Can Immunotherapy for Epstein-Barr Be a Potential MS Treatment?

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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.

Epstein–Barr virus
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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.

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 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:

  • Fatigue
  • Balance
  • Cognitive skills (such as word-finding skills, concentration, and mental clarity)
  • Mood
  • Manual dexterity (improvement in handwriting)
  • Urinating at night
  • Leg spasticity
  • Sleep
  • Vision acuity
  • Overall 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 10 participants did not show any MS symptom improvement.; however, they did remain stable. One participant also experienced an initial MS symptom improvement but then deteriorated with an increase in their EDSS score at the end of the study. 


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 1 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 inflammation within the central nervous system as has happened in other experimental therapies.

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). Results from early studies have thus far been uncertain.

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.

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  1. Guan Y, Jakimovski D, Ramanathan M, Weinstock-Guttman B, Zivadinov R. The role of Epstein-Barr virus in multiple sclerosis: from molecular pathophysiology to in vivo imaging. Neural Regen Res. 2019 Mar;14(3):373-86. doi:10.4103/1673-5374.245462

  2. Hoover K, Higginbotham K. Epstein Barr virus. In: StatPearls [Internet]. Updated November 20, 2020.

  3. 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

  4. McLaughlin LP, Bollard CM, Keller MD. Adoptive T cell therapy for Epstein–Barr virus complications in patients with primary immunodeficiency disorders. Front Immunol. 2018;9:556. doi:10.3389/fimmu.2018.00556

  5. Rowntree LC, Nguyen THO, Halim H, et al. Inability to detect cross-reactive memory T cells challenges the frequency of heterologous immunity among common viruses. J Immunol. 2018 Jun 14;200(12);3993-4003. doi:0.4049/jimmunol.1800010