"The Kissing Disease" and Multiple Sclerosis: Is there hope for a vaccine?

Patient Expert

Glandular fever, infectious mononucleosis, mono, and "the kissing disease" are terms for the same disease caused by the Epstein-Barr virus (EBV) which is a human lymphotropic herpesvirus which lays dormant in the body once infected.

In young children, the virus is usually asymptomatic.   But in adolescents and young adults, whose immune systems are very active, it can manifest as mononucleosis.   Estimates are that 90-95% of the world population is infected with the Epstein-Barr virus.

Researchers from the University of Queensland, led by Michael Pender, confirm the connection between EBV and multiple sclerosis.   Supported by Multiple Sclerosis Research Australia, Pender investigated the hypothesis that a defect in the immune system of patients with MS affects the ability to recognize EBV and allows the virus to persist in the brain.   The presence of EBV infections may then trigger the development of MS in genetically susceptible people.

Study results are published online in the Journal of Neurology, Neurosurgery, and Psychiatry - "Decreased T-cell reactivity to Epstein-Barr virus-infected lymphoblastoid cell lines in multiple sclerosis."   For more information, you can download the results.

Additional research in Switzerland (Jilek, Schluep, et al.) supports the hypothesis that EBV might be associated with MS onset.   Findings show that high levels of CD8+ T-cell activation against EBV appear early in the course of MS, but decline over time.   Published in Brain - "Strong EBV-specific CD8+ T-cell response in patients with early multiple sclerosis.

A separate study (Lünemann, Jelcic, et al.) published online concludes that clonally expanded EBNA1-specific CD4+ T cells potentially contribute to the development of MS by cross-recognition of myelin antigens. In The Journal of Experimental Medicine - "EBNA1-specific T cells from patients with multiple sclerosis cross react with myelin antigens and co-produce IFN-{gamma} and IL-2." Here is the abstract.

Finally, research to develop an effective vaccine for the Epstein-Barr virus is ongoing at the Australian Centre for Vaccine Development, Queensland Institute of Medical Research.   Results from an early vaccine trial are published in the Journal of Virology - "Phase I Trial of a CD8+ T-Cell Peptide Epitope-Based Vaccine for Infectious Mononucleosis."

As reported in The Sydney Morning Herald, Vaccine Hope in MS Link to Virus, the connection between the Epstein-Barr virus and the onset of MS, when combined with the development of an effective vaccine against EBV, may give hope to future generations of persons having a higher risk of developing multiple sclerosis.

Lead researcher at University of Queensland, Michael Pender, has said that once the glandular fever vaccine is fully tested, it could be included in Australia's childhood vaccine program for people who had a diagnosed relative (a higher risk factor).   However, Robert Booy, a professor in pediatrics with the National Centre for Immunization Research at the Children's Hospital at Westmead, said that until scientists could establish the exact cause of MS, it was impossible to ensure a vaccine did not contain proteins which could trigger multiple sclerosis.

The scientific chairman of MS Research Australia, Bill Carroll, agreed, saying he was excited that the link between Epstein-Barr and multiple sclerosis had been further confirmed, but remained cautious about the efficacy of a vaccine.

"EBV is an important prerequisite in multiple sclerosis but it is not the only factor which causes the disease. There is also often a 20-year time lag between contracting EBV and MS, so it is impossible to say that other factors, influenced by genetics and the environment, do not come into play during that time and can still result in a person developing the disease," Dr Carroll said.

You can also listen to a radio interview with Dr. Michael Pender of Queensland University for more information.