Research shows a new cause of multiple sclerosis

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Researchers at Sweden’s Karolinska Institutet have made significant strides in understanding how the Epstein-Barr virus (EBV) could trigger or worsen multiple sclerosis (MS).

Their study, published in Science Advances, explores how certain individuals carry antibodies against the virus that inadvertently attack a protein found in the brain and spinal cord.

Epstein-Barr Virus: A Common Yet Complex Virus

EBV is a type of herpesvirus that infects most individuals early in life and stays in the body, typically without showing any symptoms.

It is one of the most pervasive viruses affecting humans, with over 90% of the global population carrying the virus for life as a latent, often asymptomatic, infection.

While typically contracted in childhood without severe symptoms, in young adults, it often leads to infectious mononucleosis, also known as glandular fever or the “kissing disease.”

The Connection Between EBV and Multiple Sclerosis

The link between EBV and MS was discovered several years ago, but the relationship has puzzled researchers.

Mounting evidence, including two papers published in Science and Nature last year, suggests that EBV infection tends to precede MS and that antibodies against the virus may play a part. However, the exact molecular mechanisms remain largely uncharted.

Olivia Thomas, a postdoctoral researcher at the Department of Clinical Neuroscience at Karolinska Institutet and shared first author of the paper, noted, “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.”

The Role of Misdirected Antibodies

Thomas and her team analyzed blood samples from more than 700 MS patients and 700 healthy individuals.

They found that antibodies binding to a specific protein in the Epstein-Barr virus, EBNA1, could also attach to a similar protein in the brain and spinal cord called CRYAB. This protein helps prevent protein aggregation during cellular stress conditions, such as inflammation.

These cross-reactive antibodies, instead of fighting the infection, could mistakenly target the brain and spinal cord, causing damage.

This process could lead to severe symptoms in MS patients, including balance issues, mobility problems, and fatigue. These antibodies were found in about 23% of MS patients and 7% of the control group.

“This shows that, while these antibody responses are not required for disease development, they may be involved in disease in up to a quarter of MS patients,” Thomas added. This finding highlights the variation among patients and the need for personalized therapies.

Looking Forward: The Role of T Cells

The researchers also found a likely similar cross-reactivity among T cells of the immune system.

Mattias Bronge, an affiliated researcher at the Department of Clinical Neuroscience at Karolinska Institutet and shared first author of the paper, stated, “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 multiple sclerosis and contribute to disease progression.”

This research provides promising leads in understanding the intricate relationship between EBV and MS, potentially paving the way for the development of more targeted therapeutic strategies.

Further studies could bring about significant advancements in treating and managing MS by focusing on these newly discovered mechanisms.

By exploring these interactions more deeply, scientists hope to find better ways to treat MS and improve the lives of those affected by this challenging disease.

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