A short talk I gave on EBV vaccination as a strategy to prevent and/or treat MS. Do you think it is feasible? What do we need to do to make this a reality?
Eid et al. Association of adverse childhood experiences with the development of multiple sclerosis. J Neurol Neurosurg Psychiatry . 2022 Jun;93(6):645-650.
Objective: To study whether exposure to childhood emotional, sexual or physical abuse is associated with subsequent multiple sclerosis (MS) development.
Methods: A nationwide, prospective cohort study based on participants in the Norwegian Mother, Father and Child cohort study. Enrolment took place 1999-2008, with follow-up until 31 December 2018. Childhood abuse before age 18 years was obtained from self-completed questionnaires. We identified MS diagnoses through data-linkage with national health registries and hospital records. The Cox model was used to estimate HRs for MS with 95% CIs, adjusting for confounders and mediators.
Results: In this prospective cohort study, 14 477 women were exposed to childhood abuse and 63 520 were unexposed. 300 women developed MS during the follow-up period. 71 of these (24%) reported a history of childhood abuse, compared with 14 406 of 77 697 (19%) women that did not develop MS. Sexual abuse (HR 1.65, 95% CI 1.13 to 2.39) and emotional abuse (HR 1.40, 95% CI 1.03 to 1.90) in childhood were both associated with an increased risk of developing MS. The HR of MS after exposure to physical abuse was 1.31 (95% CI 0.83 to 2.06). The risk of MS was further increased if exposed to two (HR 1.66, 95% CI 1.04 to 2.67) or all three abuse categories (HR 1.93, 95% CI 1.02 to 3.67).
Interpretation: Childhood sexual and emotional abuse were associated with an increased risk of developing MS. The risk was higher when exposed to several abuse categories, indicating a dose-response relationship. Further studies are needed to identify underlying mechanisms.
Agree! It’s a complicated picture! Several factors at play. For me I think stress played a huge role in triggering my immune system into overdrive, along with EBV and possibly low Vitamin D. I’ll never really know for sure but if EBV plus other factors are the cause, knocking out a main player must surely be key
Thank you for this. Have you considered looking at childhood traumatic events as part of the puzzle? After reading The Body Keeps The Score (Bessel Van Der Kolk), attending a workshop on Complex PTSD and studying to become a counsellor, I can understand how the brain and body, and also immune system, changes due to trauma. I believe it was an important factor in my development of MS 20 years ago.
Did anything get agreed at the meeting regarding starting an EBV vaccination study or using anti-virals for people with MS?
I can see why the term “necessary but not sufficient” is a bit confusing. It doesn’t really capture the critical importance of EBV infection / mono ie if you never get infected with EBV you won’t get MS. How do you know that EBV infection isn’t enough on its own? I know lots of MSers who never smoked, were out-doorsy, and didn’t work with chemicals. Perhaps it’s only the (bad) genes that are required with EBV infection.
Thank you for sharing your thoughts around this. I think this is great and agree that it needs both to be done and to be a large international effort. I would definitely help in any way that I possibly can.
Agree entirely on the stress factor I was just eighteen when my eldest daughter was born very bad forceps birth (was told caesarean should have been performed ) resulted in brain damage to my daughter and epilepsy cerebral palsy 44 years later terrible behaviour difficulties add to that nursing my dad and my husband through major surgery ( just to add my husband left as soon as i needed a stick to walk) and my very lovely youngest daughter ( love them both) twelve years or so after the birth started very strange symptoms which I now know were the start of m.s. so I totally agree with the stress related theory
I had mono., caused by EBV, in 1987, at the age of 17, but my sister didn’t. I was diagnosed with MS, 4 years later., and since then, I’ve often wondered why researchers could not see the direct correlation?
I am sure that EBV vaccines will prevent people from getting MS. I hope that anti EBV therapies will be developed and that eradication of chronic EBV will be an effective or curative therapy, this gives me hope (medical evidences are with us)! I think that the therapeutical role of mRNA vaccine in chronic infection is undervalued.
This is fascinating to me as a pwMS diagnosed in 2014 with highly active rapidly evolving RRMS and on Tysabri as my DMD.
In the UK is this shared with the MS Society who already keep an MS Register which I complete regularly and with the MS Trust because they are my go to charities since my diagnosis?
I would love to help to develop something from a pwMS perspective for use with General Practitioners? It's been on my mind since my diagnosis but I haven't taken it any further to date because living with MS and volunteering has been my focus up until now.
Thank you so much for sharing this Prof G, it is greatly appreciated!
Hi Prof G, I’m organising a fundraiser & would like to raise funds for an MS cause. I usually donate to the MS Society but thought this time I could raise money for the MS-Selfie. I don’t think it’s a registered charity, is it? Can I still do this? I plan to do a verrry long swimathon :) :)
Eid et al. Association of adverse childhood experiences with the development of multiple sclerosis. J Neurol Neurosurg Psychiatry . 2022 Jun;93(6):645-650.
Objective: To study whether exposure to childhood emotional, sexual or physical abuse is associated with subsequent multiple sclerosis (MS) development.
Methods: A nationwide, prospective cohort study based on participants in the Norwegian Mother, Father and Child cohort study. Enrolment took place 1999-2008, with follow-up until 31 December 2018. Childhood abuse before age 18 years was obtained from self-completed questionnaires. We identified MS diagnoses through data-linkage with national health registries and hospital records. The Cox model was used to estimate HRs for MS with 95% CIs, adjusting for confounders and mediators.
Results: In this prospective cohort study, 14 477 women were exposed to childhood abuse and 63 520 were unexposed. 300 women developed MS during the follow-up period. 71 of these (24%) reported a history of childhood abuse, compared with 14 406 of 77 697 (19%) women that did not develop MS. Sexual abuse (HR 1.65, 95% CI 1.13 to 2.39) and emotional abuse (HR 1.40, 95% CI 1.03 to 1.90) in childhood were both associated with an increased risk of developing MS. The HR of MS after exposure to physical abuse was 1.31 (95% CI 0.83 to 2.06). The risk of MS was further increased if exposed to two (HR 1.66, 95% CI 1.04 to 2.67) or all three abuse categories (HR 1.93, 95% CI 1.02 to 3.67).
Interpretation: Childhood sexual and emotional abuse were associated with an increased risk of developing MS. The risk was higher when exposed to several abuse categories, indicating a dose-response relationship. Further studies are needed to identify underlying mechanisms.
Agree! It’s a complicated picture! Several factors at play. For me I think stress played a huge role in triggering my immune system into overdrive, along with EBV and possibly low Vitamin D. I’ll never really know for sure but if EBV plus other factors are the cause, knocking out a main player must surely be key
Thank you for this. Have you considered looking at childhood traumatic events as part of the puzzle? After reading The Body Keeps The Score (Bessel Van Der Kolk), attending a workshop on Complex PTSD and studying to become a counsellor, I can understand how the brain and body, and also immune system, changes due to trauma. I believe it was an important factor in my development of MS 20 years ago.
Thank you so much and I hope you are feeling better
Did anything get agreed at the meeting regarding starting an EBV vaccination study or using anti-virals for people with MS?
I can see why the term “necessary but not sufficient” is a bit confusing. It doesn’t really capture the critical importance of EBV infection / mono ie if you never get infected with EBV you won’t get MS. How do you know that EBV infection isn’t enough on its own? I know lots of MSers who never smoked, were out-doorsy, and didn’t work with chemicals. Perhaps it’s only the (bad) genes that are required with EBV infection.
Thank you for sharing your thoughts around this. I think this is great and agree that it needs both to be done and to be a large international effort. I would definitely help in any way that I possibly can.
Agree entirely on the stress factor I was just eighteen when my eldest daughter was born very bad forceps birth (was told caesarean should have been performed ) resulted in brain damage to my daughter and epilepsy cerebral palsy 44 years later terrible behaviour difficulties add to that nursing my dad and my husband through major surgery ( just to add my husband left as soon as i needed a stick to walk) and my very lovely youngest daughter ( love them both) twelve years or so after the birth started very strange symptoms which I now know were the start of m.s. so I totally agree with the stress related theory
Hello Dr. Giovanni,
have you heard if the ATA 188 study, being conducted in the US, to see whether EBV is a contributing factor, to eventual diagnosis with MS?
I had mono., caused by EBV, in 1987, at the age of 17, but my sister didn’t. I was diagnosed with MS, 4 years later., and since then, I’ve often wondered why researchers could not see the direct correlation?
I am sure that EBV vaccines will prevent people from getting MS. I hope that anti EBV therapies will be developed and that eradication of chronic EBV will be an effective or curative therapy, this gives me hope (medical evidences are with us)! I think that the therapeutical role of mRNA vaccine in chronic infection is undervalued.
This is fascinating to me as a pwMS diagnosed in 2014 with highly active rapidly evolving RRMS and on Tysabri as my DMD.
In the UK is this shared with the MS Society who already keep an MS Register which I complete regularly and with the MS Trust because they are my go to charities since my diagnosis?
I would love to help to develop something from a pwMS perspective for use with General Practitioners? It's been on my mind since my diagnosis but I haven't taken it any further to date because living with MS and volunteering has been my focus up until now.
Thank you so much for sharing this Prof G, it is greatly appreciated!
Are you aware of the ATA 188 study testing for the same factors in the State?
Thank you sir for sharing your thoughts on this. Can existing antivirals be used to bring down the number of anti-EBNA1 antibodies and hence treat MS?
Could MS be cured if immune system could be made to tolerate myelin sheath? Is there any research going on on that front?
Bad luck such an insult. Also your circle is off where it should be.
Hi Prof G, I’m organising a fundraiser & would like to raise funds for an MS cause. I usually donate to the MS Society but thought this time I could raise money for the MS-Selfie. I don’t think it’s a registered charity, is it? Can I still do this? I plan to do a verrry long swimathon :) :)
I do not ever remember having EBV as child or or teenager. Is this something I should ask my neuro to test for?