An EBV controversy

A
Epub ahead of printLassmann et al. Epstein-Barr virus in the multiple sclerosis brain: a controversial issue–report on a focused workshop held in the Centre for Brain Research of the Medical University of Vienna, Austria. Brain. 2011 Aug 16. 

Recent epidemiological and immunological studies provide evidence for an association between Epstein-Barr virus (EBV) infection and multiple sclerosis, suggesting a role of EBV infection in disease induction and disease course. 

A key question in this context is whether EBV-infected B lymphocytes (the immune cells that make antibodies) are present within the central nervous system and the lesions of MS’ers. 
Previous studies on this topic provided highly controversial results, showing EBV reactivity in B cells in the vast majority of MS’ers and lesions, or only exceptional EBV-positive B cells in rare cases. 
In an attempt to explain the reasons for these divergent results, a workshop was organized under the umbrella of the European Union FP6 NeuroproMiSe project, the outcome of which is presented. 
This report summarizes the current knowledge of EBV biology and shows that EBV infection is highly complex. There are still major controversies, how to unequivocally identify EBV infection in pathological tissues, particularly in situations other than EBV-driven lymphomas (a type of cancer due to EBV) or acute EBV infections. 
It further highlights that unequivocal proof of EBV infection in MS lesions is still lacking, due to issues related to the sensitivity and specificity of the detection methods.
“And you thought only CCSVI was controversial.”

“This issue is only in relation to whether or not EBV infection has a direct role within the brain and spinal cord of MS’ers.”

“The controversy does not extend to strong epidemiological association between EBV and MS. With regard to the latter the data is unequivocal.”

“I still believe EBV causes MS. What I don’t know is how it does this and where the virus acts. That is the million dollar question.”

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

5 comments

Leave a Reply to Anonymous Cancel reply

  • Hello, in a previous thread you mentioned that in adult MS, EBV is found in 99.9% of cases.

    This struck me as an amazing statistic, then I googled a bit and read that over 95% of the general population also show evidence of EBV infection. Now it seems a bit less amazing…

    Can anyone out there help me understand why this small difference is so significant?

    Also, how well does the EBV theory fit into Bradford-Hill's 9 criteria for causation? Thanks

  • Re: "I still believe EBV causes MS. What I don't know is how it does this and where the virus acts. That is the million dollar question."

    I am intrigued Prof G. You must have theories about the nature of what is perhaps happening with MS vis-à-vis EBV, therefore any chance you can please share with us your thoughts about this topic?

  • Re: "…any chance you can please share with us your thoughts about this topic?"

    Too soon for this. We will keep you posted.

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