Multiple sclerosis (MS) has been unexplained for more than 150 years since 1868, when French neurologist Jean-Martin Charcot gave the disease its name to women who had abnormal convulsions. According to the scientific journal Science on the 13th (local time), a Harvard University research team who analyzed blood test data of more than 10 million Americans found that the cause is highly likely to be the Epstein-Barr virus (EBV), one of the herpes viruses. time) reported.
Multiple sclerosis is an autoimmune disease that occurs when an abnormality occurs in the immune system and immune cells attack the myelin sheath, the insulating material surrounding the axons of nerve cells in the spinal cord and brain. This results in vision problems, pain, weakness, and numbness in the limbs, which get worse over time. Injection of antibodies that deplete B cells, one of the white blood cells, can alleviate symptoms, but there is no cure.
Scientists have long pointed to EBV as one of the main suspects for this multiple sclerosis. 99% of patients with multiple sclerosis have been infected with EBV. In addition, EBV enters the body and remains dormant in B cells for life. The problem is that 95% of people who do not have multiple sclerosis are also infected with the virus.
An ideal way to tackle this problem would be to follow a group of young people who were not infected with EBV and compare them to whether they were more likely to develop multiple sclerosis when they were infected than those who did not. Researchers led by Alberto Askerio, a professor at Harvard University’s TH Chan School of Public Health, have found a way to solve this dilemma. This is an analysis of the medical record database of 10 million U.S. soldiers who have been tested for human immunodeficiency virus (HIV) every two years after enlisting from 1993 to 2013.
Of these soldiers, 955 later developed multiple sclerosis. Among them, 801 soldiers had sufficient blood samples. Thirty-five of 801 patients tested negative for EBV on the first blood test. However, after an average of 5 years, all but one in 35 patients tested positive for EBV. In contrast, only half of the 107 controls who did not have multiple sclerosis tested positive for EBV during the same period. In other words, EBV steatosis is 32 times more likely to cause multiple sclerosis, which is about the same level as heavy smoking causes lung cancer, Askerio said.
The researchers also tested other common viruses as analytes, but found no comparable viruses to EBV. The researchers also found other evidence. Eventually, they found that polyneuropathy soldiers had increased levels of a protein associated with nerve degradation after EBV infection. Professor Askerio was convinced that EBV was the causative agent of multiple sclerosis by asking, “How can you explain that you have polyneuropathy if you are not infected with EBV?”
Other researchers were cautious. Jeffrey Cohen, a researcher at the National Institute of Allergy and Infectious Diseases in the United States, said the new evidence is very interesting, but still only shows a link. Professor Emanuel Wovant of the University of California, San Francisco (UCSF) said the paper did not explain why the majority of people with EBV don’t get MS. Only 1 in 1000 people infected with EBV will develop multiple sclerosis. Lawrence Steinman, a professor at Stanford University who wrote a commentary on the paper, said, “Obviously there are other fuses that lead to MS.”
How EBV causes disturbances in the immune system is also not explained. Some researchers suspect that EBV transforms B cells into pathogenic ones. Other researchers, including Professor Steinman, speculate that the EBV protein is similar to a neuronal protein, causing the immune system to not differentiate between the two, causing it to attack nerves.
Developing an EBV vaccine and vaccinating young people with a family history of multiple sclerosis may prove a causal role between EBV and multiple sclerosis. Professor Gavin Giovanoni of the University of Queen Mary, UK, said that the preventive effect of a vaccine “fills the last box on the checklist”.
British pharmaceutical company GlaxoSmithKline developed a vaccine based on the epidermal protein of EBV a few years ago, but failed in clinical trials. Rather, the two vaccines currently in early clinical trials are more promising. These are the nanoparticle vaccine developed by Cohen NIAI Researcher and the mRNA vaccine developed by Moderna.
The paper can be found at the following address ( https://www.science.org/doi/10.1126/science.abj8222 ).
By Han Gun-pil, reporter [email protected]
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