Connected, but at what level?

Healthline recently caught up with Bruce Bebo, executive vice president of research at the National Multiple Sclerosis Society, to better understand the relationship between Epstein-Barr virus (EBV) and multiple sclerosis (MS).

Bebo explained, “Everyone in their lifetime will be exposed to EBV.”

He added that there is an understood connection between developing mononucleosis and the risk for MS.

Mononucleosis is also a possible by-product of EBV.

In addition, EBV is a member of the herpes family of viruses.

The Centers for Disease Control and Prevention (CDC) says EBV was first identified in 1964 as one of the most common human viruses in the world, infecting 90 percent of the population at some point in their lives.

Many people do not experience illness or only have mild symptoms. EBV is best known as the major cause of infectious mononucleosis.

Most people are infected with EBV early in childhood and produce no symptoms. But those who are not infected during childhood may have a tendency to get mononucleosis at a later time in life.

Mononucleosis is an infectious condition that can arise from EBV. Transferred by saliva, it has also been known as the “kissing disease.”

The tie to multiple sclerosis

The Epstein–Barr virus (EBV) activates the retrovirus HERV-W/MSRV in patients with infectious mononucleosis.

This activation has been found to be associated with multiple sclerosis.

Bebo said, “We understand there is a connection between developing mononucleosis and the risk for MS. We have all practically been exposed to this virus (EBV). Only a fraction got mono. But that fraction of folks has a higher risk for MS.”

He explained that people with MS respond to EBV differently than others.

There is a tendency for MS patients to have a higher level of immune reactivity to the illness. Bebo discussed how this is a chicken and egg thing.

“Is that a consequence of the inflammation of the nervous system? Or was the virus reactivated and caused the inflammation that causes the damage of MS?” he said.

“This is not a great study to show the difference, but it adds to the body of knowledge, of EBV and MS. It makes a contribution but does not help us understand the real connection,” said Bebo.

A father investigates

Healthline spoke with Ashton Embry of Calgary, Canada. Embry is an MS advocate, retired research scientist, and father of MS patient, Matt Embry.

When his son was diagnosed, Embry did what he knew best. He researched.

He decided that “his son’s chances would be best if he could reduce any and all probable cause.” During his research, he found several constants, one of which was the presence of EBV.

A longtime advocate of the EBV/MS connection, Embry mentioned the contribution of another recent study, which found EBV present in the brain of most cases of MS.

The study suggests that meticulous and thorough examination be made, or this low level of EBV could be missed, skewing data. The study also suggests that EBV may infect more than one cell type in MS, including microglia and astrocytes, creating a more dynamic relationship between the two.

More research is suggested to verify these findings and to find the possible link between the presence of EBV, neuroinflammation, and neurodegeneration.

MS is not the only disease showing a connection to EBV.

It is also associated with nearly 200,000 annual cases of cancer. Currently, there is no FDA approved vaccine to prevent EBV infection.

“The only way we are ever going to know if EBV is a trigger for MS, or activates immune system that causes MS, is to have a vaccine for EBV,” Bebo explained. “We won’t be able to answer until we can prevent the viral infection, and then prevent the MS.”

“I look forward to the day we can do that,” said Bebo.

The University of Kansas School of Engineering and School of Pharmacy, with a $1.8 million, five-year grant from the National Institutes of Health, is hoping to find an effective vaccine or drug therapy against EBV.

Editor’s note: Caroline Craven is a patient expert living with MS. Her award-winning blog is GirlwithMS.com, and she can be found @thegirlwithms.