Epstein-Barr virus may be leading cause of multiple sclerosis | Hacker News Reader

Epstein-Barr virus may be leading cause of multiple sclerosis

hsph.harvard.edu

72 pointsjasonhansel19 comments

In other news: multiple sclerosis is contagious.

Most of us don't develop an autoimmune disorder fighting EBV. But that is the luck of the draw.

I know of no reason not to suspect EBV and other viruses of causing numerous mental and other chronic illnesses. The number of such known will only ever increase. A vaccine against a virus protects you from both the known and the unknown consequences. A successful vaccine against each virus will probably be the only way to discover most such effects.

I wouldn't say MS is contagious. It is an autoimmune disease, but EBV is a putative risk factor. The paper notes that people are diagnosed with MS 5-10 years after the EBV initial infection, so would not be contagious from either an EBV or MS point of view.

I think around 95% of the population will get EBV at some point in their lives. I'd be very curious to know how a vaccine would impact public health, but I am cautious about it - I suppose there may be some possible positive effects of the virus given humans have probably co-evolved with it.

If everyone who has it got it because of a virus, it is contagious by definition, howsoever long the incubation period is, or the prevalence of asymptomatic infection. Once people are vaccinated against EBV, it will cease to be caught or spread by them.

This is a great finding. If I were on one of the teams developing an EBV vaccine (e.g. Moderna) I would be a little worried about the possible knock-on effects of the vaccine as a result of this study. MS is an auto-immune disorder, so it's not out of question that an EBV vaccine could kick-start the same auto-immune reaction that causes the MS-EBV link.

An alternative optimistic scenario is that the EBV infection itself leads to an increased likelihood of MS (as opposed to the EBV-triggered autoimmune response above). Either way, a clinical study of an EBV vaccine would not detect a relationship to MS unless it ran for 5-10 years.

This seems, to my layperson eyes, like a pretty exciting result. Would love to hear someone familiar with the literature pipe in.

As another layperson, there seem to be links between virus and diseases that are at face value completely unrelated, HPV and cancer, Epstein-Barr and MS, H. Zooster and Alzheimer.

Makes you wonder how many more diseases we will eventually find out are actually triggered by viral infection.

I'm not familiar with the literature, but I did read the paper. They looked at military personnel who have had samples taken and saved, and were able to 'go back in time' to look their EBV status at enrolment and later on. They found that either having previously had EBV or acquiring EBV after enrolment increased your risk of having MS.

However, to put things in context, more than 90% of the population will be exposed to EBV, so I'm not 100% sure how to interpret this. It might be better to think of the headline as 'EBV seronegative people are protected from MS', given people who are 'seronegative' (their immune system doesn't show any evidence of them fighting the disease) are the minority population here.

The paper talks about the possibility of a confounding factor and reverse-causation, though I think the focus is too much on the EBV seropositive population and it would be interesting to think about what is unusual about the EBV seronegatives.

thanks!

Just a week ago Moderna started Phase I trial for this virus

A more thorough article: https://www.scientificamerican.com/article/epstein-barr-viru...

It should say that the immune system is the cause.

it should not for the same reason we don't blame the bullet when someone gets shot, or the train for driving over the suicidal person. That's the difference between a proximate and a root cause.

No. They are trying to use a vaccine to solve the problem and this is wrong because the virus is not the root cause of harm. Even if they did manage somehow to prevent the virus from getting in, which the vaccine will fail at, it wouldn’t matter because this same kind of immune dysfunction is at the center of a million other diseases. A treatment that controls the immune system wipes them all out in one stroke. But people are stuck on yesterdays thinking

That’s a lot of wild claims without any substantiation. The bar at HN surely is higher than this.

It's not.

It’s not so wild. Inflammation is very ancient and it does a lot more than make a paper cut turn red. It pulls lots of fundamental levers, metabolic levers. Inflammatory signals are one of the great frontiers of medicine. We have barely scraped the surface of it.

That’s the opposite of substantiating. Hand waving ‘it’s the early days’ commentary

Now where have we seen this before…

From the article:

"In this cohort, the risk of MS increased 32-fold after infection with EBV but was unchanged after infection with other viruses."

You are right despite what other HNers think. MS is first and foremost an auto-immune disease. It is not that surprising that infections that provoke a large immune response can trigger an autoimmune condition. When we understand the immune system better, especially around the early stages of response to a potential pathogen, we'll understand how auto-immune disease starts and is maintained. EBV has long been a putative risk factor for MS, but given 95% of the population will have EBV, it clearly only goes some way to explaining how MS comes about.

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