A recent study conducted by Harvard T.H. Chan School of Public Health researchers has found that the Epstein-Barr virus (EBV) may be the leading cause of multiple sclerosis (MS) worldwide. This finding comes as a breakthrough in multiple sclerosis research, as it is the first study to provide “compelling evidence” to support the potential link between the Epstein-Barr virus and multiple sclerosis. Below, we’ll take a closer look at what the Harvard study found, and what this means for future treatments for MS. First, let’s start with what EBV is.
What Is the Epstein-Barr Virus?
EBV is one of the most common types of herpes viruses that affect humans. EBV is so common, in fact, it’s estimated that nearly 95% of adults in the United States have a dormant infection of the virus. While this number means that almost every adult in the U.S. has an EBV infection, many people remain unaware of what EBV is. That’s because it’s is more commonly known as the virus that causes mononucleosis, or mono.
EBV can be incredibly hard to diagnose, as its symptoms will often mirror that of the common cold or flu. That said, more moderate to severe cases of EBV can cause symptoms such as chronic fatigue or brain fog. While rare, EBV can become a chronic condition, known as chronic active Epstein-Barr virus (CAEBV). This condition can cause serious health conditions such as anemia, nerve damage, and liver failure.
Most people become infected with EBV as a child, as the virus is spread primarily through things like sharing drinks or kissing (hence the nickname “kissing virus”). For most people, the dormant infection remains inactive for the rest of their lives. In cases where EBV causes someone to become sick, symptoms will typically arise within four to six weeks and can last for several weeks or months.
To better understand the potential link between the Epstein-Barr virus and multiple sclerosis, let’s next take a look at what MS is.
What Is Multiple Sclerosis?
MS is a potentially disabling disease of the brain and spinal cord (central nervous system) that affects as many as 2.8 million people worldwide. It is an autoimmune disease, which means it actively works against the immune system. In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerves.
Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.
There is currently no cure for MS, and scientists are still unsure as to what causes the disease. However, the discovery that EBV may be the leading cause of MS may have uncovered a potential treatment, and even cure, for the disease. Below is what scientists believe to be the link between the Epstein-Barr virus and multiple sclerosis.
What Is the Link Between Epstein-Barr Virus and Multiple Sclerosis?
The Harvard study, published in the journal Science on January 13, has pointed towards EBV as the potential leading cause of MS worldwide. This discovery comes as a massive breakthrough in MS research, as scientists have been trying to prove a link between the Epstein-Barr virus and multiple sclerosis for years.
“The hypothesis that EBV causes MS has been investigated by our group and others for several years, but this is the first study providing compelling evidence of causality,” said Alberto Ascherio, professor of epidemiology and nutrition at Harvard Chan School and senior author of the study. “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.”
Establishing a concrete relationship between EBV and MS has been difficult because EBV infects approximately 95% of adults, MS is a relatively rare disease, and the onset of MS symptoms begins about 10 years after EBV infection.
Analyzing the Data
To determine the connection between EBV and MS, the researchers conducted a study among more than 10 million young adults on active duty in the U.S. military and identified 955 who were diagnosed with MS during their period of service.
The team analyzed samples taken biennially (every two years) by the military and determined the soldiers’ EBV status at the time of the first sample. They then examined the relationship between EBV infection and MS onset during the period of active duty. What they found was the risk of MS increased 32-fold after infection with EBV but was unchanged after infection with other viruses. Serum levels of neurofilament light chain, a biomarker of the nerve degeneration typical in MS, increased only after EBV infection. The group says their findings cannot be explained by any known risk factor for MS and suggests EBV is the leading cause of MS.
Ascherio says that the delay between EBV infection and the onset of MS may be partially due to the disease’s symptoms being undetected during the earliest stages and partially due to the evolving relationship between EBV and the host’s immune system, which is repeatedly stimulated whenever latent virus reactivates.
But, what does this mean for the future of MS treatment? Can EBV be prevented? And if possible, would that mean that we could prevent the majority of MS cases? Sadly, while understanding the leading cause of MS is a huge breakthrough, there is still a long way to go before there is a real cure.
What Does This Mean for Future Multiple Sclerosis Treatment?
“Currently there is no way to effectively prevent or treat EBV infection, but an EBV vaccine or targeting the virus with EBV-specific antiviral drugs could ultimately prevent or cure MS,” said Ascherio.
Finding a cure to EBV, while yet unknown, remains the best possible way to prevent or cure MS. Currently, that cure is unknown, but that doesn’t mean that scientists from around the world have not been trying. In recent years, there have been several breakthroughs in EBV research, all of which could help uncover a potential vaccine.
In April 2018, the first human antibody that blocks Epstein-Barr Virus was discovered, called AMMO1. This antibody blocks the glycoproteins (a type of protein responsible for most immune system responses) gH and gL. Scientists say that these two glycoproteins are points of vulnerability, and can be used to block infection. It is the most promising discovery to date.
As of November 4, 2021, the pharmaceutical company Moderna was preparing to begin a Phase I clinical trial of mRNA-1189, its mRNA vaccine targeting EBV. The company says their vaccine “encodes five glycoproteins to inhibit both mechanisms for viral entry into B cells (gp350 plus gH/gL/gp42), adds protection for epithelial cells (gH/gL), and includes gB for protection of all cells.” In a nutshell, this means that the viral proteins produced by the vaccine can be recognized by the immune system.
While the link between the Epstein-Barr virus and multiple sclerosis is clear, the road to a cure for MS remains unknown. However, as research continues towards an EBV vaccine, hope may be on the horizon.
Did You Know There Was a Link Between Epstein-Barr Virus and Multiple Sclerosis?
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