A new treatment that boosts immunity to Epstein-Barr virus may benefit patients with multiple sclerosis, according to the results of an Australian study published in the Multiple Sclerosis Journal.
In their study report, Michael Pender, a professor at the University of Queensland School of Medicine, Brisbane, and colleagues describe how a patient with advanced multiple sclerosis (MS) experienced noticeable clinical improvement after receiving 6 weeks of the immunotherapy treatment.
MS is an inflammatory disease, where the body's own immune system attacks and destroys myelin, the protein that insulates the nerves in the spinal cord, brain and optic nerve and stops the electrical signals they convey from leaking out.
As the disease advances, symptoms progress from mild numbness in the limbs to paralysis and blindness.
Estimates from the National Multiple Sclerosis Society suggest MS affects around 400,000 Americans. In Australia, the number of people affected by the disease is thought to be over 23,000.
Epstein-Barr virus (EBV) is a virus of the herpes family and one of the most common viruses in humans. It affects 9 out of 10 people at some point in their lives and is best known as the cause of glandular fever (infectious mononucleosis). EBV was the first human virus found to be associated with cancer.
Prof. Pender has been researching MS for over 30 years and 10 years ago proposed the idea that people with MS have impaired immunity to EBV.
First study to test EBV-specific adoptive immunotherapy in MS patient
In this latest study, he and his colleagues tested a new treatment that boosts the ability of CD8 T cells in the immune system to fight against EBV. They believe the approach, called adoptive immunotherapy, could potentially treat MS and other chronic autoimmune diseases.
The study had one patient, a 43-year-old man with secondary progressive MS. They gave him a 6-week course of the treatment, which appeared to produce no adverse side effects.
The treatment involves taking some of the patient's blood so the researchers can harvest some of his own T cells and grow them in the lab together with an EBV vaccine. Then, the boosted cells are transferred back to the patient intravenously.
The treatment was developed in the lab of study co-author Rajiv Khanna, a professor at the QIMR Berghofer Medical Research Institute, also in Brisbane, where Prof. Khanna uses it to treat patients with EBV-related malignancy.
The patient started to show signs of clinical improvement within 2 weeks of starting treatment. These improvements were still there 21 weeks later, at the most recent follow-up point.
This is the first time the treatment, called EBV-specific adoptive immunotherapy, has been used to treat a patient with progressive MS.
Prof. Pender says:
"The beneficial effect of boosting immunity to EBV by this treatment highlights the importance of impaired immunity to EBV in the development of MS. We believe the treatment corrects the impaired CD8 T cell immunity that allowed EBV infection to cause MS."
'An amazing change for the better'
The patient, Gary Allen, has been unable to walk or transfer himself without assistance since 2008, and he works full-time from his home in Brisbane. He had his first MS attack in 1994 and was diagnosed with relapsing-remitting MS in 2000, which later developed into secondary progressive MS.
After receiving the treatment, he experienced a significant improvement in attention, memory, thinking and hand function, a reduction in fatigue and painful spasms, and increased work productivity.
Also, an MRI scan of his brain showed decreased disease activity, his cerebrospinal fluid showed a decrease in antibodies, and at the latest follow-up, there was some improvement in leg movement.
Mr. Allen says he can carry out everyday tasks more easily and is able to spend more time with his son, and adds, "whether you look at my work, time with family or resurgent social life, it's been an amazing change for the better."
The researchers say the treatment now needs to undergo a clinical trial to test its safety and effectiveness in a larger sample of patients with varying forms of MS.
In February 2013, Medical News Today reported how another team of researchers in the US discovered new clues to Epstein-Barr virus that they hope will help researchers explore unexplained links between EBV, autoimmune diseases, malaria and cancer.
Written by Catharine Paddock PhD