Can the Epstein-Barr Virus Lead to Multiple Sclerosis?

A recent review of data from US military recruits reveals that multiple sclerosis (MS), a disease with an unclear cause, is a consequence of Epstein-Barr virus infection (EBV).

Multiple sclerosis (MS) is a central nervous system demyelinating disease. The exact cause of this condition is unknown, but the Epstein-Barr virus is suspected to be a contributing factor.

“The hypothesis that EBV causes MS has been investigated by our group and others for several years, but this is the first study providing compelling evidence of causality,” said Alberto Ascherio, senior author of the study. “This is a big step because it suggests that most MS cases could be prevented by stopping EBV infection, and that targeting EBV could lead to the discovery of a cure for MS.”

However, the majority of people infected with this widespread virus do not acquire multiple sclerosis, and it is impossible to prove causation in humans.

Kjetil Bjornevik et al. evaluated the theory that MS is caused by EBV by analyzing data from more than ten million US military recruits over a 20-year period, 955 of whom were diagnosed with MS during their service.

Using military serum samples collected twice a year, the researchers were able to ascertain the soldiers’ EBV status at the time of their first sample and the link between EBV infection and the onset of MS while they were serving.

They discovered that after EBV infection, the probability of having MS increased 32-fold in people who were previously EBV-negative.

“These findings,” according to the authors, “cannot be explained by any known risk factor and suggest EBV as the leading cause of MS.”

According to Ascherio, the delay between EBV infection and the development of MS could be related to the disease’s early symptoms going unnoticed, as well as the growing link between EBV and the host’s immune system, which is constantly activated whenever the latent virus reactivates.

Anti-CD20 monoclonal antibodies are one of the most effective treatments for MS, according to the researchers. They claim that directly targeting EBV could have significant advantages over anti-CD20-based treatments, which require intravenous administration and may raise the risk of infection.

“Currently there is no way to effectively prevent or treat EBV infection, but an EBV vaccine or targeting the virus with EBV-specific antiviral drugs could ultimately prevent or cure MS,” said Ascherio.

Source: 10.1126/science.abj8222

Image Credit: Getty

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