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Epstein Barr Infection Raises Risk of Pediatric Multiple Sclerosis: Presented at AAN

By Charlene Laino

HONOLULU, HI -- April 7, 2003 -- Infection with Epstein Barr virus appears to raise the risk of pediatric multiple sclerosis, findings from a new study suggests.

Brenda L. Banwell, from the department of pediatrics, Hospital for Sick Children, in Toronto, Canada, presented the findings here on April 2^nd at the 55^th Annual Meeting of American Academy of Neurology.

Dr. Banwell noted that adults with multiple sclerosis are more likely to be seropositive for Epstein Barr virus than individuals that without the disorder, and that acute mononucleosis in adulthood is known to raise the risk of multiple sclerosis several-fold.

Since seropositivity for Epstein Barr virus is nearly universal by adulthood, any comparative analysis between adult multiple sclerosis patients and controls is limited, she said.

Children offer a better model for studying the association, she explained, since if there is a link, pediatric multiple sclerosis patients would be expected to be Epstein Barr virus-positive at an age when their healthy peers may not yet have had exposure to the virus.

For the prospective study, the researchers obtained serum samples from 25 children who had been diagnosed with multiple sclerosis and 75 age-matched controls from whom serology was drawn due to acute symptoms of abdominal pain, pharyngitis or rash.

All 100 samples were analyzed for Epstein Barr virus capsid antigen (EBV-VCA), Epstein Barr virus nuclear antigen (EBV-EBNA) and Epstein Barr virus early antigen (EBV-EA).

To determine if any other viral infection might play a role in the pathobiology of multiple sclerosis, serology from the 25 pediatric multiple sclerosis patients and 15 age-matched controls were also analyzed for parvovirus B19 (parvo B19), cytomegalovirus (CMV) and varicella zoster (VZV).

The study showed that 89% of pediatric multiple sclerosis patients were positive for EBV-VCA and EBV-EBNA, compared with 31% of controls (P<0.0004). Three children with multiple sclerosis (12%) were negative for all three Epstein Barr virus antigens, Dr. Banwell said.

Multiple sclerosis patients were no more likely to be seropositive for any of the other viruses than controls: parvovirus B19 (49% vs. 64%, p=NS); CMV (42% vs. 64%, p=NS); and VZV (88% vs 92%, p=NS).

While the study was not designed to find out why Epstein Barr virus infection might raise the risk of multiple sclerosis, Dr. Banwell noted that the virus has a lifelong effect in promoting B cell proliferation and T cell surveillance, and may play a pivotal role in promoting the autoimmune cascade that induces central nervous system demyelination in children with multiple sclerosis.


[Study title: Viral Studies in Pediatric Multiple Sclerosis. Abstract: S41.002]

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