Is There A Relationship Between Multiple Sclerosis And Epstein Barr Virus?
In recent weeks there have been questions on the MultipleSclerosis.net website and Facebook page regarding a possible relationship between Multiple Sclerosis and the Epstein-Barr Virus (EBV).
This is an age-old question that I’ve heard many times over the years, so I decided to address it by reaching out to a friend of mine, Kathleen Costello, Assistant Professor of Neurology at The Johns Hopkins MS Center, to ask her to provide us with her professional opinion about MS and EBV.
But before I do that, let me define what Epstein Barr is.
According to the Centers for Disease Control and Management, “Epstein-Barr virus, is a member of the herpes virus family and one of the most common human viruses. Symptoms of infectious mononucleosis are fever, sore throat, and swollen lymph glands. EBV also establishes a lifelong dormant infection in some cells of the body's immune system. The clinical diagnosis of infectious mononucleosis is suggested on the basis of the symptoms of fever, sore throat, swollen lymph glands, and the age of the patient.”
Let me also provide you with information about EBV and MS from The National Multiple Sclerosis website:
In 2003, a study published in the Journal of the American Medical Association1 suggested that increased levels of immune antibodies that fight Epstein-Barr Virus (EBV)—the very common virus that causes infectious mononucleosis and other disorders—may be associated with an increased risk of developing MS.
Although no causal relationship was established between EBV and multiple sclerosis, the researchers found that in spite of the fact that virtually all of the study participants, with and without MS, had early exposure to this virus, the antibodies to EBV were consistently higher in those individuals who subsequently developed MS than in the control group that did not develop MS. Furthermore, the risk of developing MS increased with increasing levels of antibodies, which were subsequently found to increase with age.
In 2006, investigators reported that individuals who showed signs of significant exposure to the Epstein-Barr virus were twice as likely to develop MS up to 20 years later. While this study, funded in part by a pilot research grant from the National MS Society, added more evidence linking the virus to the risk of developing MS, it still did not prove that EBV actually causes MS.
In 2007, investigators reported finding traces of Epstein-Barr virus in postmortem brains examined from people with different forms of MS. They found traces of EBV infection in immune cells (B cells and plasma cells) that had infiltrated 21 out of 22 brains from people with MS, but not in brains from people who had other neurological diseases that, like MS, involve inflammation.
The Society concludes that, “In spite of these findings, however, it is still not possible to determine whether EBV causes MS, or whether its presence is a consequence of MS.”
Now let’s go back to Kathleen. I asked her some questions regarding EBV and MS, and here are her responses:
Is there any truth that having Epstein Barr is a viral trigger causing MS?
It is believed that previous EBV infections can a risk factor for the development of MS. However, it is not the only possible risk factor. For instance, other risk factors are likely to be smoking, low Vitamin D, a genetic predisposition.
In your experience, do you see any direct relationship between the two?
I do not see a direct relationship in my practice; however many patients endorse a history of EBV infection sometime in the years prior to the onset of the MS.
Kathleen kindly referred to more recent research that has been done since 2007 about the relationship between EBV and MS. If you are interested, please refer to the listing below.
I hope this answers your questions. Feel free to leave thoughts or questions in the comments section, and I’ll get back to you as soon as I can.
Stay cool and take good care.
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