Some people develop multiple sclerosis after an infection. Could a vaccine prevent that — and what does it reveal about the long-term effects of viruses?
MS, a debilitating autoimmune disease, affects around 2.8 million people worldwide. As the immune system attacks nerves in the brain and spinal cord, stripping off their protective myelin sheathing, people with MS experience symptoms including fatigue, numbness, pain, loss of vision and depression. The symptoms worsen over time, and can lead to disability and shortened life expectancy. Drugs can slow the progress of disease, but don’t completely prevent symptoms.
Then, the team measured levels of a protein called neurofilament light chain, a marker of neurodegeneration. After EBV infection, those individuals who went on to develop MS had higher levels of neurodegeneration than did people who did not develop the condition. The combination of solid epidemiological data and mechanistic explanation is a compelling sales pitch for the post-viral theory, says Paul Lieberman, a molecular virologist at the Wistar Institute in Philadelphia, Pennsylvania. He was convinced even before the most recent data, but they “push the needle further”, he says. The surest way to convince the doubters would be to show that prevention or treatment of EBV wards off MS. “A clinical trial is definitely worth trying,” says Lieberman.
In the best case, EBV vaccines will provide long-lasting sterilizing immunity — blocking infection altogether. Vaccines against human papillomaviruses do this, and so prevent cervical cancer. But previous EBV vaccine candidates have not given that level of protection .
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