dei casi causa infezioni benigne, ma che può essere letale in individui con specifiche vulnerabilità genetiche e, in una frazione di soggetti apparentemente sani, può innescare a distanza di molti anni malattie autoimmuni devastanti. Negli ultimi anni, studi epidemiologici di straordinaria ampiezza e ricerche meccanicistiche di grande eleganza hanno rivoluzionato la nostra comprensione di come, quando e perché l’EBV diventa patogeno. In questo articolo ripercorriamo le conoscenze classiche sulla mononucleosi infettiva e le integriamo con le scoperte più recenti, che ci raccontano una storia di timing, genetica e sfortuna immunologica. Una storia che culmina in una provocazione apparentemente paradossale: in assenza di vaccini, potrebbe essere meglio che i nostri bambini incontrino questo virus "da piccoli" piuttosto che "da grandi"?
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Corrispondenza: alberto.tommasini@burlo.trieste.it