New evidence for a link between Epstein-Barr virus and multiple sclerosis
By Roberta Attanasio
For years, Epstein-Barr virus has been a prime suspect in the effort to identify the cause of multiple sclerosis, a progressive neurodegenerative disease that affects nearly 1 million people in the United States and an estimated 2.8 million people worldwide. A recently published study shows that, indeed, Epstein-Barr virus is the likely cause of multiple sclerosis—an inflammatory disease of the central nervous system. In people with multiple sclerosis, the immune system attacks the myelin sheaths protecting neurons in the brain and spinal cord, disrupting communication within the brain, and between the brain and body. The interruption of communication signals causes unpredictable symptoms such as numbness, tingling, mood changes, memory problems, pain, fatigue, blindness and/or paralysis.
Epstein-Barr virus (or EBV for short), is the common cause of infectious mononucleosis, also known as “mono.” Following infection, EBV is not eliminated but becomes latent (inactive) in the body throughout the life of the infected individual. In some cases, the virus may reactivate. Alberto Ascherio, senior author of the study, said that the hypothesis of causality between EBV and multiple sclerosis has been investigated by their group and others for several years, but this is the first time that research results provide compelling evidence for it. Causality implies that some individuals who developed multiple sclerosis after EBV infection would not have developed the disease if they had not been infected with EBV. He also said that the new study is a big step because it suggests that most multiple sclerosis cases could be prevented by stopping EBV infection, and that targeting EBV could lead to the discovery of a cure for multiple sclerosis.
For the study, published in the journal Science (January 2022), the researchers analyzed serum samples collected biennially—over a period of two decades—from more than 10 million young adults on active duty in the U.S. military. They identified 955 individuals who were diagnosed with multiple sclerosis. Then, they examined the relationship between EBV infection and the onset of multiple sclerosis during the time of active duty. The researcher found that the risk of multiple sclerosis increased 32-fold after infection with EBV but was unchanged after infection with other viruses, as for example cytomegalovirus. Furthermore, serum levels of neurofilament light chain, a protein that serves as biomarker for nerve degeneration typical of multiple sclerosis, increased only after EBV infection. All together, these findings strongly suggest that EBV is the leading cause of multiple sclerosis.
However, nearly everyone is infected with EBV—95 percent of adults carry it—but only a small fraction of infected individuals develops multiple sclerosis. Thus, other factors, such as genetic susceptibility, may contribute to the development of the disease.
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4 Comments
Yogeeta Frank
Article Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625064/
It is interesting that the Epstein-Barr virus (EBV) is the likely suspect of multiple sclerosis since so many people contract EBV, but most people do not contract multiple sclerosis. Millions of people around the world are affected by Epstein-Barr because it is easily contracted by bodily fluids like saliva. Since large groups of people contract EBV only a small amount of people develop MS. This article states that multiple sclerosis increases infection with EBV but was unchanged after infection with other viruses. Thus, this article made me question if EBV can expose any genetic openings for MS to infect its host.
In this research article, I found discuss whether there is a genetic vulnerability that EBV exposes. The authors discuss the interaction between EBV infection and HLA-DR15 could be the opening for MS to initiate its pathology. The researchers studied immune-deficient mice infected by EBV. The finding suggests that the infection leads to a reduction of EBV-specific immune control by activating an increased T cell immune response. However, researchers were unable to conclude a definitive genetic vulnerability.
In the end, I believe finding the genetic weakness can display the cause of multiple sclerosis and provide a solution to cure multiple sclerosis or even the Epstein-Barr virus. I hope by looking closer into the genetic vulnerability of the immune system can provide an answer to this mystery.
Travis Patrick
In your post, you mention that EBV remains inactive in the body even after infection. I had a question about if there were any microbes associated with multiple sclerosis that can reactivate EBV in the body? I know that microbes play a critical role in regulating the immune system and that certain bacteria may be harmless in the body. Still, they can suddenly become pathogenic when they interact with other microbes.
You mentioned in your post that only a small percentage of the infected people with EBV develop multiple sclerosis. An article by Joana R. Lerias highlights that EBV is only very infectious to a small percentage of people who get it and that reasoning for this may be due to genetic variations of the EBV strain. There might be microbes associated with these strains of EBV that cause existing microbes in the brain to become pathogenic, resulting in a dysbiosis of the brain microbiome, thus causing multiple sclerosis. I am also curious about the effects EBV has on T-cells in the body and whether EBV can slow or delay T-cell responses in the body. If EBV can slow or delay T-cell responses, these responses can also be why many individuals who get EBV develop multiple sclerosis.
Reference: https://pubmed.ncbi.nlm.nih.gov/32039196/
Kristen Bharadwaj
If prevention of the Epstein-Barr Virus can decrease the cases of multiple sclerosis, how can we prevent the virus? A study by Jeffrey Cohen in 2018 focused on developing an Epstein-Barr Virus (EBV) vaccine to prevent infectious mononucleosis. Monomeric EBV gp350 was used to determine if the infection rates decreased as a trial, and concluded that multimeric forms, viruslike particles, and nanoparticles might be more effective methods in order to decrease infection rates. Creating a vaccine for EBV would be beneficial not only to prevent development of multiple sclerosis and mononucleosis because the EBV can lead to a wide variety of ailments including anemia , nerve damage, liver failure, and/or interstitial pneumonia according to a study done by the Genetic and Rare Diseases Information Center in 2020. The study done by Cohen also states how an EBV vaccine could prevent Hodgkin lymphoma and Burkitt lymphoma along with mononucleosis and multiple sclerosis. The article in The Global Fool mentions how prevention of Epstein-Barr Virus can prevent multiple sclerosis, but the prevention of EBV would lead to the prevention of many more diseases mentioned in the other articles. The article by Cohen mentions prevention measures such as a vaccine and different types of vaccination or inoculation methods that can be used to prevent EBV, but it also mentions how more clinical trials should be done in order to have a vaccine. Since EBV can lead to the formation of many other diseases, there should be more research done on the possibilities of a vaccine for the virus.
Sources: https://pubmed.ncbi.nlm.nih.gov/29896681/
https://rarediseases.info.nih.gov/diseases/9534/chronic-active-epstein-barr-virus-infection
Kyle Barry
After reading the article, I was surprised to find that Epstein-Barr virus (EBV) was associated with multiple sclerosis because while most adults are infected with the virus, most adults do not have multiple sclerosis. I have heard about other viruses like HPV causing oral and cervical cancers, but I did not expect EBV to be associated with an autoimmune disease because it is so common. This article made me ask how EBV could be involved in multiple sclerosis development.
In a research article I found which helped me better understand my question, the authors investigated if CD8+ T cells were implicated in multiple sclerosis and EBV (CD8+ T cells are cells of our immune system that kill cancer or virally infected cells). The researchers inspected brains donated from progressive multiple sclerosis patients and found elevated counts of CD8+ T cells that were targeted toward EBV and found them stuck to EBV-infected cells. The researchers concluded that EBV is playing a role in the progression of multiple sclerosis by encouraging accumulation of CD8+ T cells specific for EBV in the brain, which leads to inflammation and central nervous system destruction.
Overall, I believe that the finding of CD8+ T cells being involved in multiple sclerosis is a significant step because the true cause of multiple sclerosis is still unknown. Hopefully, future studies can take a closer look at the CD8+ T cell response in multiple sclerosis patients and find out how to control this response if it is ever proven to be a factor in multiple sclerosis disease progression.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880158/