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

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After you have been exposed to the Epstein-Barr virus (EBV), it will remain in your body for a lifetime. While it doesn't usually cause illness, this virus 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.

The symptoms resemble those of other common viruses and most people never even realize they are infected at all. There is currently no treatment to eradicate EBV from your body. There is also no vaccine currently available to prevent EBV infection.

Epstein–Barr virus
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Based on evidence that EBV may contribute to the development of MS, researchers are working to find a treatment that targets the virus. It's still not clear whether treating EBV could slow down a person's MS disease course or perhaps even prevent MS from developing in the first place.

While these goals are only emerging, one very small study showed some promise. This Australian study examined the safety and effects of EBV-targeted immunotherapy—a therapy that uses a person's own immune system to combat illness.

EBV-Targeted Immunotherapy

In the Australian study published 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. This is a type of immunotherapy in which the participants' EBV-specific T cells are removed from the bloodstream, regrown in a laboratory, and then infused back into their blood.

While being regrown, the T cells were stimulated to target the EBV virus with the aim of making them better able to attack and control the virus within the body.


Results revealed that among the 10 participants who received the targeted EBV therapy, seven showed improvements in various 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 was one of the most commonly reported clinical improvements. This is important 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.

In addition to improvements in their MS symptoms, three of the participants experienced a reduction in their Expanded Disability Status Scale (EDSS) score.

Some participants did not show any MS symptom improvement and remained stable. One participant 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 (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 in terms of safety and 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 a study was simply by chance or from actually receiving the T-cell therapy.

Moreover, as the authors of the study noted, 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 with other experimental therapies.

One possible explanation for worsening symptoms is that the T cells may mistake non-EBV antigens for EBV antigens within the brain and spinal cord—a phenomenon called cross-reactivity. Results from early studies have thus far been uncertain.

Lastly, the potential long-term benefits of this unique immunotherapy are unclear. A follow up three years later showed sustained benefit. However, 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.

6 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.
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  2. Hoover K, Higginbotham K. Epstein Barr virus. In: StatPearls [Internet].

  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

  6. Ioannides ZA, Csurhes PA, Douglas NL, Mackenroth G, Swayne A, Thompson KM, Hopkins TJ, Green KA, Blum S, Hooper KD, Wyssusek KH, Coulthard A, Pender MP. Sustained clinical improvement in a subset of patients With progressive multiple sclerosis treated with Epstein-Barr virus-specific T cell therapy. Front Neurol. 2021 Mar 15;12:652811. doi:10.3389/fneur.2021.652811

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.