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Multiple sclerosis (MS) is a disease that has had doctors and scientists stumped ever since it was first identified. While they could put up theories of what might cause the crippling autoimmune disease, they couldn’t ever prove any of them.
In fact, while they’ve long suspected that there was a link between certain viral infections and the development of the disease that affects nearly one million Americans, making a definitive case for it has been out of reach.
“Nobody really knows what causes autoimmune diseases, and for many decades, all sorts of different viruses have been hypothesized,” said William Robinson, MD, PhD, professor of immunology and rheumatology at Stanford. “But when people did further mechanistic digging, everything fell apart, and it turned out that getting those other viruses didn’t actually cause MS.”
And without knowing the cause behind the disease, the medical community has been working with one hand tied behind their back when it comes to treating it.
Luckily, the scientists did not give up on their research into MS and what role viral infection might play in its development.
And that persistence has finally paid off with an answer to what causes the disease, which could lead to new breakthroughs and new hope for MS patients everywhere.
The viral link to MS
One of the groups of viruses, researchers have felt could be the root of MS has been the herpes viruses. It’s a group of viruses known for causing diseases such as herpes simplex (and those irritating cold sores), chicken pox and Epstein-Barr.
And previous research has shown MS patients to have increased antibodies to a number of these – including chicken pox and the Epstein-Barr virus (EBV). In particular, 99 percent of these patients are known to have EBV antibodies, compared to 94 percent of people without MS.
So Stanford scientists set out to determine once and for all if MS is caused by a virus and could that virus be EBV.
They did it by examining the antibodies produced by immune cells (called B cells) in the blood and spinal fluid of and tested them for reactivity against hundreds of different antigens.
“We started with human antigens,” Robinson said, “but couldn’t find clear reactivity. So eventually we tested them against EBV and other herpes viruses, and lo and behold, several of these antibodies, and one in particular, bound to EBV.”
And while that can seem like a lot of scientific mumbo jumbo, what it means is that the Epstein-Barr virus is what sets off the MS cascade.
Basically, it triggers multiple sclerosis by priming the immune system to attack the body’s own nervous system.
“Part of the EBV protein mimics your own host protein — in this case, GlialCAM, found in the insulating sheath on nerves,” explained Robinson. “This means that when the immune system attacks EBV to clear the virus, it also ends up targeting GlialCAM in the myelin.”
And this is what causes the symptoms and disability seen in MS.
You see, that myelin that is targeted when your body is trying to defend against EBV forms the protective coating around your nerve cells (as well as your brain and spinal cord).
And when it’s damaged, electrical impulses can no longer jump efficiently from one nerve to the next, resulting in the numbness, muscle weakness and severe fatigue of multiple sclerosis.
“EBV tricks the immune system into responding not only to the virus, but also to this critical component of the cells that make up the white matter in our brains,” said co-author Lawrence Steinman, MD, professor of neurology at Stanford. “To use a military metaphor, it’s like friendly fire: In fighting the virus, we damage our own army.”
Looking at it practically, the researchers say that their results back up findings from a previous study that showed that of 801 MS cases, EBV infection was present in all but one case at the time of MS onset. Additional data found that of 35 people who were initially EBV-negative, all but one became infected with EBV before the onset of MS.
The implications of a virus-fueled disease
And that’s good news because now that we know what starts it, we can focus on stopping it for MS sufferers and possibly even preventing it altogether.
“This is the first time anyone has shown rather definitively that a virus is the trigger for multiple sclerosis,” Steinman said. “And these exciting findings open up some new directions for clinical trials in MS treatment.”
He also noted that in the future, a vaccine against Epstein-Barr virus could eventually eradicate MS, in the same way polio was eradicated from the United States in the 1970s.
In the meantime, MS sufferers do have options that could help them cope with symptoms that are important to incorporate into daily life, including:
- Taking supplements that provide autoimmune support
- Avoiding diets that contribute to autoimmune issues
- Consuming the skin of some fruits which may reverse the damage of MS
Study identifies how Epstein-Barr virus triggers multiple sclerosis – Stanford Medicine