This Is MS Multiple Sclerosis Community: Knowledge & Support

Another evidence for a viral connection in MS.

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Varicella-zoster virus in cerebrospinal fluid at relapses of multiple sclerosis

OBJECTIVE: Recent studies in peripheral blood mononuclear cells (PBMCs) have indicated that exacerbations of multiple sclerosis (MS) could be associated with the reactivation of latent varicella-zoster virus (VZV).

METHODS: Ultrastructural observations for viral particles were made by electron microscopy in cerebrospinal fluid (CSF) from 15 MS patients during relapse, 19 MS patients during remission, and 28 control subjects. Initial findings were reproduced in a confirmation cohort. In addition, DNA from VZV was quantified by real-time polymerase chain reaction in PBMCs and CSF from a large number of MS patients (n = 78 ).

RESULTS: We found by electron microscopy the presence of abundant viral particles identical to VZV in CSF obtained from MS patients within the first few days of an acute relapse. In contrast, viral particles were not seen in CSF samples from MS patients in remission or from neurological control subjects. Also, DNA from VZV was present in CSF and in PBMCs during relapse, disappearing in most patients during remission. The mean viral load was 542 times greater in CSF at relapse than in CSF at remission and 328 times greater in CSF at relapse than in PBMCs at relapse.

INTERPRETATION: The ultrastructural finding of viral particles identical to VZV, together with the simultaneous presence of large quantities of DNA from VZV in the subarachnoid space, almost restricted to the periods of exacerbation, as well as its steady diminution and eventual disappearance from clinical relapse to clinical remission are surprising and constitute the strongest evidence to support the participation of VZV in the pathogenesis of MS.

Source: Ann Neurol 2008.(12/03/08 )

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Maybe obvious question - could the stronger MS treatments be knocking down an intractable virus along with the immune system or does biochemistry not work that way?

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Some interesting thoughts about VZV and MS-

the virus can have a relapsing/remitting pattern ie: lay dormant and then resurge- as in adult shingles, (or MS...)
the virus has been given as a vaccine since 1995- children are no longer exposed to it during the elementary school years, but are now given vaccines as infants and toddlers. (correlation to younger children presenting with MS?)
VZV is part of the human herpes family of EBV, HSV- implicated in MS
Everybody gets VZV.

Reason I'm thinking about VZV today is because my husband had a strange rash on dx last year, and is seeing derm today for the same rash, which has come back this March. I'm hoping/praying this rash does not signal a relapse- or anything worse. we'll see...
best,
AC

_________________
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
dual stents placed 5/09
CCSVI in MS

Was thinking about this this morning, and had another (obvious) thought: why don't we see MS as being contagious if its virus based?

Or is it possible to literally have herpes or a similar virus but never show any signs of it?

It is possible to have these viruses and never know it. I read at some point that a large portion of the population carries a herpes virus, many never showing any signs.

A couple of years back a research team in Mexico led by Julio Sotelo made a discovery that went largely unnoticed. They showed that the chicken pox virus varicella zoster (which is a well known form of herpes) was present in the CSF of 95 % of MS patients during relapses. It was not found in the CSF of controls.

Why is that I wonder?

Not only that but as they measured the virus it showed an increasing curve that correlated with the degree off the relapses, until it was 542 times greater than during remission. Not surprisingly, Sotelo seems to think that this virus is "linked to the pathogenisis of MS."

http://cat.inist.fr/?aModele=afficheN&cpsidt=18747883

Herpes attacks are known to often occur as a reaction to physical and psychological stress...rather like MS.

Is it possible for Zamboni's CCSVI theory to fit in with findings like these? Well, I tried, and I did come across this:

Varicella zoster virus vasculopathies

Chicken pox is known to sometimes cause devastating vascular damage as a complication in children - maybe it can also do minor vascular damage that goes unnoticed. Come to think of it these two theories could sit very well together....

Better start eating blackcurrants!


gainsbourg

On the other hand, there is this group:


Varicella zoster virus is not a disease-relevant antigen in multiple sclerosis.

Ann Neurol. 2009 Apr;65(4):474-9.
Burgoon MP, Cohrs RJ, Bennett JL, Anderson SW, Ritchie AM, Cepok S, Hemmer B, Gilden D, Owens GP.
Department of Neurology, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA. mark.burgoon@uchsc.edu

Herpesvirions and varicella zoster virus (VZV) DNA were recently reported in all 15 cerebrospinal fluid (CSF) samples from patients with relapsing-remitting multiple sclerosis (MS) obtained within 1 week of exacerbation. Using identical electron microscopic and polymerase chain reaction techniques, including additional primer sets representing different regions of the VZV genome, we found no herpesvirions or VZV DNA in MS CSF or acute MS plaques. Although enzyme-linked immunosorbent assay analysis demonstrated a higher titer of VZV antibody in MS CSF than in inflammatory control samples, recombinant antibodies prepared from clonally expanded MS CSF plasma cells did not bind to VZV. VZV is not a disease-relevant antigen in MS.

http://www.ncbi.nlm.nih.gov/pubmed/19399839

I don't know why that other group are so dismissive.

Okay, they couldn't detect a direct connection between the mysterious presence in the CSF of Varicella Zoster Virus (DNA and antibodies) and MS pathology...(now that would be news!)...but that doesn't mean there isn't one. Remember, herpes is notorious for cloaking itself from the immune system.

Why was VZV not found in the CSF of any of the controls, including those with other neurological illnesses? Why was it exclusively found, only during MS relapses, disappearing completely during remission? For me 95% out of 131 MSrs and 0% out of 125 controls is too much to be coincidental.

Viruses are poorly understood, none more than the herpes virus. Up until the 1980's doctors were categorically telling us that there was absolutely no chance of catching genital herpes from oral herpes because they were totally different types (HSV1 and HSV2). Common sense told everybody else that there was a risk, and eventually the experts realised they'd got it wrong. A lot of people may have contracted genital herpes because they were misinformed!

Nobody knows why physical over exertion and stress can prelude herpes attacks or why stress so often seems to bring on MS attacks...is there some common denominator here?

In 2009 there was a big breakthrough with regard to the role of herpes in causing Alzheimers. It was discovered that herpes is a major cause of protein plaques in the brains of Alzheimers sufferers.

http://www.sciencedaily.com/releases/2008/12/081207134109.htm

gainsbourg

My 14yo was diagnosed with MS on the 17th December and around 10-14 days later she also developed shingles on her face which was treated with anti virals. Shingles is very unusual in a 14yo from my understanding.

Hi tcavm,

Interesting to hear about your daughter developing shingles 14 or so days after the MS diagnosis. Stress often precedes shingles by roughly the same time span.

Surely research has now established beyond doubt - viruses are a definite part of the MS equation, just as they have been saying about the peripheral nerves equivalent of MS - Guillain Barré Disease - for ages now, even though the role they play may not actually be an active one.

Herpes, Epstein Barr and HH-6 viruses may (or may not) play an active pathalogical role in MS...they could all be bystanders, catalysts or by products - but the curious presence of the Varicella Zoster Virus DNA (and antibodies) during attacks is beyond dispute.

I think it is immensely important establishing any part of the MS equation - because the more pieces of the equation that are known, the easier it should become to work out the "active" parts.

On the other hand, the fact that candida overgrowth is known to be present in all case of aids and cancer, has never, to my knowlege solved the mystery of those diseases.

By the way, sorry to hear about your 14 year old. I'm sure you will find lots of support and information here on this site. MS has a scary reputation but isn't always so terrible. Many with the illness get off lightly and I hope she will turn out to be one of those people.

I am a great believer that learning to cope with stress and anxiety is paramount, though it's unlikely to get so much as a mention from the neurologists. Of course, this is a big ask for anyone struck down by a debiltating and unpredictable disease.


gainsbourg