EBV vaccine studies begins Good Luck and Good Hunting

E

A New Years present for some. Some people have been suggesting that EBV is the cause of MS.

It may well be but how do you you prove it?

Get rid of EBV and hope that MS goes away…..we may say.

Some people believe it is the target for the immune response in MS, but many people do not think this is the case and can make up many alternative ideas of how EBV could be important.

If it is the trigger factor and not the target in MS it may be too late to do anything about once you have been infected, so it is not going to a straight or quick route to a cure in MS.

Moderna has developed RNA vaccine technology that has revolutionised the fight against SARS-CoV-2 but making antibodies to stop infection and by making T cells to destroy infected cells. We can say the technology is relatively safe given that a few billion people have tried it and it is possible to use this in children.

Can this be done for EBV?

Do we want to get rid of EBV? and Will this impact on MS?

Moderna’s EBV vaccine trials have begun and they are safety studies in young adults that is estimated to take 2 years. People are being vaccinated with four different RNA species against gH, gL, gp42, gp220. gL is not good luck and gH is not good hunting but they will need both to hunt down the EBV virus. These are molecules involved in EBV virus binding to cells so they are hoping to stop infection. Will it clear virally infected cells? As we have seen with omicron despite vaccination infection is not always prevented

The Phase 1 randomized, observer-blind, placebo-controlled study of mRNA-1189 will be conducted at approximately 15 sites in the U.S. The primary purpose of the Phase 1 study is to assess safety and tolerability of mRNA-1189 in healthy adults ages 18 to 30. Moderna expects to enroll approximately 270 participants. The ClinicalTrials.gov identifier is NCT05164094

Cyclomegalovirus is another latent virus (i.e. it hides from the immune system like EBV) and is a problem in immunosuppressed people and Moderna have targeted this virus too. They have started phase III trials in 6000 people NCT05085366

What will be the impact on the immune response as both CMV and EBV hide in the immune system. We will have to wait and see

CoI None relevant

Disclaimer: This is the work of the author and has no relationship to any institutions

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MouseDoctor

41 comments

  • This could be the game changer if it’s finally approved. I realise EBV is not yet proven to be the trigger, or a trigger, but it’s implicated. It’s too late for we pwMS, but if it can eliminate MS in future, like smallpox, wouldn’t that be good. Vaccine technology has totally changed the way illnesses could be dealt with, so even if all that’s achieved is the elimination of EBV and other sneaky viruses, then maybe something good will emerge from the pandemic.

  • I am proof positive that progression can also be caused by our systems’ inability to keep EBV in check. During a year of progression, a smart holistic doc sent me for an EBV panel and I had active infection. Only symptom? MS progression. So yes, n=1, but treatment reversed my progression.

    I’ve been waiting for this for a long time. It would be thoroughly disappointing if it was only offered as prevention. I was given a shingles vax series to stop shingles. I require an EBV vax to stop this chronic and progressing issue as well.

      • First, acyclovir. Not really recommended for EBV, but within a week m my function returned.

        I started Mavenclad in 2020 – tried to stop the antiviral once my immune system was back abs crashed within a couple of weeks.

        Completed my two years May 2031, stopped acyclovir in November and I’m doing WELL! Enough b memory cell change to deal now.

        • Hi, I’m just wondering what dose of acyclovir you were on. Also I’m assuming it was just acyclovir and not a pro-drug like valacyclovir/famcyclovir? I’m glad you are doing well now!

          • Boring old acyclovir. I did find a paper outlining the best options from what we have for EBV and it was second tier. I didn’t save the article.

            I don’t “think” it would make a difference unless your blood work showed active infection. I would do a blood panel first. This has been my working hypothesis for some time and with my Mavenclad improvement, it seems likely.

            EBV is responsible for some nasty cancers as well, so it’s key.l to know if it’s a current issue.

            https://www.frontiersin.org/articles/10.3389/fimmu.2017.01867/full

            I’ve always found it intriguing that amantadine is an antiviral that works for “some” people with MS. I suspect it’s those antiviral properties working to suppress replication of something else. Or does it also have some action against EBV replication? 🤔 I haven’t looked into that or tried it.

      • I don’t know 🤷‍♀️.

        But I was already getting shingles when I had the shingles vaccine, and that stopped. My immune system could not keep it in check prior to the vaccine. It could afterwards. I’ve had no issues at all with shingles even during the times I was off acyclovir.

        Different types of vaxes. All hypothesis at this point. A hypothesis I’m very eager to test out.

        I do think my situation involves premature immunosenescence in MS. As is currently being researched.

        • I’m curious to know more about your experience with recurrent shingles. Did the rash keep coming back in the same place or in different spots? Was it ever disseminated? Did you get the shingrix vaccine while you had active lesions? How soon after getting the shingrix vaccine did your shingles infection subside and you were able to stop the antivirals?

          I’m asking because after being on kesimpta and then having a flare which was treated with IV steroids + a taper, my wife developed shingles and has been battling a persistent shingles infection for the last 5 months. The only thing controlling it is 2 times the standard dose of valacyclovir.

      • Could be, could not be.

        Maybe first 1 or 2 rounds of B-cell depletion, followed by antivirals and the vaccine, when repopulation happens, to stop reinfection of B-cells.

      • Your provider requests an EBV blood panel comprised of three tests measuring anti-EBV antibodies: VCA IgM, VCA IgG and EBNA-1 IgG. Depending on which are negative and positive, your status can be determined. Historical infection is normal and not an issue. 95% (?) of people with MS have had it previously.

    • How old were you when MS symptoms appeared and MS was diagnosed?
      How active was the MS?
      At what age did you get the EBV check and start the anti-viral?

  • I suppose this vaccine could help people with MS is EBV is causing progression in some way. It’s targeting latent EBV.

    Maybe it could clear the system. Time will tell, it could also make MS worse

  • Thank you for this post and it is really interesting and I would like to know how the trial goes but I too believe there is some light at the end of this pandemic tunnel. The anti-viral medication along with how pwMS have success (& the patient’s symptoms know best) with thinking differently about treatment, prevention and god willing a eliminating the disease.

    To stop progression for pwMS & to start thinking early enough on how some folk, could possibly be pre-disposed to the condition. If you have a family member or other members of your immediate family are young enough to be sought out, to have a vaccine to prevent EBV – has to be the way forward. As it can be too late – if it is one of the driving factors of how MS starts. Even if it hasn’t been completely proven – what have you got to lose. If the vaccine is safe – all young family members of pwMS should be contacted (possibly managed by their connection with pwMS) to have it done!

    We can all share this information and if we are ahead of our own Neuro team and organisation – then let’s start 2022 and make some changes so that it can happen! Costs must be thought about of course, but if someone develops MS later on in life, the costs will be a lot higher than a vaccine. We have now armies of people who can now administer vaccines, thanks to Covid!

  • If the EBV vaccine and similar vaccines work (such as CMV), outside of M.S., will this have any impact on ‎Immunosenescence in the aging bodies? Will these vaccines allow for people to mount a more robust immune response to novel pathogens as they age by freeing up immune cells that would otherwise be used to keep infections like EBV at bay?

    • This is my hypothesis.

      It appears my system was so tied up trying to keep EBV replication to a dull roar, that my entire immune system was senesced. No fevers, no response to illness, progression marching on. I was on an antiviral for three years which gave me my life back despite the fact that none are great FOR EBV. I’ve just been able to stop the antiviral without crashing post year 2 Mavenclad.

      This is a vaccine I will line up for.

      • Could you please clarify “No fevers, no response to illness”
        Do you mean that you never had the usual colds and other minor infections?

        • Exactly. I concluded erroneously that my immune system must be good! Turns out, my regulatory immune system was AWOL. Inflammatory immune system was doing very well. 🤦‍♀️

          I likely HAD the illnesses, but only symptoms were fatigue … declining balance … “MS” symptoms.

          No sign of a perky immune system doing the work.

          This has improved considerably now. The improvement, and actual signs of illnesses returned (including ridiculously tiny fevers) after I started acyclovir and I expect this will continue with Mavenclad.

          • Re “I concluded erroneously that my immune system must be good”

            That’s exactly what I concluded for my daughter 🙁

            Anyway, it’s great to hear your story. You did well or were lucky to find the doctor who treated you.

  • Since Ebv infect 95 percent of the world population and 100% of pwms (acording to some screening assays)

    Given that the majority of injections occur in early chilldwood will this be to late for the trial population to
    h ve a positive signal

    Nice post

    • Another big question is what will the safety signals be. If we coexist so closely with EBV there might be some major evolutionary advantages that aren’t immediately apparent.

  • Maybe to early. But will this trial include people with MS? At some point

    This vaccine, if effective maybe 10 years from approval, then there maybe a need for a trial in people with MS. There’s another 5 years

    Still interesting to see how it unfolds and the effect it will have, to be effective against preventing MS it will need to include children and teenagers. However this is MS, not sure on the other diseases caused by EBV

  • Dear MouseDoctor, dear everyone,

    I wish you all a happy new year!

    Many thanks, Doctor, for this page and for all other works.
    Great thanks and best wishes to ProfG, too.

  • Progression in PwMS isn’t directed, advanced, or mitigated by EBV; it’s a completely different process that drives progression. We all need to be careful in thinking we’ve gotten a handle on this disease by trying to make an idea fit the appearances—correlation does not imply causation.

    • Science is never “done”. The scientific process is exhausting. But in my case, EBV reactivation WAS progressing me. Blood work and treatment proof. N=1. Comorbid conditions play a huge role in how MS rolls.

      Is the research there yet? Of course not. doesn’t meant it’s not a thing for some of us.

  • First, I should clarify.

    I doubt what I was experiencing WAS progression. It was called progression, but I suspect it was worsening. And that is my fear; that when those with MS get worse in absence of increased lesions, it’s ASSUMED to be progression.

    I was told transitioning to secondary around 2016. Dxed RRMS to get treatment. 2018’was headed to wheelchair – then thyroid and EBV issues were found. Active secondary (basis for Mav treatment).

    I had weird neuro stuff for decades but was very mild. Milder after I started an anti inflammatory diet in 2001. I didn’t suspect a disease lol. Despite that, at perimenopause 9 years ago (I was around 48) everything blew up. In retrospect, I believe at diagnosis I was crazy active secondary with a super benign RRMS phase. But who knows. It really doesn’t matter once you start looking for root causes.

    In addition, neuroplastic exercise has helped me slowly regain mobility.

    It’s a management game.

    • Sorry I’m confused
      In MS, aren’t worsening and progression the same thing? Two names for the same thing

        • That’s unfortunate. I felt it was overreaching to suggest I was actually reversing or managing real progression. I do think there is a difference. Slow worsening due to a comorbid condition that is manageable should not be misidentified.

          Perhaps there should be a delineation.

          Currently there is only one drug and supportive care for SPMS.

          My dream is that, just like at diagnosis, if an MS patient is progressing slowly over a certain number of months, neurologists would then do bloodwork. Full viral panels, FULL thyroid testing, cortisol testing, A1C but also insulin resistance, and more. Sleep study should have happened already. In particular if said patient has fatigue of any sort (general, motor, cognitive).

          The majority of those with MS don’t have doctors who will do this because neurologists are in charge of MS. Plus with testing restrictions, doing tests for things that are not obviously happening are frowned upon.

          Thyroid levels are a case in point. There is no testing beyond TSH. Some small older studies have shown that pwMS are more likely to have low T3 with normal TSH. T3 may play a part in remyelination. (I’m not quoting all the research to save time). There are things now in development along this line of attack and trials examining the role of liothyronine in remyelination.

          Yet some with MS could simply need active thyroid hormone. Without mine, I’m in a chair. Extremely cognitively impaired.

          So I doubt I’m managing progression. Just worsening. ;). If they are the same thing, this is significant.

  • Here is some more additional info on it

    https://mobile.twitter.com/DrEricDing/status/1481755126004072449

    HUGE—We now have evidence that Multiple Sclerosis is likely caused by an infection—notably, the Epstein-Barr virus increased risk of developing MS by a whopping **32-fold***—via Harvard epidemiology team. ➡️ Hopeful because EBV vaccine coming soon

    https://www.statnews.com/2022/01/13/strong-new-evidence-suggests-virus-triggers-multiple-sclerosis/

    https://www.science.org/doi/full/10.1126/science.aay3638

    Eric Feigl-Ding
    @DrEricDing

    THREAD ON mRNA:

    Jan 12, 2021
    FANTASTIC NEWS—A potential vaccine for multiple sclerosis is now within sight on the horizon! And it’s an mRNA vaccine by BioNTech, maker of the Pfizer #COVID19 vaccine.

    Study in mice shows great promise for improving symptoms & stopping MS progression!

    CLICK HERE:
    https://mobile.twitter.com/DrEricDing/status/1348912864942305280

    2) Sahin’s team showed that an mRNA vaccine encoding a disease-related autoantigen successfully ameliorated MS symptoms in sick animals and prevented disease progression in rodents showing early signs of MS.

    Has the Black Swan landed?

    • You are mixing vaccines one is an anti-viral and the other is an myelin vaccine and as I have said before the data is not as impressive as is suggested, lets see if it moves forward they have the resource to do it

  • FANTASTIC NEWS—A potential vaccine for multiple sclerosis is now within sight on the horizon! And it’s an mRNA vaccine by BioNTech, maker of the Pfizer #COVID19 vaccine.

    Study in mice shows great promise for improving symptoms & stopping MS progression!

    THREAD:

    Click Here to continue:
    https://mobile.twitter.com/DrEricDing/status/1348912864942305280

    ….2) Sahin’s team showed that an mRNA vaccine encoding a disease-related autoantigen successfully ameliorated MS symptoms in sick animals and prevented disease progression in rodents showing early signs of MS….

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