An Epstein-Barr Virus Primer for MS Patients
You may have heard about the research that’s just been published about the Epstein-Barr virus (EBV) and multiple sclerosis (MS). The Harvard T.H. Chan School of Public Health study reports that being infected by EBV raises the risk of developing MS by 32 times. This isn’t a small or a short study. The researchers looked at 20 years of data covering more than 10 million U.S. military members.
“This is a big step because it suggests that most MS cases could be prevented by stopping EBV infection, and that targeting EBV could lead to the discovery of a cure for MS,” the study’s senior author, Alberto Ascherio, MD, said.
Needless to say, the news has generated a good deal of discussion on MS News Today‘s Facebook page. That discussion has revealed that not everyone with MS knows what EBV is and why studying it is important to people with MS. So, following is a little EBV primer I’ve put together.
You probably have EBV
EBV is carried by about 90% of the world’s population. Many people are infected with it in childhood but frequently show no symptoms. So, there’s a good chance that you may be carrying this virus and not know it.
If symptoms do appear, they often show up as fatigue, fever, a bad sore throat, and swollen lymph nodes. If that sounds to you like mononucleosis, you’re right. Though EBV can be responsible for other illnesses, mono is the most common. The virus affects the central nervous system, and some of those other illnesses include optic neuritis (swelling of the eye nerve), transverse myelitis (swelling of the spinal cord), and Guillain-Barré syndrome (an immune system disease). See where I’m heading with this?
EBV and MS
Several studies over the past few years have suggested an EBV-MS connection, and that link might be in memory B-cells. When EBV is in the body in its dormant form, it situates itself inside those B-cells. Some of our disease-modifying therapies are designed to target B-cells, reducing their numbers or preventing them from traveling into the central nervous system.
So …
It seems logical to me, as a nonscientist, that if a vaccine could be developed to protect someone against EBV, it might also protect against multiple sclerosis. Some scientists agree.
The researchers in the Harvard study wrote: “The extremely low MS risk in EBV-negative individuals suggests that, by far, most MS cases are caused by EBV and could thus potentially be prevented by a suitable vaccine.”
EBV vaccine in the works
Moderna, the company that produces one of the mRNA-based COVID-19 vaccines, has started a clinical trial for a possible EBV vaccine, using the same mRNA technology. Researchers hope to enroll about 270 participants across 15 sites in the U.S.
I hope that MS researchers will put their heads together with their EBV-researching colleagues on the development of such a vaccine, and that MS advocacy organizations will fund researchers traveling this road. I think it will move us closer to an MS cure.
You’re invited to visit my personal website at www.themswire.com.
Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.
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Comments
Ruth Hoham
I’m glad to hear about this news, although I assume a vaccine will not be retroactive, offering little assistance to we EBV-carrying MSers!!!
Ed Tobias
Hi Ruth,
You're right. Vaccines prevent illness but they don't cure it. Keep an eye on remyelination research, however. That could hold the key to reversing our symptoms.
Ed
MRS RITA WHITE
Very interesting research on connection between EBV and MS.
I have a theory, that could it be that a patient who gets diagnose with MS, has low vitamin D level and that triggers the activation of EBV.
My daughter was quite unwell, for couple of weeks in 2015, then developed Optic Neuritis. MRI and spinal fluid showed signs of MS. Her vitamin D level was 17 nmol which was extremely low.
Every Neurologist should do Vitamin D levels when a person is diagnosed with MS. I have followed Dr Boster's advice and increased her vitamin D levels.
Agnes. Louise Malm
My best friend has M S. I SO WISH THAT A CURE WILL BE FORTHCOMING SOON, thank you for this interesting article. God bless Ed Tobias and his team workers whoever they may be!
Ed Tobias
Agnes, Thanks so much from all of us at MS News Today. I'm glad you thought my column was interesting and we all hope your best friend will do well.
Ed
Beatriz
I don't know if I understand correctly but this discover is to prevent de MS and not to cure those who all ready have MS. Please could help me ?
Ed Tobias
Hi Beatriz,
Researchers think the Epstein-Barr virus may play a major role in the development of MS in someone's body. They also hope that they can develop a vaccine that will prevent the Epstein-Barr virus. If they can develop this vaccine it might also prevent someone from becoming ill with MS. Unfortunately, it probably wouldn't help people who already have MS.
Ed
Barbara Bearden
I have had MS since 1979 and have known that it was caused by the mono that I had in 1959. I never was the same after that. At a MS support meeting about 25 years later we were talking about mono and how almost all of us had it as teenagers. We wondered why the researchers did not talk to people with MS and find out what diseases they had that might be similar. Also the majority of us had pernicious anemia. It is probably to late for me but I really would like to see this horrible disease cured.
Ed Tobias
Hi Barbara,
Thanks for your comments. The research, to this point, isn't saying that mono causes MS. Rather, research is showing that the virus that causes mono, Epstein-Barr, is likely a major factor in the development of MS in the body. You make a great point, however, about needing to dive deeper into the health backgrounds of people with Ms. Thankfully, that's what this Harvard study did and hopefully it will lead to our ability to prevent MS.
Ed
Mary Clark
My hope is that an EB vaccine will help reduce the MS risk for children and siblings of MS patients who do not have EB antibodies yet. I assume drug companies will start developing a monoclonal antibody treatment that will target just the EB components of B cells rather than B cells in their entirety which would be safer. Anti-viral(s) drugs similar to the way HIV drugs work could potentially put MS into remission. Although not a cure, these types of new treatments might be a game changer.
George ten Bosch
Hi Ed,
Your 'MS Today' is never missed! Thanks.
In view of the fact that currently all focus in MS medication-land is on symptomatic treatment, there is a need for causal treatment without further delay. MS, and in particular progressive MS, is an unmet medical need, as almost all patients with MS eventually progress to more serious disabilities.
With regard to your statement "Vaccines prevent illness but they don't cure it", there may be some exceptions. For instance, HPV-positive cervix uteri may turn HPV-negative after HPV-antigen vaccination.
So, there is hope.
Ed,
Thanks for this forum!
Sarah Shapiro
They can perhaps find ways to dampen the immune reaction to myelin that is mistaken for EBV. There is something else there though. Most of the population has antibodies to EBV but only a small proportion get MS. There are one or more variables that influence this process. A vaccine that prevents EBV may very well prevent ms since without the EBV the other variables may not matter. It will be harder to come up with a cure for this same reason. But there is already research and trials in this idea of taming EBV in progressive disease, so at least it is something to hope for as well as the eradication of new cases of MS.
Ed Tobias
Hi Sarah,
All of your info is right on the mark. Thanks for taking the time to comment.
Ed
Ed Tobias
Hi Sarah,
I'm sorry for my delayed response. I think your thoughts are right on track. It seems as if EBV is just one part of the MS equation, but it appears to be a major one. So, research into an EBV vaccine is very encouraging to me. Let's hope for quick progress.
Ed
Emily Gibson
A vaccine might not help those of us with MS already, but what about targeting removal of EBV from our systems? I think it is the activation of the latent virus that causes problems. Like when I had a bout of Shingles, and then MS relapses. I think the Shingles, and my immune response to that, activated the EBV. Or with chronic inflammation from food intolerances like gluten or dairy, does that serve to activate the EBV? Can we remove the virus from our system? And why does Vit D help? I am talking the mega-doses under Dr. supervision, with the Coimbra Protocol. What is Vit D's role in fighting EBV? So many questions. :)
Ed Tobias
Hi Emily,
Those are all good points but I don't have the answer to your questions. Prevention and treatment are both necessary, just as they are for other illnesses. I'm glad that some researchers are trying to prevent EBV and, hopefully, others are working on treating that virus.
Ed
Dennis G Kleid, Ph.D.
It seems to me that a vaccine that will prevent the Epstein-Barr virus (EBV) thus mononucleosis, makes good sense for children and the pharmaceutical businesses. As we know the virus infection can be quite debilitating for many children, but not all. The virus spreads through the body and productively infects various cells types. In some cell types, the virus infection reaches the cell nucleus and EBV sequences insert into the DNA. What kind of cell has EBV integration, whether or not those very cells replicate over time, and most importantly where within the chromosomal DNA or mitochondrial DNA the EBV integrates makes a difference in its latent ability to cause an illness, including MS or another disease thus far unidentified
Ed Tobias
All good points, Dennis. Thanks for sharing them.
Ed