Multiple Sclerosis (MS) affects the CNS in among 2.8 million people worldwide. The front runner among causal agents is Epstein-Barr virus (EBV), a human herpesvirus. It is present in around 90% of adults by the age of 35. Early studies support the link between EBV and MS, which has been discussed for over 40 years.
Through a 20-year partnership with the United States military, Bjornevik et al. explored MS incidence. The United States screens active-duty personnel for HIV at the start of their service and biennially thereafter. This provides more than 62 million serum samples from a group of over 10 million people from 1993 to 2013. The investigation determined EBV status at initial testing, recording 5.3% of individuals EBV-negative.
Out of 801 MS cases only one occurred in an EBV-negative individual at last sample. These data suggest that EBV is a “trigger for the development of MS”, opening new doors of prophylactic and therapeutic vaccination. The next step is to produce an effective vaccine against EBV in order to reduce the risks of MS. Luckily, Senior Researcher Gary Nabel of ModeX Therapeutics thinks this is closer than initially thought.
So far we have found two experimental vaccines to block the two pathways that EBV uses to establish itself in the host body. These two pathways, B immune cells and epithelial cells, seem to be protected against infection in the vaccines. By genetically fusing two attachment proteins onto Ferritin, the vaccines can serve their purpose. Nabel stated that Ferritin “serves as a carrier, where we can essentially decorate the outside of the particle with the viral proteins”. When the immune system observes these proteins, it responds and registers them for future infection. The vaccines demonstrated good animal responses and clinical trials are expected to begin in the next year.
A safe and effective vaccine is exciting, particularly in consideration of the costs of MS treatment. In the United States these can exceed $70,000 yearly. For lower income countries, access and availability is a barrier to treatment, with less than 35% of MS patients in South America able to access treatments. Financial incentives, as always, come into play, with the opportunity for global healthcare costs to be significantly reduced.