Study Shows How EBV May Help Trigger MS

Research Summary: Clonally expanded B cells in multiple sclerosis bind EBV EBNA1 and GlialCAM

New studies linking Epstein-Barr virus (EBV) to multiple sclerosis have been the biggest research news of 2022. 

Today, we are going to summarise a study that has looked to answer the question: How may EBV be involved in triggering multiple sclerosis?

What?

The study looked at whether or not antibodies generated against Epstein-Barr virus could also react against parts of the myelin sheath.

Who?

This research was conducted by a team at Stanford University in California, USA.

Where?

The article was published in Nature.  The abstract can be viewed here.

When?

The study was published in January, 2022.

BACKGROUND #1:  Studies over the past 12 months have highlighted that a previous infection with Epstein-Barr virus appears to be necessary, but not sufficient, for multiple sclerosis to develop.  You can learn more about this background information here.

BACKGROUND #2:  This more concrete link between EBV and multiple sclerosis opens up a number of novel treatment and prevention opportunities in multiple sclerosis.  You can learn more about these avenues here.

BACKGROUND #3:  While the link between EBV and multiple sclerosis seems to be more firmly established, how exactly the virus is involved in initiating the disease is not well understood.

FINDING #1:  Antibodies that reacted against parts of Epstein-Barr virus were detected in the cerebrospinal fluid (CSF) from a small cohort of people living with multiple sclerosis.  

FINDING #2:  Interestingly, the antibodies that reacted against parts of EBV were also able to react against a protein called GlialCAM.  This protein is found in the central nervous system, which makes it particularly relevant to multiple sclerosis.

There has been a lot of excitement around the new findings regarding the potential role of Epstein-Barr virus in multiple sclerosis, and what it may mean for future treatment and prevention of the disease.  This study has provided some very interesting insights into why that link may be important, but there are still some questions that need to be answered.  

THOUGHT #1:  This research shows a clear mechanism through which Epstein-Barr virus may trigger multiple sclerosis.  To summarise this really simply, the findings suggest the following steps:

• • • A person is infected with Epstein-Barr virus

   

  • • The person generates a normal immune response against the virus, including the production of antibodies

   

  • • The antibodies that are produced against EBV are also able to react against a protein in the central nervous system called GlialCAM.  This process is known as molecular mimicry.

   

  • • The antibodies start ‘accidentally’ targeting GlialCAM, which leads to damage and an autoimmune response in the central nervous system.

   

THOUGHT #2:  While this is a really strong possibility, it would be good to see this study replicated in a much larger population of people living with multiple sclerosis.  This would help us understand how common this phenomenon is.

THOUGHT #3:  Even if the molecular mimicry described in this study is part of the puzzle, there is still a lot of work to understand how all of the other pieces fit.  Why are women diagnosed with multiple sclerosis almost 3 times more than men?  Does the time in your life that you get infected with EBV make a difference?  How does this interact with the other genetic and environmental risk factors that have been identified?  

In conclusion, Stanford’s study is another exciting step forward in this area of research.  We will continue to closely follow all of the studies on this topic and provide updates as soon as they become available. 

As always, if you have any questions for Brett, please either comment below or join the conversation on our social channels.

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Read other articles we have published on Epstein-Barr virus here.