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.

* * * * *

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.

* * * * *

Affiliate disclaimer: This affiliate disclosure details the affiliate relationships of MS, Health & Disability at 50shadesofsun.com with other companies and products. Read more.

* * * * *

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.

MS is linked to Glandular Fever, I have no doubt

This article, written by me, first appeared on Multiple Sclerosis News Today website.

shutterstock_326201135
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.

So, you can just imagine my delight in seeing that research into this is now in its second year of a two-year project in Australia.

Early last year, MS Research Australia awarded a $150,000 grant to support a project being conducted at Murdoch University, as was reported in Multiple Sclerosis News Today in March 2015.1 The project is aiming to expand scientific knowledge about the possibility or probability that MS is linked to glandular fever and the Epstein-Barr Virus (EBV).

shutterstock_350858348EBV is known to cause glandular fever, otherwise known as infectious mononucleosis.2

The research grant was awarded to David Nolan, an adjunct associate professor at the Institute of Immunology and Infectious Diseases (IIID), and is funding two years of investigation.

Research is focusing on MS and the infectious condition known as glandular fever following encouraging results on the link between MS development and viral infections.

My personal interest in this research is because I firmly believe that glandular fever did trigger MS in me.

Let me explain. When I was finally diagnosed with MS in 2002, I was 49 years old. However, the neurologist who gave me the news said that he had gone back through my medical records and found evidence of MS existing as long ago as my 20s. Early to mid-20s to be exact.

Remarkable ‘coincidence’

Thinking nothing of it at the time, not then being aware of any possible link, I had glandular fever at the age of 21, almost 22, and evidence of MS in my early to mid-20s. Isn’t that a remarkable coincidence? If you believe in coincidences, that is!

A clinical link may not be scientifically proven in my case but, if you were me, would you need any further proof? I most certainly don’t!

Now I am waiting to see what the Murdoch University investigation proves.

As previously reported in Multiple Sclerosis News Today, Prof. Nolan spoke about the research. He said: “It appears that there is a strong association between the Epstein-Barr virus and MS but it’s too early to say if it is the cause.

“We know that the Epstein-Barr virus specifically infects immune cells that produce antibodies, B cells, essentially hiding away within the immune system. For reasons that are still poorly understood, it seems that those affected by MS have an abnormal response to this virus and that the nervous system might be unintentionally targeted by the immune system as part of this response.”

Nolan and his research team are searching for infected B cells while attempting to develop a targeted treatment to address them. The main purpose of the project is to find a way to stop disease progression through novel therapeutic approaches that can address the underlying mechanisms of the disease.

During these two years, researchers are focusing on Epstein-Barr virus infected cells. “The research funding gives us a chance to make a real step forward in understanding the basis of Multiple Sclerosis and therefore improving both disease monitoring and treatment,” added Dr. Nolan.

 

1MS Research Australia Funds Project on MS and Epstein-Barr Virus, MS News Today.

2Patient – Trusted medical information and support and many other sources.

 

MSNT strapline copy

 

 

News from Australia: ‘Catching glandular fever can prevent multiple sclerosis’

news corp logo  Logo of News Corp Australia.

What? Really?  The headline above not only caught my eye but stopped me in my tracks yesterday when I saw it on another blog site.

I already knew that the Epstein Barr Virus that leads to glandular fever also has a link to MS but in a negative way. So how could someone now be saying the opposite? This deserved further investigation.

Clicking on the story itself, published on news.com.au website, and it all becomes clear – the headline is misleading. It does not reflect the whole story written by Sue Dunlevy, of News Corp Australia Network.

In her original article, Sue wrote:

A DOSE of Epstein Barr Virus that causes glandular fever as a child and high dose prescription vitamin D could be the key to slashing Australia’s high rate of the debilitating Multiple Sclerosis disease.

Remember the key words ‘as a child’. They are crucial. Later, in the same article, it is explained . She wrote:

Prof David Booth.

Prof David Booth.

Sydney University Professor David Booth says people who contact Epstein Barr Virus that causes glandular fever before the age of ten are four times less likely to contract MS while those who get it later in life are up to 20 times more likely to get the disease.

So, catching glandular fever before you are 10 means you are LESS likely to fall foul of multiple sclerosis but getting GF at an older age means you are MUCH MORE likely to develop the disease. I had glandular fever when I was 21 and when MS was finally diagnosed, 28 years later, my neurologist said my medical records showed symptoms in my early to mid-20s.

The article also contained news from Australia about MS and vitamin D:

The distance of our major capital cities from the equator means Australians are at greater risk of the disabling disease that attacks the protective insulation around nerve fibres (myelin) in the brain and spinal cord.

Every day four Australians are diagnosed with MS, the average age of diagnosis is just 30 years of age and people living in Hobart are seven times more susceptible to the disease than those living in North Queensland. The closer you are to the equator when you grow up, the less likely you are to get MS.

Currently, there is no cure and the breakthrough treatments that are available have serious side effects.

Researchers who have identified the genes linked to MS want to trial a special prescription vitamin D to see if it can help treat and prevent the disease that afflicts 23,000 Australians.

Professor Booth has helped identify the genetic key to how vitamin D may be protective against Multiple Sclerosis (MS). “Vitamin D is the master regulator of which genes are turned on and off in a cell and they control the body’s immune response,” he says.

These genes are implicated not just in MS but also Crohn’s disease, inflammatory bowel disease, lupus and Coealiac (sic) disease.

“Now we know vitamin D genes increase your risk of auto-immune diseases, if we can track down what vitamin D does we can better use it to treat the problem, he says.

MS Research is currently funding a trial to test over the counter vitamin D supplements in preventing MS. Professor Booth says there could also be merit in testing high dose vitamin D prescription drug paracalcitol as a prevention and treatment for MS. This drug gets around the body’s regulation of vitamin D levels.

Other ways you can reduce your risk of MS is to stop smoking, get enough sunlight, reduce salt in your diet.

Back to the headline. To correct it, just add those three key words I told you to remember ‘as a child’ and the heading would read ‘Catching glandular fever as a child can prevent multiple sclerosis’.

Attack on myelin insulation involved in Zika deaths

who logo

Zika, a mosquito-borne disease that has now declared an international public health emergency by the World Health Organization, has certain similarities to other illnesses that some people may find disturbing.

In Columbia, so far, Zika has caused three deaths and the country’s Health Minister, Alejandro Gaviria, said there was a “causal connection” between Zika, the Guillain-Barré disorder and all three deaths.

Earlier, Brazilian scientists said they had detected for the first time active samples of Zika in urine and saliva but it is not clear whether the virus can be transmitted through bodily fluids.

Martha Lucia Ospina, head of Colombia’s National Health Institute, said: “We have confirmed and attributed three deaths to Zika. In this case, the three deaths were preceded by Guillain-Barré syndrome.”

Whoa! Just a second. Guillain-Barré  syndrome? Yes, this has been described as a rare disorder in which the body’s immune system attacks part of the nervous system. It isn’t normally fatal. It is an autoimmune disease caused by the body’s immune system mistakenly attacking the peripheral nerves and damaging their myelin insulation.

And that, as anyone living with, or having a knowledge of, multiple sclerosis will tell you is exactly the same – the body’s immune system mistakenly attacking the nerves’ myelin insulation.

Unfortunately, it doesn’t stop there.

MS has been linked to the Epstein-Barr virus as one of its possible causes. EBV can lead to glandular fever and then, it seems more than likely, to multiple sclerosis.

Meanwhile, Guillain–Barré syndrome (GBS) is a rapid-onset muscle weakness as a result of damage to the peripheral nervous system. You need to ignore the similarities in the names, it is just a coincidence as Barr and Barré were different scientists.

The precise cause of Guillain-Barré is unknown. According to the USA’s Centers for Disease Control and Prevention (CDC), about two-thirds of people with Guillain-Barre develop it soon after they’ve been sick with diarrhoea (US diarrhea) or a respiratory infection. This, according to healthline.com, suggests that the disorder may be triggered by an improper immune response to the previous illness but other infections have also been associated with Guillain-Barré.

These include: influenza; cytomegalovirus, which is a strain of the herpes virus; Epstein-Barr virus infection or mononucleosis (glandular fever); mycoplasma pneumonia, which is an atypical pneumonia caused by bacteria-like organisms; and HIV or AIDS.

With Guillain-Barré, many people experience changes in sensation or develop pain, followed by muscle weakness beginning in the feet and hands. The symptoms develop over half a day to two weeks. During the acute phase, the disorder can be life-threatening with about a quarter developing weakness of the breathing muscles and requiring mechanical ventilation. Some are affected by changes in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure. Sometimes this immune dysfunction is triggered by an infection.

Diagnosis is usually made based on the signs and symptoms, through the exclusion of alternative causes, and supported by tests such as nerve conduction studies and examination of the cerebrospinal fluid.

Various classifications exist, depending on the areas of weakness, results of nerve conduction studies, and the presence of particular antibodies. It is classified as an acute polyneuropathy.

 

Why me? Maybe I have my answer

IMG_0796_cropped  ms montage

Most people being forced to live with an illness such as multiple sclerosis are bound to ask in those blackest of moments ‘why me?’ Despite my positive outlook on life, I certainly did a few years ago when I had several falls in one day.

I can still recall that awful day when, having taken yet another tumble, I swore out loud about ‘this ******* MS’ and, in pure frustration, hammered the floor with my good hand as I cried out ‘why me?’

Ok, so those dark emotional days are well behind me now, I have grown used to living with my MS. Looking back is something I do with pleasure, remembering the good times and my successes while forgetting the rest. Looking forward is full of anticipation and hope, while the present is for living every moment to the fullest that can be managed.

Now, the question ‘why me?’ is no longer asked. MS is an uninvited guest that is not going away. But I am still interested in how it got in. In other words, what caused it in me.

No single cause of MS has yet been identified but various sources reveal that scientists believe that the likelihood of contracting the illness is linked to four factors. These are: Immunologic, Genetic, Environmental and Infections.

Immunologic; It is well established that in MS the immune system malfunctions and attacks the central nervous system. Researchers know that the myelin sheath is directly affected, but they don’t know what triggers the immune system to attack the myelin.

Genetic: Several genes are believed to play a role in MS. The chance of developing MS is slightly higher if a close relative, such as a parent or sibling, has the disease. According to the Multiple Sclerosis Foundation (MSF), if one parent has MS, the risk of their children getting the disease is estimated to be between two and five percent. Scientists believe that some people are born with a genetic susceptibility to react to certain, but as yet unknown, environmental agents. Maybe an autoimmune response is triggered when they encounter these agents.

Environmental: It is now well-known that MS is more predominant in countries that are further away from the equator and this has indicated that a lack of vitamin D may play a role. Vitamin D does benefit the function of the immune system. People who live near the equator are exposed to more sunlight. The more sunlight that skin receives, the more the body naturally produces the vitamin.

Infections: Researchers are considering the possibility that viruses and bacteria may cause MS. Viruses are known to cause inflammation and a breakdown of myelin (called demyelination). Therefore, it’s possible that a virus could trigger MS. Several viruses and bacteria are being investigated to determine if they’re involved. These include: measles, human herpes virus-6 and Epstein-Barr virus that causes glandular fever.

Ok, so how does all that affect me? I have no idea about the immunology but there was no-one in my family with MS, so a genetic cause can be discounted.

Of course, environmental factors could well play a part as from birth until my 63rd birthday I lived in the UK, first in the south-east and, for the last 23 years, further north in North Wales. The lack of sunlight in the UK, especially the further north you go, comes as no surprise, but University of Oxford researchers used NASA satellite data to quantify the decreasing levels of UV (ultraviolet) rays from the sun as you move north. Less UV means less vitamin D produced in the body. There are also concerns that worries about skin cancer mean people can cover up too much. New official advice stresses the need to strike a balance between healthy sun exposure and skin cancer risks.

I have already said, in a previous blog post https://50shadesofsun.com/?m=201508&paged=2, the poor British weather with almost constant grey skies, rain and strong winds – plus my desire to increase my vitamin D level – was the prime reason behind our move to Spain.

Finally, and for me the most telling factor, is infection. Of the infection listed as possible causes of MS, one was the Epstein-Barr virus that causes glandular fever and this I had in or about 1974. That year I was approaching my 22nd birthday.

When I was finally diagnosed with MS, 27 years later, the consultant neurologist told me that he had gone back through my medical records and found evidence of MS as far back as my mid-20s.

Hmm, glandular fever at 21, almost 22, and evidence of MS mid-20s. A clinical link may not be scientifically proven but, if you were me, would you need any further proof? I most certainly don’t!