FRIDAY, Nov. 14, 2025 (HealthDay News) — One of humanity’s most common viruses is behind the autoimmune disease known as lupus, according to new research.
Epstein-Barr virus (EBV) resides quietly in the bodies of 19 out of 20 Americans and most often causes mononucleosis in teenagers and young adults, researchers said.
But the virus can cause abnormalities in a small number of immune cells, setting off a cascade that leads to widespread lupus attacks on patients’ skin, joints and internal organs, researchers reported Nov. 12 in Science Translational Medicine.
“This is the most surprising discovery to come out of my lab in my entire career,” lead researcher Dr. William Robinson, professor of immunology and rheumatology at Stanford School of Medicine in California, said in a news release. “We believe that is the case in 100% of lupus cases.”
According to the Lupus Foundation of America, approximately 1.5 million Americans suffer from lupus. Lupus causes the immune system to start attacking a person’s cells, causing damage throughout the body.
For reasons unknown, researchers noted that 9 out of 10 people with lupus are women.
Researchers say most people, once they reach adulthood, can become infected with the Epstein-Barr virus by sharing a spoon, drinking from the same glass or exchanging kisses.
“Pretty much the only way not to get EBV is to live in a bubble,” Robinson said. If you lead a normal life, your chances of contracting the disease are approximately 20 to 1.
Once a person has EBV, the virus takes up residence in infected cells and remains latent for the rest of a person’s life, researchers say.
One type of cell that EBV colonizes is immune cells known as B cells. In response to infection, B cells produce antibodies that encourage other immune cells to attack and kill invading viruses and bacteria.
Using a highly accurate genetic sequencing system, the research team discovered that this is a rare event. Less than 1 in 10,000 B cells in EBV-infected but otherwise healthy patients have inactive EBV.
However, the levels of EBV-infected B cells in lupus patients are 25 times higher, affecting 1 in 400 people.
Researchers say the latent virus forces dormant B cells to produce a viral protein called EBNA2. This protein acts as a switch that activates a series of genes in B cells, including genes that cause inflammation.
The end result, the researchers said, is that B cells become highly inflamed and begin to trigger other types of immune cells to attack healthy cells.
Professor Robinson suspects this linkage could extend beyond lupus to other autoimmune diseases that have been previously associated with Epstein-Barr virus, such as multiple sclerosis, rheumatoid arthritis and Crohn’s disease.
But one question remains unanswered. If almost everyone has latent EBV in some of their B cells, why do only some people develop lupus?
Robinson speculates that certain EBV strains may be more likely to cause infected B cells to go wild, starting a cascade that ends in lupus.
The findings could lead to treatments for lupus, the researchers said.
One approach being studied involves removing all of a person’s circulating B cells, a process called ultra-deep B cell depletion. Over the next few months, the person’s bone marrow is replaced by new EBV-free B cells.
Detailed information
The Cleveland Clinic has more information about the Epstein-Barr virus.
Source: Stanford Medicine, press release, November 12, 2025
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