Epstein-Barr virus antibodies can distinguish MS from other neuroinflammatory diseases

The connection between multiple sclerosis and Epstein-Barr virus (EBV) is strengthening, according to a paper published this week in JAMA Neurology by a team of international researchers, including one from the University at Buffalo. Bianca Weinstock-Guttman, MD, SUNY Distinguished Professor in the Department of Neurology at the Jacobs School of Medicine and Biomedical Sciences at UB, a leading international expert on MS and the director of the New York State MS Consortium, is one of the co-authors of the paper titled “Epstein-Barr Virus Antibodies to Differentiate Multiple Sclerosis From Other Neuroinflammatory Diseases.”

The researchers found that in this multicenter, international case-control study of 2,091 patients with neuroinflammatory diseases, high titers of EBV-specific nuclear antigen peptide antibodies were more common and consistently higher in MS than in other neuroinflammatory diseases, such as myelin oligodendrocyte glycoprotein-associated diseases (MOGAD) and neuromyelitis optica spectrum disorders (NMOSD). The study involved 1,976 healthy controls.

Patients in the study were from Germany, Austria and the U.S., including some of Weinstock-Guttman’s patients from Western New York. First author on the paper is Hannes Vietzen, principal investigator at the Center for Virology, Medical University of Vienna.

“This study indicates that serial testing for EBV-specific antibodies could serve as an additional biomarker to help distinguish MS from other neuroinflammatory diseases that may have similar clinical and radiographic features,” explains Weinstock-Guttman, who directs UB’s Jacobs Multiple Sclerosis Center for Treatment and Research, and UB’s Jacobs Pediatric MS Center.

Previous research led by Vietzen has demonstrated that these antibodies are specific for MS and absent in healthy controls. “The presence of specific EBV antibodies in MS but not in other neuroinflammatory diseases further supports a unique underlying biological mechanism in MS and its link to EBV infection compared to other neuroinflammatory conditions,” she says.

Weinstock-Guttman adds that future research will focus on better understanding the connection between EBV infection and the risk of developing MS. She notes that studies are also underway examining pediatric MS cases that test negative for EBV antibodies. Researchers are also investigating ways to prevent EBV infection through vaccination or other antiviral agents, as well as the role EBV may play in disease progression.