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Within the human body, dormant EBV resides in B cells. I wonder if this might be behind the efficacy displayed in drugs like Rituxan, when used treat MS patients. Rituxan destroys B cells in the human body, and I assume it destroys EBV along with them... Might this be a positive example "unexpected consequences"?...
Thanks for the article. There is lots of research looking at EBV and MS (in children with MS, in lesions with those with MS etc etc). The evidence is accumulating, but like you, I find it frustrating that no one can currently say "yes, its the trigger / cause".
Marcstck,
I think you are spot on. Once infected with EBV, it stays with you for life in B cells. Depleting B cells through treatments such as Rituxan, should provide further evdience of EBV invovlement (and some clinical benefit). There are next generation anti-B cells treatments in the pipeline.
I wonder if the fact that the virus is found in greater numbers in early MS is the reason that some of the meds (Cytoxin, Revimmune, Rituxan) work in RRMS and not the later stages.
gwa
Last edited by gwa on Wed Jul 09, 2008 10:52 am; edited 1 time in total
If EBV is the causative agent MS, there must be something else at play. How UV light affects the virus? How vitamin D levels affect it, modern diet, antibiotics, toxins....etc. The issue of latitude and MS prevalence still needs to be addressed.
AC _________________ Husband diagnosed RRMS March 2007
pursuing endothelial healing
Copaxone, Swank, supplements, laughter
An interesting issue regarding geographic distribution. I have read somewhere that EBV infection tends to be at a much earlier stage in life in developing countries. It seems to be the timing of EBV infection which is important. Of course there is also the possible protective effect of Vit D. Also, MS among woman is on the rise. A conference in November is examining many of these issues - see link to programme.
Joined: May 04, 2006 Posts: 3371 Location: Mid-Michigan
Posted: Wed Jul 09, 2008 11:34 am Post subject:
VERY good point AC and wise of you to notice and point it out.
So many times in MS research, researchers resort to trying to force the conditions to meet the facts rather than accept that one square corner is enough to keep the peg from being a consideration for the circular hole and that they need to keep looking.
Bob _________________ Wife diagnosed with MS in Feb. 2006 and is a participant in the Tovaxin IIb clinical trial.
Anyone have an idiot's explanation as to why EBV is untreatable? I don't understand how any virus can survive high dose chemotherapy. Perhaps its a matter of detection and being unable to identify compromised cells/dna.
Joined: May 04, 2006 Posts: 3371 Location: Mid-Michigan
Posted: Thu Jul 10, 2008 7:20 am Post subject:
rainer wrote:
Anyone have an idiot's explanation as to why EBV is untreatable? I don't understand how any virus can survive high dose chemotherapy. Perhaps its a matter of detection and being unable to identify compromised cells/dna.
Hi rainer,
I'm not aware of any studies which address the exact issue that you mention and you bring up a very interesting situation.
For the most part I don't think would be considered "cost effective" (in terms of risk vs benefit) to treat viruses by eliminating the cells in which they survive, but you've got a point in that total lymphocyte ablation like Revimmune should eliminate all traces of those viruses.
I wonder if that's something which Johns Hopkins has confirmed along the way?? Maybe that's part of the reason why infections after Revimmune treatments isn't nearly the risk that was originally expected?
Bob _________________ Wife diagnosed with MS in Feb. 2006 and is a participant in the Tovaxin IIb clinical trial.
Joined: Jul 28, 2005 Posts: 1268 Location: Sydney, Australia
Posted: Fri Jul 11, 2008 8:04 am Post subject:
Lyon wrote:
...to treat viruses by eliminating the cells in which they survive, but you've got a point in that total lymphocyte ablation like Revimmune should eliminate all traces of those viruses.
I don't think its that simple. Just think about the common cold. It can "live" outside the body during transfer. If you were to kill EBV's favourite hiding place, that does not mean you have killed every copy of it in your system.
Joined: May 04, 2006 Posts: 3371 Location: Mid-Michigan
Posted: Fri Jul 11, 2008 11:45 am Post subject:
CureOrBust wrote:
I don't think its that simple. Just think about the common cold. It can "live" outside the body during transfer. If you were to kill EBV's favourite hiding place, that does not mean you have killed every copy of it in your system.
You're right Cure, it may not be that simple. There are a lot of things that only time can tell.
Bob _________________ Wife diagnosed with MS in Feb. 2006 and is a participant in the Tovaxin IIb clinical trial.
Joined: Sep 11, 2007 Posts: 662 Location: southern California
Posted: Fri Jul 11, 2008 12:07 pm Post subject:
Here's someone thinking about the geographic implications of EBV and vitamin D. Only a hypothesis...
Vitamin D status modulates the immune response to Epstein Barr virus: "Synergistic effect of risk factors in multiple sclerosis."
"Vitamin D receptors are expressed on EBV infected B cells, antigen presenting cells and activated lymphocytes, and the bioactive vitamin D metabolite dihydroxyvitamin D(3) suppresses antibody production and T cell proliferation and skews T cells towards a less detrimental Th2 phenotype. EBV infected B cells constitute a constant challenge to the immune system, also during seasonal periods of relative low vitamin D status."
http://www.ncbi.nlm.nih.gov/pubmed/17574770
I've been drinking the vitamin D cool aid recently. This might explain why EBV mutates into different diseases in different latitudes.
What a really lousy virus!
AC _________________ Husband diagnosed RRMS March 2007
pursuing endothelial healing
Copaxone, Swank, supplements, laughter
All I can say is wow. I had a BAD 9 month case of EBV in 2006. Then another 9 months later I was diagnosed with MS. I had no previous symptoms of MS that I can ever recall before all this started. In addition, I was told I had a severe Vitamin D deficiency. In fact the neurologist told me that I had several risks factors and that all the stars had lined up. 1) recent and bad case of EBV 2) vitamin D deficiency 3) and grew up in a cold climate in the northeast. Total bummer.
Welcome. I had my bad EBV run-in at 15, but was not dx with MS until 39. However, there were three of us in an office and one colleague got a bad case of EBV (Glandular Fever) a year before i was dx (so I might have got re-infected?) and he got dx with MS a year after me. Here's some more info on the Vit D part of the puzzle:
Vitamin D, hope for a new disease fighter for Multiple Sclerosis 14 July 2008
In a Newark laboratory, researchers watch as mice stricken with multiple sclerosis suddenly walk. They peer into microscopes and see the growth of breast cancer cells dramatically slowed.
They are examining, up close, the power of vitamin D.
"We're believers," said Sylvia Christakos, a longtime vitamin researcher at UMDNJ-New Jersey Medical School.
Many others are following. A spate of provocative studies shows the potential health benefits of vitamin D on everything from breast, prostate and colon cancer to auto- immune disorders such as Type I diabetes, rheumatoid arthritis, lupus and multiple sclerosis.
The so-called "sunshine vitamin" may even protect the heart.
Some researchers, citing widespread vitamin D deficiencies among Americans, call current federal guidelines outdated and argue most people need far more of the nutrient than they get from food, multi-vitamins and the sun.
Others say more research is needed before Americans start downing supplements or exposing unprotected skin to height-of-the- day sun, whose ultraviolet rays help create the vitamin.
Few researchers, however, have studied the nutrient more closely than Christakos.
"There is finally more of a recognition of the value of vitamin D to prevent various diseases," she said. "But it's cheap and over-the-counter so you won't turn on the television and see commercials pushing vitamin D."
In a review scheduled for publi cation this week in the online Journal of Cellular Biochemistry, Christakos and her team conclude proper blood levels of vitamin D can protect people from multiple sclerosis. The review said the nutrient may help maintain balance in the immune system.
The team looked at MS in mice, and found those treated early with an active form of vitamin D improved dramatically. The stricken mice, once paralyzed, were able to walk, though Christakos said that does not mean the same will happen for people with MS.
The lab has gone a step further to show how vitamin D may work on a genetic level. Working with researchers from Stanford University, they showed how vitamin D likely inhibits a key inflammatory response involved in MS.
The data on vitamin D is accumulating. For example:
A Canadian study found women with breast cancer were nearly twice as likely to see their cancer spread, and far more likely to die, if deficient in the vitamin.
A 2007 study in the American Journal of Clinical Nutrition concluded improving calcium and vita min D levels substantially reduces all cancer risk in post-menopausal women.
In last year's New England Journal of Medicine, researcher Michael F. Holick of Boston University School of Medicine cited a study that found elderly French women given 1,200 mg of calcium and 800 international units (IU) of vitamin D daily for three years reduced their risk of hip fracture by 43 percent.
Holick cited another study that found women who took more than 400 IU of vitamin D had a 42 percent reduced risk of developing multiple sclerosis. Another study found that 10,366 Finnish children who were given 2,000 IU of vitamin D per day during their first year of life and were followed for 31 years had their risk of developing Type I diabetes reduced by 80 percent.
Holick said Americans should take at least 1,000 IU of vitamin D daily as well as a multivitamin with another 400 IU. Christakos said vi tamin D supplements are especially important for those at risk of immune disorders, such as siblings of people with Type I diabetes or MS.
Government guidelines, however, recommend just 200 IU for those under 50; 400 for those 51-70; and 600 for those over 70.
Jennifer Koentop, a spokeswoman for the U.S. Department of Health and Human Services, said the government is negotiating with the Institute of Medicine, a national advisory organization, to review the vitamin D guidelines.
Humans once routinely absorbed vitamin D from the sun, but when jobs and society moved in doors exposure to sunlight dropped. Holick estimates half of all Americans are vitamin D deficient. Deficiency rates among African-Americans may be higher.
Reinhold Veith, a researcher at the University of Toronto, said people can safely put on a bathing suit and expose much of their skin, without sunscreen, for as little as five minutes several times a week to obtain vitamin D.
Most dermatologists disagree, however. The American Academy of Dermatology, on its website, said people who want additional vita min D should use supplements to prevent skin cancer and damage.
Debate continues over supplements, too. Laura Byham-Gray, associate professor of nutritional sciences at the UMDNJ-School of Health Related Professions, does not recommend higher doses.
"What we consider a vitamin D deficiency is still under debate," she said. She cites the hype that once surrounded vitamin E, which researchers later learned actually increased mortality.
Vitamin D proponents said as much as 10,000 IU daily will not cause toxicity.
"Policy makers want a high level of evidence before committing themselves," Veith said. "But all the accumulating evidence on vitamin D has been like a slow rising sun. When do you call it daytime?"
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