Research: EBV and Vitamin D

#MSBlog: What is the link between EBV and vitamin D deficiency? Can we square the circle?

Epub: Salzer et al. Epstein-Barr virus antibodies and vitamin D in prospective multiple sclerosis biobank samples. Mult Scler. 2013 Apr.

BACKGROUND: The antibody reactivity against Epstein-Barr nuclear antigen-1 (EBNA-1), and 25-hydroxyvitamin D (25(OH)D) status have been associated with MS risk. Interaction between these two factors has been proposed.

OBJECTIVES: The objective of this paper is to examine the association between antibody reactivity against EBNA-1 and five EBNA-1 domains, and the risk of MS, and to examine if these antibodies and 25(OH)D status interact regarding MS risk in prospectively collected blood samples.

METHODS: Antibody reactivity and 25(OH)D levels were measured using ELISAs in n = 192 MSers and n = 384 matched controls. The risk of MS was analysed using matched logistic regression. Interaction on the additive scale was assessed.

RESULTS: The risk of MS increased across tertiles of antibody reactivity against EBNA-1, domain EBNA-1402-502, and domain EBNA-1385-420; p trends < 0.001. In young individuals (below median age at sampling, < 26.4 years), these associations were stronger, and 25(OH)D levels correlated inversely to antibody reactivity against EBNA-1 and the EBNA-1 domains. No statistical interaction was found.

CONCLUSIONS: This study confirms that increased antibody reactivity against EBNA-1 is a risk factor of MS. 25(OH)D status might influence the immune response towards Epstein-Barr virus in young subjects, and thereby modulate MS risk.

“To square the circle of MS causation we have to be able to explain how EBV infection and vitamin D deficiency interact with each other in the causal pathway. This study suggests that in young people vitamin D deficiency may affect one’s immune response to EBV. An abnormal immune response to EBV may be the trigger that leads to MS causation. Clearly more work is needed to investigate this further; it will have to be done in young people prior to developing MS. Maybe there is enough supporting evidence to apply for funding?”

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.


  • I hear that eventually summer will arrive in Britain. In the meanwhile I have been taking 10,000 IU of vitamin D3 throughout autumn and winter. However, is vitamin D3 consumed in capsule form less potent than it being derived from natural sunshine? Are we wasting money in ingesting vitamin D3 when in reality what we need is to move to a better climate?

  • There is no evidence that D3 as a supplement is less potent, it is chemically identical. Normally the problem is the recommended supplement dose does not match the amount created by the skin on sun exposure. Given the lack of sun and lack of toxicity at 10,000IU a day, keep taking it in the summer.

By Prof G



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