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Epstein-Barr Immunotherapy May Help with MS

Epstein-Barr immunotherapy for MS

For more than a decade, experts have wondered about a link between Epstein-Barr virus and multiple sclerosis (MS), and despite some convincing evidence, it still is not possible to clearly define the relationship between them. Now new information concerning Epstein-Barr immunotherapy and MS may bring researchers one step closer to understanding how this association may benefit MS patients.

Epstein-Barr virus is present in about 90 percent of the population, yet in most people it causes only mild or no symptoms. It is probably best known as the cause of infectious mononucleosis, which is also sometimes called the kissing disease.

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This new study represents the first time Epstein-Barr specific adoptive immunotherapy has been used in a patient who has MS. The study’s leader, Michael Pender, a professor at the University of Queensland School of Medicine in Brisbane, also is the individual who, a decade ago, proposed that the immune system of individuals with MS is impaired when it comes to fighting Epstein-Barr virus.

Epstein-Barr specific adoptive immunotherapy means that the researchers used the patient’s own cells to boost his immune system to fight disease. In this case, the patient was a 43-year-old man with secondary progressive MS.

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The scientists collected blood from the patient and took some of the CD8 T cells out so they could grow them in a lab along with a vaccine for Epstein-Barr virus. The augmented T cells were then returned to the patient intravenously. CD8 T cells are able to induce apoptosis (cell death) in cells that they target.

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The patient, who has been unable to walk without help since 2008, experienced improvement within 14 days of starting the immunotherapy and continued to do so at 21 weeks of follow-up. Among the benefits of treatment were the following:

  • Improvement in cognitive function, including attention, memory, and thinking
  • Improved hand function
  • Increased ability to work (the patient works at home)
  • Reduction in painful muscle spasms and fatigue
  • Improvement in leg function
  • Reduction in disease activity as seen on a brain magnetic resonance imaging (MRI) scan
  • Reduction in the level of antibodies in the cerebrospinal fluid

Pender noted that he and his team “believe the treatment corrects the impaired CD8 T cell immunity that allowed EPV infection to cause MS.” Clinical trials are needed to test this immunotherapy in a larger population of patients with MS.

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History of Epstein-Barr virus and MS
Here’s a brief look at some of the research history regarding Epstein-Barr virus and MS.

  • In a study published in 2003 in the Journal of the American Medical Association, a research team reported on the presence of antibodies to the virus in individuals with and without MS. They found that even though nearly all the participants had been exposed to the virus, antibody levels were consistently higher in people who later developed MS than they were in those who did not.
  • A 2006 report that was partially funded by a grant from the National MS Society found that people who showed evidence of exposure to the Epstein-Barr virus were twice as likely to be diagnosed with MS up to two decades later.
  • In a postmortem study published in 2007, investigators reported that evidence of Epstein-Barr virus infection was found in 21 of 22 brains from people who had had MS but no signs of the virus in the brains of people who had had other neurological diseases that also involve inflammation.

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The new study adds to the growing wealth of evidence of a connection between Epstein-Barr virus and MS. Further study of the Epstein-Barr immunotherapy in patients with MS will hopefully provide promising results.

Levin LI et al. Multiple sclerosis and Epstein-Barr virus. Journal of the American Medical Association 2003; 289(12): 1533-36
Pender MP et al. Epstein-Barr virus-specific adoptive immunotherapy for progressive multiple sclerosis. Multiple Sclerosis Journal 2014 Feb 3.

Image: Flickr/Iqbal Osman1