EBV as the cause of MS

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Have I posted on this paper already? I thought I had, but the blog search function had disappeared when I wrote the post. I guess not to worry it is rather rubbish anyway. Hopefully we will sort this out

However, you have heard this story of EBV as a cause of MS umpteen times before and this is more supportive evidence.

By looking in the US military, people can be found who developed MS and were shown to show evidence of EBV infection before disease.

CMV is another latent virus

What is evident is that there is a large cohort of people converting to EBV that did not get MS

Did they look to see if people developed any other condition? Is it specific to MS or not?

We wrote to Prof Ascherio and he responded “We have not been able to look at other autoimmune diseases so far.  Although in theory it is possible, each project requires an enormous investment of time to work through all the hurdles”

This is important because it will help explain what is going on, from a mechanistic point of view as it may help address whether EBV is a trigger or a target?

If it is the trigger treating EBV in MS may not have much of an effect, if it is the target then it would or could.

I keep get asked about the anti-EBV T cell therapy all the time. I would argue that I haven’t seen anything that sounds curative so far and so maybe EBV is a trigger. Maybe the treatment hasn’t been tried in the right cohort of people with MS

However there are some people that believe it is the target. If it is the target why has this been so difficult to find?

In this cohort there was one person that was EBV negative in their last sample 3 months before MS. Is this a different causal pathway or did they change?

Lots to learn, but an anti-EBV vaccine is now being developed (not yet for MS). Will someone make an effective anti-viral? Maybe and if an anti-EBV vaccine is successful and makes money it will be even more likely.

I would argue that the studies need to be done in glandular fever or other conditions first, before trying studies in MS, because doing studies with agents that aren’t good enough, won’t give us an answer.

Epstein-Barr virus and multiple sclerosis.Robinson WH, Steinman L.Science. 2022 Jan 13:eabm7930. doi: 10.1126/science.abm7930. Online ahead of print.PMID: 35025606

Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. Bjornevik K, Cortese M, Healy BC, Kuhle J, Mina MJ, Leng Y, Elledge SJ, Niebuhr DW, Scher AI, Munger KL, Ascherio A.Science. 2022 Jan 21. doi: 10.1126/science.abj8222. Online ahead of print.

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system of unknown etiology. We tested the hypothesis that MS is caused by Epstein-Barr virus (EBV) in a cohort comprising more than 10 million young adults on active duty in the US military, 955 of whom were diagnosed with MS during their period of service. Risk of MS increased 32-fold after infection with EBV but was not increased after infection with other viruses, including the similarly transmitted cytomegalovirus. Serum levels of neurofilament light chain, a biomarker of neuroaxonal degeneration, increased only after EBV seroconversion. These findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS.

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Disclaimer: This is an opinion of the author and has nothing to do with any institution

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MouseDoctor

33 comments

  • This study doesn’t take into account the changes to cellular DNA brought about by the virus, as well as the resultant mitochondrial dysfunction. MS is a multifactorial disease, and EBV as a singular cause just doesn’t cut the mustard.

  • That’s the big question now. Its it a cause that creates MS and other mechanisms are in place and targeting EBV is a waste of time.

    Or is it the driver of MS disease and its progression.

    What your hypothesis based on the current evidence?

      • D’accord, totalement.
        Was highly amused by the Breaking Bad chemist question. Have personally known a few American chemists of that persuasion in my time, mostly of Vietnam era vintage. No Brits, but by the time Ecstasy and derivative club drugs came along, I knew better than to experiment on myself in this direction.
        To the best of my knowledge, no one has ever defined EDS as an autoimmune condition in writing, although I have noticed evidence of rheumatologists (in Oxford, possibly the original company town on steroids) beginning to think about it in terms of immune dysregulation.
        Personally, I’ve had all visual evidence of ‘classical’ EDS eradicated between 1986-2003 by discreet plastic surgeons (Oxford again). Probably couldn’t get it done with any EDS diagnosis these days, we all make extensive surgical adhesions which may become problematic in future- I’m guessing collagen disorders again…
        Have begun to wonder why I unquestioningly accepted D1’s 2001 MS diagnosis as autoimmune, and wonder if it could just be episodic immune dysfunction at the start, at least in RRMS.
        Any thoughts?

  • I’m guessing that in patients who go on to develop MS, the virus (ebv) gets in the CNS and is not adequately controlled. The virus starts causing damage and the external immune system gets involved. This might explain why plasma cells end up in the CNS and pumping out antibodies (against the virus). The Sizomus trial might provide some useful insights. What happens with the JC virus and PML? Is it really that different from a CNS infected with EBV? We also need to explain why women are 2-3 times more likely to get MS. Perhaps it’s a case of not adequately controlling (when compared to men) the ebv infection.

  • I have just reminded myself of the following, and commend it to the EBV ‘believers’ , including GG

    Whenever a theory appears to you as the only possible one, take this as a sign that you have neither understood the theory nor the problem which it was intended to solve’ Karl Popper.

  • MD- only temporarily hors de combat, apparently. Yes, you’ve posted some EBV stuff before, but I haven’t noticed the longitudinal military stuff.
    As the person who will accompany me on my eventual trip to the canton of Zurich is a recently retired (but only to defence contracting abroad, it’s tax-free and good for the pension pot) senior British Army Officer, experienced field and base commander, higher education BA Aberdeen, Sandhurst, MA Bristol, I have a few words to say.
    This sort of study goes straight into his bin. In his opinion, all international military research and clinical practitioner cohorts remain hopelessly skewed towards young, healthy, fit males, and tend towards the brief side in duration. I strongly agree.

    P, who knows why the caged bird sings 😏

    • “This sort of study goes straight into his bin. In his opinion, all international military research and clinical practitioner cohorts remain hopelessly skewed towards young, healthy, fit males, and tend towards the brief side in duration. I strongly agree”

      Whilst you may not like miltary research this is about research where you have a medical history and repeated blood samples taken over time…what’s not to like about this?

      As for rest, I have decided to remove it..sorry

      • No need for sorry, you have prior consent. And I know very little about military research, I just know a man who’s needed modules taught by military clinicians. 🧘🏼

        • PS: all family, friends, and relevant clinicians are aware that I have been a paid up member of DIGNITAS for years, and that death by own hand has been my fallback position for decades now. Sadly, I have seen no evidence whatsoever that the UK is likely to so much as soften its position re assisted suicide, even during my children’s lifetime.

          • The position is changing and increasingly rapidly in the UK, as evidenced by the change of stance by the BMA. The stumbling block will be, as ever the cowardice of our politicians.

          • And a man after my own heart as well…
            Thanks.
            Have deleted Bart’s site from all my devices insofar as possible; not responsible for stuff connected to elder MS daughter on statins’ devices, so apologies in advance if anything unfortunate occurs

  • What makes EBV so special is that in humans it takes the B cells as its reservoir. Moreover, it hijacks the genome of the B cells, makes them immortal, binds with EBNA 2 on more than 50% of transcription factors of the risk genes, produces 32 specific micro-RNAs that help to stay under the host’s immune radar. B-cells that can not only produce immunoglobulins and cytokines but are also professional antigen-presenting cells. It is not without reason that other autoimmune diseases are also linked to this virus.
    To be continued…

  • What a about a child off 2 years old getting ms?

    Where is the incubacion time?

    Also some reports off spinal cord injury and later ms diagnose,what Ebv as to do with those cases?

    Spinal cord injury is related to an increased risk of multiple sclerosis: a population-based, propensity score-matched, longitudinal follow-up study

    Multiple sclerosis following a spinal cord injury: a rare and unfortunate case

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125067/

    Nice post

    • > Also some reports off spinal cord injury and later ms diagnose,what Ebv as to do with those cases?

      Physicians recurrently report that MS patients say they experienced emotional trauma shortly prior to their diagnosis. Of course, this is not proof of a connection, but it is obviously striking enough to be brought up.

      This can also be explained from a physical point of view, because trauma causes stress. Herpes virus reactivation is well documented in the case of stress. It could be that this topples a system that was previously on the threshold of manageable.

  • I think environmental factors like smoking, vit d, microbiome, stress etc shape our immune system and I guess a more infammatory environment with too little T-Regs and IL-10 may be a prerequisite for EBV infection to trigger MS.

  • I think the same thing about Covid-19:
    How and why does Sars-Cov-2 cause Long Covid and autoantibodies in a portion of the population and not in another?

    Zika and Chycungunia virus, for example, have a form of rheumatoid arthritis as sequel

  • Although the MS-EBV connection is still not 100% clear, I’d say it’s safe to say at this point, that EBV is needed to develop MS and drive progression.

    Smoking doesn’t cause everyone to get lung cancer. Some people get cancers of the mouth, stomach or colon as a result. Others have problems with their cardiovascular system as a result of smoking. And many don’t have any issues at all from it.

    It’s the same with EBV. Some get MS, others get cancer, and many people don’t have issues with the virus.

    I find it crazy, that the MS-EBV connection is still not being studied in detail therapeutically. Yes, EBV is most likely not the sole cause of MS. But taking out the main ingredient will bring results, if treated in enough people. Of that I’m sure after following the science surrounding MS and EBV for many years now.

    Hopefully the EBV vaccinations being trialed now will be successful. After CD20 b-cell depletion, they could also help in keeping EBV in check, when b-cell repopulation begins, without the need to continue the infusions indefinitely.

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