I said it 14 months ago, now researchers agree: MS is linked to ‘mono’

Great news. Science now backs my view, published here on July 14 last year, that MS is linked to glandular fever. The Epstein-Barr virus (EBV) causes mononucleosis or just mono, otherwise known as glandular fever. Researchers have just uncovered what they describe as a biological link between EBV and MS.

Fourteen months ago, in this blog, I posted an article titled MS is linked to Glandular Fever, I have no doubt: In it, I wrote:

“In my mind, MS is linked to glandular fever. From personal experience, there is no room for doubt of any kind.

“Trouble is, though, that my experience and belief is not proof. And that is why I find that efforts to establish a definite link between glandular fever, often known as the kissing disease, and MS is an exciting area of research.”

And that’s what they have now done.

biological link

Dr Annette Langer-Gould (pic: Kaiser Permanente Research).

Researchers led by Dr Annette Langer-Gould1 have now found a link between EBV and MS in three racial-ethnic groups. African-Americans and Latinos showing a higher risk for MS than Caucasians.

The research study, “Epstein-Barr virus, cytomegalovirus, and multiple sclerosis susceptibility,” was published in the journal Neurology.

In the past, other studies have suggested that EBV infection, which causes mononucleosis/glandular fever, increases the risk for MS.

Strong biological link

“Previous studies that have found a link between mononucleosis and MS have looked primarily at white populations, so for our study, we examined whether there was a similar link for other racial groups as well,” Dr Langer-Gould said in a press release. “Indeed, we did find a strong biological link for all three racial groups.

“While many people had Epstein-Barr virus antibodies in their blood, we found among all three groups, people who also developed mono in their teen years or later had a greater risk of MS. Delaying Epstein-Barr virus infection into adolescence or adulthood may be a critical risk factor for MS,” she said.

Recently, infection with cytomegalovirus (CMV), has been controversially linked to increased risk of MS. But researchers report that there was NO link for CMV. Instead, they found an inconsistent association across racial-ethnic groups. Antibodies against CMV are associated with a lower risk of MS, or clinically isolated syndrome, in Latinos. But this was not the case in African-Americans or Caucasians.

Overall, the researchers say that their results point to a strong biological link between EBV infection and MS. The say the results also highlight how understanding of the factors underlying MS can be greatly improved by multiethnic studies.

“Studies like ours that include participants from multiple racial groups can be a strong tool to test for biological risk factors, especially when the frequency of exposures to biological factors like Epstein-Barr virus and mononucleosis differ between groups. If the findings were not the same across all groups, it would be less likely that a link would be biological,” Langer-Gould said.

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1 Annette Langer-Gould, MD, PhD, is a Research Scientist in the Department of Research & Evaluation and serves as Regional Physician Multiple Sclerosis Champion at Kaiser Permanente Southern California. She is a practicing MS specialist at Los Angeles Medical Center.

Her epidemiologic research focuses on the role of vitamin D, genotype, race/ethnicity, and MS susceptibility, as well as predictors of prognosis and comparative effectiveness of MS therapeutics.

Dr Langer-Gould also leads a team developing, implementing, and evaluating programs to provide high-quality affordable care for individuals with MS.

She serves as co-chair of the Choosing Wisely Committee. She is a member of the Guidelines Development, Dissemination, and Implementation Subcommittee for the American Academy of Neurology. Additionally, she is a member of the National MS Society’s MS Prevalence Workgroup.

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50shadesofsun.com is the personal website of Ian Franks, a Clinical Writer with Healthline, the fastest growing health information site. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.