Targeting Epstein-Barr virus to treat and prevent multiple sclerosis

Recent evidence strongly implicates infection by the Epstein-Barr virus as the trigger for development of multiple sclerosis. An international research team is now gathering to unveil the role of Epstein-Barr virus in the onset and progression of multiple sclerosis.

The team has ambitious goals:

“We aim to find out why only a few Epstein-Barr virus-infected people develop multiple sclerosis, and define the underlying mechanism of this process”, explains the principal investigator, Professor Kjell-Morten Myhr of the University of Bergen.

“Our research will also seek to investigate if targeting the Epstein-Barr virus infection with antiviral treatments can improve the disease course or even stop disease progression”, says Myhr.

“Development of prevention strategies like vaccination would be the next step”, says the co-principal investigator, Professor Øivind Torkildsen at Haukeland University Hospital.

From theory to action

The researchers, representing leading universities and hospitals in Europe and the United States, will perform clinical trials of antiviral therapies targeting the Epstein-Barr virus infection in multiple sclerosis, analyze blood and saliva samples, as well as performing registry-based research.

They will build on their extensive experience and previous research within their respective fields, and take advantage of high-quality health registries and existing research cohorts of persons with multiple sclerosis. The group consists of experts in multiple fields, including Epstein-Barr virus and human genetics, virology, immunology, neurology, multiple sclerosis, clinical trial design, patient involvement, epidemiology, mathematical modeling, artificial intelligence, and data management. A governance method that takes into account patients, their needs, and experiences, will ensure multi-stakeholder engagements and co-responsibility

Multiple sclerosis and Epstein-Barr virus

Multiple sclerosis is a chronic inflammatory and degenerative disease of the central nervous system. It constitutes the most common non-traumatic cause of neurological impairment among young and middle-aged people and represents a major healthcare burden.

The research published in Science in 2022 shows that Epstein-Barr virus infection greatly increases the risk of developing multiple sclerosis and that it is near impossible to develop multiple sclerosis without first being infected by the virus.

Epstein-Barr virus infection, also known for causing mononucleosis, is very common (more than 95%) in the population. Almost all people with multiple sclerosis have been infected first by Epstein-Barr virus, while only 0,2% to 0,3% of the people who have had Epstein-Barr virus infection end up developing multiple sclerosis.

There is currently no available preventive treatment against Epstein-Barr virus infection or multiple sclerosis.

Great potential

The goal is to develop a new treatment of multiple sclerosis, targeting the underlying driver of the disease rather than downstream consequences. Further, if successful, it will identify people at high risk of developing multiple sclerosis after infection with Epstein-Barr virus and give the possibility of primary prevention of the disease in high-risk individuals. The project has the potential to provide mechanistic evidence for Epstein-Barr virus being a prerequisite for multiple sclerosis development and progression, which could form the basis for developing strategies to eradicate the disease.

"This groundbreaking research initiative holds great potential in advancing treatments options for people living with multiple sclerosis. By exploring the intricate Epstein-Barr virus-multiple sclerosis connection, it also offers the opportunity for a better understanding of the disease and the development of preventive measures.

Ultimately this leads to an improvement in the quality of people living with multiple sclerosis and, takes us one step closer to a future free from the burden of multiple sclerosis." says Elisabeth Kasilingam, CEO of the European Multiple Sclerosis Platform.

Source: News Release
The University of Bergen
September 20, 2023