Research shows important cause of multiple sclerosis

Scientists at Sweden’s Karolinska Institutet have uncovered important details about how the Epstein-Barr virus (EBV) might trigger or worsen multiple sclerosis (MS), a debilitating neurological condition.

Their research, published in Science Advances, sheds light on a mechanism where antibodies produced in response to EBV may mistakenly attack the brain and spinal cord, contributing to MS symptoms.

Epstein-Barr Virus: A Widespread Infection

EBV is a common virus that infects most people early in life. It belongs to the herpesvirus family and remains in the body for life, often without causing noticeable symptoms. In fact, over 90% of the global population carries EBV as a latent, lifelong infection.

While EBV infections in childhood are usually mild, the virus can cause infectious mononucleosis, or “kissing disease,” in adolescents and young adults. Despite its prevalence, EBV’s role in causing other health issues, such as MS, is only beginning to be understood.

Linking EBV to Multiple Sclerosis

Scientists have long suspected a connection between EBV and MS, but the exact relationship has remained elusive.

Recent studies, including groundbreaking papers in Science and Nature, have shown that EBV infections often occur before MS develops. These studies suggest that antibodies generated to fight EBV might also contribute to the disease.

The new study from Karolinska Institutet builds on this knowledge. Olivia Thomas, a postdoctoral researcher and one of the lead authors of the study, explains, “MS is an incredibly complex disease, but our study provides an important piece in the puzzle and could explain why some people develop the disease.”

Antibodies Gone Awry

The researchers analyzed blood samples from over 700 MS patients and a similar number of healthy individuals. They discovered that some antibodies produced to target a protein in EBV, known as EBNA1, also bind to a similar protein in the brain and spinal cord called CRYAB.

This brain protein plays a protective role, preventing harmful clumping of other proteins during inflammation or cellular stress.

When these antibodies mistakenly attack CRYAB, they can damage the brain and spinal cord, potentially worsening MS symptoms such as fatigue, mobility problems, and balance issues.

Around 23% of MS patients in the study had these cross-reactive antibodies, compared to just 7% of the healthy control group.

Thomas emphasized, “While these antibody responses are not required for the disease to develop, they may play a role in up to a quarter of MS patients.”

The Immune System’s T Cell Response

Beyond antibodies, the study also suggests that T cells—another key component of the immune system—may similarly confuse EBV and brain proteins. This could further contribute to the damage seen in MS.

Mattias Bronge, another lead researcher, highlighted the next steps: “We are now expanding our research to investigate how T cells fight EBV infection and how these immune cells may damage the nervous system in MS and contribute to disease progression.”

Toward Personalized MS Treatments

The findings of this study underline the complexity of MS and the variability among patients. Not all MS cases involve the same triggers or immune responses, meaning that future treatments may need to be personalized.

Targeting specific immune responses, like those involving cross-reactive antibodies, could open new avenues for therapy.

By unraveling the relationship between EBV and MS, researchers are closer to developing tailored treatments that address the unique mechanisms behind the disease in individual patients.

While there’s still much to learn, these discoveries mark a significant step toward understanding and managing MS more effectively.

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