Multiple Sclerosis and Epstein-Barr Virus
- Monday, July 20, 2009, 13:25
- Multiple Sclerosis
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- Dick:
- Dr. Phillips, because it is always such a basic question for patients and for families, could you talk to us briefly about the current research looking at what may cause MS?
“Nobody knows what causes MS. It seems to be most likely caused by not a single virus, but probably several fairly common viruses.” - Dr. Phillips:
- It’s real easy to give you the bottom line briefly. That is, even at this many years later, despite intensive efforts, nobody knows what causes MS. It seems to be most likely caused by not a single virus, but probably several fairly common viruses are most likely potential culprits. If these are common viral triggers, why don’t most people have MS triggered by these common viruses? Because, there’s a genetic component to it as well. Nine hundred and ninety-nine out of a thousand people who might encounter a certain common virus rid themselves of the virus with no future consequences. But, one person out of a thousand might encounter a relatively common virus, but because of their genetic background, the process of healing themselves from that viral infection may set into motion a cascade of immunological events that at a later time manifests itself by immunological reactivity against components of the brain and spinal cord that we think of as MS.
- Dick:
- Would this very broad rule of thumb apply to a virus like Epstein Barr? I know there’s been some effort to look at that virus specifically.
- Dr. Phillips:
- Yes. Actually the Epstein Bar virus, or EBV, story goes back at least 20 years. Although it has made news recently, with all due respect to the researchers and the study itself, I really think that it would be an overstatement, and the investigators themselves from Harvard are careful to point out that this does not mean that EBV is the cause, or necessarily even a cause of the disease. In studies like this, and this was an epidemiological study that tested blood samples from a large number of women involved in the Harvard Nurse’s trial, it’s real difficult to know. You’re kind of almost in a chicken-and-egg paradox situation. Did these people show heightened reactivity to Epstein Bar virus because they are people with MS or destined to have MS? Or, is their heightened reactivity to Epstein Bar virus a causative factor in developing MS? There’s really no way to sort that out.
I think that evidence such as the Epstein Bar virus story is probably best interpreted as supportive evidence for an underlying viral trigger of which the EBV agent may be one of many.
But not the sole one that can trigger this cascade of events that ends up as being manifested as MS.
- Dick:
- Thanks for addressing that, Dr. Phillips. Thanks also for launching our discussion in a wonderful manner this evening.
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