Treatment for Epstein-Barr Virus May Help People With Multiple Sclerosis

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Australian scientists say they’ve found a new immunotherapy that’s showing promise as a treatment for multiple sclerosis.
The therapy is based on a treatment for Epstein-Barr virus.
The connection between Epstein-Barr and multiple sclerosis (MS) was made more than 40 years ago. Recent scientific research continues to show a correlation.
At times, researchers have suggested that a vaccine for Epstein-Barr could be an answer to MS.
This potential new treatment is based on the theory of Dr. Michael Pender, a professor at The University of Queensland and the Royal Brisbane and Women’s Hospital in Australia.
Pender unveiled a new theory in 2003 that MS is caused by an accumulation of cells in the brain infected by Epstein-Barr and that a therapy targeting the virus could potentially stop the progression of MS.
“(Epstein-Barr) affects B cells and once affected, never leaves these B cells,” Pender told Healthline. “In healthy people, the immune system works all the time keeping the virus under control by using T cells.”
A common infection
About 90 percent of the public is infected with Epstein-Barr, although many don’t suffer from any serious effects.
All MS patients have the virus, Pender said.
Pender proposes that the Epstein-Barr virus (EBV) could accumulate in the body, causing other chronic autoimmune diseases such as lupus, rheumatoid arthritis, and type 1 diabetes.
He suggests that people who present with these conditions may have a decrease in these T cells that control the virus.
“This is the same process that causes chronic intestinal issues like irritable bowel disorder (IBD). It is the accumulation of EBV cells in the gut causing flora to get out of balance,” Pender told Healthline.
Boosting T cells
The immunotherapy treatment involves isolating T cells, then stimulating them in a laboratory environment and retraining them to be more effective T cells.
“We are giving back the T cells that are doing a good thing — like managing the EBV. They are removed and grown and given back to the patient,” Pender said. “These cells will go back into the brain and start killing the cells creating the damage.”
Five years ago, Pender treated the first patient with T-cell immunotherapy in a phase I trial supported in part by MS Research Australia.
In the latest study conducted this year, seven of 10 participants said it alleviated symptoms for up to three and a half years.
The study was supported by California-based Atara Biotherapeutics, a T-cell focused company.
“If this theory is correct, then a targeted EBV treatment such as T cells could kill infected cells in the brain,” said Pender.
“This is very early but exciting and promising,” said Kathy Costello, a nurse practitioner at the Johns Hopkins Multiple Sclerosis Center in Maryland and the associate vice president of healthcare access for the National Multiple Sclerosis Society.
“EBV has been looked at and thought to be one of the risk factors for MS, but there are many, many more people with EBV than who ever get MS. It’s unlikely that it’s the only cause or only risk factor for MS,” Costello told Healthline.
“There are many researchers looking at EBV and how it plays a role in MS,” she added. “More people believe that infection of EBV triggers the disease, or risk of development of MS, like smoking cigarettes, taking vitamin D, watching weight/obesity. They all contribute to the risk of developing MS.”
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There were no control groups.
Most improvements, but not all, were somewhat subjective, including fatigue and quality of life.
Costello explained that phase I trials are often small and are designed to look at safety and dosage rather than effectiveness. When a treatment has reached this point, the scientists have done preclinical work, the effectiveness has been shown in a dish or with lab animals, and now it’s time to move to human beings.
When the dosage and safety is confirmed, then phase II will look at safety and efficacy endpoints.
Once the treatment has made it to phase III, there may be several hundred to several thousand participants. At this point the efficacy of the treatment becomes primary focal point while continuing to collect safety data.