Brain & Nervous System Multiple Sclerosis Treatment Can Immunotherapy for Epstein-Barr Be a Potential MS Treatment? By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Colleen Doherty, MD Medically reviewed by Medically reviewed by Diana Apetauerova, MD on August 23, 2020 linkedin Diana Apetauerova, MD, is board-certified in neurology with a subspecialty in movement disorders. She is an associate clinical professor of neurology at Tufts School of Medicine. Learn about our Medical Review Board Diana Apetauerova, MD on August 23, 2020 Print Table of Contents View All Table of Contents Emerging Research EBV-Targeted Immunotherapy Results Safety Epstein-Barr virus (EBV) causes a lifelong infection and has been linked to the development of multiple sclerosis (MS) in genetically susceptible people. Infection with EBV is extremely common. In fact, approximately 90% of the world's population is infected. This is because the virus is easily spread, mostly through saliva, but it can also be transmitted through other bodily fluids such as blood or semen. Even if infected with EBV, the symptoms resemble those of other common viruses. Many people never even realize they are infected at all. There is currently no treatment to remove the virus from your body. There is also no vaccine currently available to prevent EBV infection. Hailshadow / Getty Images Emerging Research Based on the strong evidence that EBV may be a culprit behind MS pathogenesis, researchers are now working tirelessly to find a treatment that targets EBV. Hopefully, this will result in the slowing down of a person's MS disease course and perhaps even prevent MS from developing in the first place. While these goals are only emerging, very early studies are showing some promise. This includes one Australian study that examined EBV-targeted immunotherapy—a therapy that uses a person's own immune system to combat a foreign invader, like a virus or cancer. What Is Immunotherapy? EBV-Targeted Immunotherapy In the Australian study in The Journal of Clinical Investigation, 10 patients (five with secondary progressive MS and five with primary progressive MS) were given an adoptive T-cell therapy—a type of immunotherapy in which EBV-specific T cells from the bloodstreams of the participants are removed, regrown in a laboratory, and then infused back into their blood. While being regrown, the T cells were stimulated to be more targeted towards the EBV virus. This way they can better attack and control the infection within the body. Results Results revealed that among the 10 participants who received the targeted EBV therapy, seven showed clinical improvement, with improvements in various reported MS symptoms, such as: FatigueBalanceCognitive skills (such as word-finding skills, concentration, and mental clarity)MoodManual dexterity (improvement in handwriting)Urinating at nightLeg spasticitySleepVision acuityOverall quality of life The reduction in fatigue is one of the most commonly reported clinical improvements. This is intriguing because fatigue is one of the most prominent and disabling symptoms of both MS and acute infectious mononucleosis, also called mono—an illness caused by EBV infection. Besides the MS symptoms listed above, it's interesting to note that three of the participants experienced a reduction in their Expanded Disability Status Scale (EDSS) score. On the flip side, two of the 10 participants did not show any MS symptom improvement. However, they did remain stable, meaning there was no reported worsening of their MS symptoms. Keep in mind, one participant experienced an initial MS symptom improvement but then deteriorated with an increase in their EDSS score at the end of the study. (Although, the authors of the study noted that this was "in the setting of heightened psychosocial stressors.") The Many Symptoms of Multiple Sclerosis Safety Overall, the T cell therapy used in this study was well-tolerated and safe with no serious adverse events reported. In fact, the only treatment-related adverse event reported in the study was "transient dysgeusia," or impaired taste, occurring in one participant. Study Review It's important to note that this study is a phase one trial, which is the first step in a long process to examine a new therapy. In other words, the purpose of this study (and any phase one trial) is to test the waters and to determine whether this T-cell immunotherapy can be given safely without worrisome side effects. This study only included a very small number of participants. In addition, with phase one trials, there is no control group. This means that it is difficult to determine whether any clinical improvement seen in this study was simply by chance or from actually receiving the T-cell therapy. Moreover, as the authors of the study dutifully noted, this immunotherapy is not without risk. It's possible that transferring EBV-specific T cells into the blood of people with MS could backfire and actually worsen MS by triggering or aggravating inflammation within the central nervous system. The thought behind this potential outcome is that the T cells may mistake EBV antigens for antigens within the brain and spinal cord (this phenomenon is called cross-reactivity). Lastly, the potential long-term benefits of this unique immunotherapy are unclear. It's possible that as the T cells' ability to target EBV within the body dwindles, a person's MS could worsen. A Word From Verywell Larger and more controlled trials are needed to see if EBV-specific T cell therapy is indeed an effective MS therapy. Regardless, this study is a good first step—and it serves as a motivator for those with MS to remain resilient and hopeful in their own MS journeys. How Are Mono and MS Linked? Was this page helpful? Thanks for your feedback! Get tips and advice on how you can live a full and happy life with MS. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. (2018). Epstein-Barr Virus and Infectious Mononucleosis. Pender MP, Burrows SR. Epstein-Barr virus and multiple sclerosis: potential opportunities for immunotherapy. Clin Transl Immunology. 2014 Oct;3(10):e27. doi:10.1038/cti.2014.25 Pender MP et al. Epstein-Barr virus-specific T cell therapy for progressive multiple sclerosis. JCI Insight. 2018 Nov 15;3(22). doi:10.1172/jci.insight.124714