20 ms·

Multiple Sclerosis Causality

635 points by nabla9 5y ago

deltaonefour 5y ago
If MS is a faulty immune response from EBV, wouldn't a vaccine theoretically and potentially trigger this same faulty immune response? There are obviously other causative factors influencing MS. One is EBV, the other is likely a specific type of immune system.
- croes 5y ago
  EBV stays in the human body, a vaccine wouldn't.
  - deltaonefour 5y ago
    The immune system upon reacting to EBV or a vaccine should theoretically eliminate EBV on contact so it won't stay in your body? Are you implying that that a vaccine cannot eliminate EBV? Additionally, a faulty immune response also means your immune system can't differentiate between EBV and your nerve cells. So theoretically speaking even if there's no EBV in your body having MS means that your body thinks EBV is in your body even if it's not. A vaccine in my mind could still induce this reaction.
    - croes 5y ago
      I meant that it's unlikely that a EBV vaccine triggers the same response as EBV because EBV stays and the vaccine wouldn't. Same with the Corona vaccines unlike this implies https://news.ycombinator.com/item?id=29942670 https://news.ycombinator.com/item?id=29942670
  - Metacelsus 5y ago
    Some vaccines (like VZV vaccine) persist in the body.
    - panabee 5y ago
      are you on twitter? your blog is highly educational. i'm interested in learning more about EBV and other viruses. for instance, given that VZV is common but not every infection causes shingles, how does VZV pass koch's postulates to establish causality? similar question applies to SARS-CoV-2 and CRS.
- vintermann 5y ago
  Climate is also a known factor. MS is more prevalent in temperate climates. A study from some years back suggested that if you move before the age of 15 or so, you get the risk of your new climate instead.
- epgui 5y ago
  Short answer is no. Long answer is that the question is premature (we need to answer more mechanistic questions first, and then we need to have an actual potential vaccine strategy to talk about) and there is currently no particular reason to suspect this.
- adnmcq999 5y ago
  That’s why I won’t MRNA
aljungberg 5y ago
The parallel to Guillan Barré Syndrome seems intuitive. MS and GBS are both autoimmune disorders which damage myelin. MS is slower and chronic while GBS is acute and rarely relapses. What if MS is a low grade persistent immune response to a chronic viral infection such that those bad antibodies are created in small amounts indefinitely?
mirekrusin 5y ago
Is anybody testing for virus/bacteria vs virus/bacteria interactions?
Miner49er 5y ago
From my understanding, the leading theory of what causes autoimmune diseases is viruses. The immune system responds to the virus and ends up mistakenly attacking the body as well. This seems to support that, and shows that different viruses cause different autoimmune diseases. More info: https://www.nature.com/articles/d41586-021-01835-w https://www.nature.com/articles/d41586-021-01835-w
- f6v 5y ago
  I’ve been reading recent research on MS and other autoimmune conditions. I also study APS1 in my PhD at the moment (caused by AIRE gene deficiency). I’m definitely not an expert, but I don’t think it’s a leading theory. As always in biology, autoimmune diseases probably have dozens different causes. Many of them might be environmental or genetic. Better yet a combination of the two.
- jjcon 5y ago
  Any thoughts as to why autoimmune diseases are (or at least seem) more prevelent in the 1st world?
  - colechristensen 5y ago
    Four candidates: hygiene, better diagnostics, different exposures, longer safer lives.
  - Broken_Hippo 5y ago
    If your country doesn't have a medical system that will detect such things in the general population and does not have a system to get the numbers for statistics, how are you going to know how prevalent something is? We don't know how common lots of things are in 1st world countries either, simply because we don't track.
  - epgui 5y ago
    Broadly speaking, the hygiene hypothesis is the current leading explanation. To make an analogy, in AI/ML terms, it amounts to a training set problem: you're not exposed to a diverse enough set of microbes and pathogens, or you're exposed to a biased sample, or you're not exposed to enough microbes. Your immune system's role is to act as a classifier to discriminate between good and bad, self and non-self. When you have a bad training set, you increase the odds that good things will be identified as bad, or that self antigen will be recognized as foreign.
NerdyNumbersGuy 5y ago
This featured quite heavily in todays issue of The RECC’E I put out this morning! Worth a quick read if you like quick- fact insights https://email.recce.news/a7i9l9x8y1 https://email.recce.news/a7i9l9x8y1
deleted 5y ago
[deleted]
deltaonefour 5y ago
This is a bit off topic but I have a question about causality. Is causality really a fuzzy concept? For example I assume if action A causes event B I assume the connection is 100%. Can we really say that action A has a 30% chance of causing event B? I ask because the more I think about it, when someone says action A causes a 30% chance of event B occurring what he is technically saying is action A is one causative factor that must occur and that we're missing information about other causative factors. In the case of this article. A causative link is established between EBV and MS to a fuzzy probable degree. This seems to me that technically what's actually occurring is that a fuzzy causal link simply means that there are other causative factors we don't yet know about, and likely this is a specific type of immune system that reacts to EBV in a certain way. Would my assessment be accurate? All causal connections are either 100% and any fuzziness just means we're missing information about other joint causal events that must occur to trigger the outcome. Does anyone who's a statistician know?
- echelon 5y ago
  > we're missing information about other causative factors. Welcome to biology. Perhaps EBV is particularly immunogenic, but it has to reactivate in the presence of CD8+ T-cells or CD20+ B-cells along with some other self-signal or co-infection. Perhaps there's a chain of immune signaling that must happen upstream in other immune cell populations. Perhaps other agents can trigger autoimmune behavior in these cells, and EBV isn't strictly required. Maybe other viruses in the herpesvirus family (HSV, zoster, etc.) There could be more than one set of causes, and they might not even look similar. In the crazy absurd limit, maybe nothing at all. Maybe autoimmunity sporadically arises with no causal agent. Random radiation hits the cell at the wrong time. All or none of these could be the case. Diseases can have a multitude of causes, sometimes with complex interactions and interdependencies, sometimes not. With cancer it's a progression of increasingly worse state changes, and that could be the case here too.
- peter303 5y ago
  There was a similar debate in the 1880s. Dr. Robert Koch claimed some diseases were caused by bacteria and developed a procedure to prove it. The germ theory of disease was controversial until then. Its suspected several diseases without known causes may be caused by a bacterium, virus or protein. But lack the evidence to satisfy the Koch postulates. These diseases include some cancers and many human nervous system diseases.
dmitryminkovsky 5y ago
> and the team identified 1566 matched controls for them. Can anyone please shed some light on this? How would this work?
onemoresoop 5y ago
Interestingly, Moderna has some trial for mRna vaccine for Epstein-Barr virus [0] [0]- https://www.clinicaltrialsarena.com/news/moderna-ebv-vaccine-trial/ https://www.clinicaltrialsarena.com/news/moderna-ebv-vaccine...
brechmos 5y ago
What is interesting is that Epstein-Barr has been reported to be related to Multiple Sclerosis since the early 1980s. https://pubmed.ncbi.nlm.nih.gov/?term=epstein+barr+multiple+sclerosis https://pubmed.ncbi.nlm.nih.gov/?term=epstein+barr+multiple+... It is great if there is new information and if this leads to knowledge on how to reduce the chance of getting MS.
Metacelsus 5y ago
For more on EBV, I've discussed it on my blog here: https://denovo.substack.com/p/epstein-barr-virus-more-maladies https://denovo.substack.com/p/epstein-barr-virus-more-maladi... (It doesn't just cause MS!)
xdrone 5y ago
Here's a John McDougall talk, he had some close ties to Dr Swank, known for a lot of early MS research. https://www.youtube.com/watch?v=fmZdI8jinIw https://www.youtube.com/watch?v=fmZdI8jinIw tldw: When your stomach layer is compromised, unprocessed food gets into your body. Food like animal protein, similar to our proteins, get attacked by the immune system, some of your cells are also mistakenly attacked. Anyone with the compromised stomach is at greater risk for auto immune diseases. For example look of rates of ms among celiac or crohn's sufferers. Same goes for type 1 diabetics, also autoimmune. Research suggests casein from dairy gets in the body, your immune system accidentally attacks your pancreas insulin making cells. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518798/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518798/
- sumosudo 5y ago
  All the health problems of modern society can be diminished greatly by ensuring the proper functioning of the gut.
  - bagacrap 5y ago
    please tell me how to ensure proper function of my gut
    - sumosudo 5y ago
      https://health.ucdavis.edu/newsroom/news/headlines/what-is-gut-health-and-why-is-it-important/2019/07 https://health.ucdavis.edu/newsroom/news/headlines/what-is-g... https://www.thegoodgut.org/restore-gut-health/ https://www.thegoodgut.org/restore-gut-health/
kisamoto 5y ago
I will read this but as someone who has had a family member diagnosed with MS if there are other connections or papers people can recommend I would be very grateful.
cjensen 5y ago
It's weird to me that they say 35 of the 801 MS cases were negative then positive before getting MS. The control group had 107 of 1566 were negative, but they don't bother to tell us how many of them ended up positive. I assume enlisting is a high-risk place to get EBV, and without info on the control I don't see how you can draw conclusions. But I'm basing this on the summary rather than the actual article: does the article have the info?
- couchand 5y ago
  It's well known that (1) most people have EBV some time in their life, and (2) most people don't have MS. The news that any number of people who don't develop MS get EBV would be mundane.
asdfasgasdgasdg 5y ago
Moderna are trialing an EBV vaccine. If it's successful, I wonder if we will see an end to MS. A cure would be great but failing that a prevention is almost as good.
mactournier 5y ago
Contrary to the HN title, the paper is not about causal inference, it is a case-control study. A good primer on the limitations of case-control studies can be found here: https://www.medicalnewstoday.com/articles/280936#limitations https://www.medicalnewstoday.com/articles/280936#limitations
- letmevoteplease 5y ago
  The abstract of the study states, "These findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS."
- axlee 5y ago
  Your contrarian approach is detrimental to proper research. Authors have found a very strong link that cannot be explained by any other risk factors. What risk factors are you suggesting they should look into?
animanoir 5y ago
I wish I was still a virgin.
gregwebs 5y ago
Dr. Terry Walhs was diagnosed with MS and became wheel chair bound. She came up with a protocol that was able to reverse her MS. I recall from previous interviews that her theory was that MS was a disease of the mitochondria. https://terrywahls.com/ https://terrywahls.com/
- _qua 5y ago
  And what's the theory for why supposedly successful treatment is not embraced by the medical community? Is it not more likely that her diagnosis was incorrect, or her course was atypical than that she independently discovered a cure which is rejected by the medical community at large?
  - Broken_Hippo 5y ago
    In many circles, the Wahl's protocol (basically diet) is considered a scam. Diet does not cure MS. Governments and health insurances surely would rather pay for food every month than pay the costs of current medications. On the other hand, medications have greatly improved quality of life for MS patients over the last 20 years or so. Folks diagnosed today aren't in the same dire boat as someone 30 years ago.
    - gregwebs 5y ago
      As a counterpoint example someone close to me was diagnosed with irritable bowel syndrome and told by doctors that there was no treatment and that diet did not help. When she adopted a paleo like diet with no other changes the IBD symptoms went away permanently almost immediately. Another counterpoint is that I was told by doctors when I was younger that diet was not a treatment for acne. This advice being based entirely on a single study with a single dietary intervention. I think you have a mistaken understanding of what it takes to change one’s diet. A government handout wouldn’t help in the slightest. It also doesn’t help for a doctor to give someone a list of foods to eat or not eat.
      - Broken_Hippo 5y ago
holidayacct 5y ago
scotty79 5y ago
I wonder how many viruses infecting humans we know nothing about just because they don't cause any obvious symptoms.
- alok-g 5y ago
  I had read somewhere that there are about 400 trillion viruses in a healthy human being's body, which is about ten times the number of human cells.
obert 5y ago
Glad that we might eventually get rid of diseases from starting, but when it comes to a cure, research is unbalanced towards treating instead, because it makes more money.
steelframe 5y ago
This might explain why between 1992 and 2017 interferons were the go-to treatment for MS. Interferons (IFNs) are a group of signaling proteins made and released by host cells in response to the presence of several viruses. A virus-infected cell will release interferons causing nearby cells to heighten their anti-viral defenses. After my diagnosis I personally went on Avonex (an interferon) in 2000, which was the only disease-modifying treatment (DMT) for MS at the time. My neurologist told me that they had no idea why interferons worked for MS, but they proved to be relatively safe and effective as slowing both clinical and symptomatic progression of MS. Naturally I asked the question to all my doctors, "Can a virus in the CNS be involved in triggering T-cells to cross the blood-brain barrier?" They would usually respond, "That's as good an explanation as any." So I religiously stayed on interferons through to 2014, when the FDA approved an oral medication for MS. By that time I was really getting tired of the constant injections (I hate needles), and my MS had caused minimal problems for me up to that time, so I decided to give the non-interferon DMT it a try. The clinal trial data for this non-interferon medication looked promising. But in the year I was on the non-interferon DMT my MS progressed, and I didn't go back to interferons until after things culminated in a serious attack (relapse). I currently live with a lot of symptoms from new lesions that formed in my spinal cord in that year I was off interferons. This experience had an impact on how I approach problems in general. These days I'm a lot more likely to stick with technology that is tried and true for any particular problem, even if that older technology is a little painful to set up and use. If it's been working fine up until now, don't rock the boat just because another option has come along. Of course this doesn't mean I'm inclined to always only ever use old technology. If something very clearly superior comes along that has overhelming evidence of effectiveness, I'm open to changing. In 2017 I made the switch to Ocrelizumab, which is a monoclonal antibody that knocks down your B cells. The data from that was so compelling that I realized that was the right thing to move to from interferons. In hindsight, that has been a much better move than my disastrous experiment with the oral meds. This recent study relating to EBV confirms my personal suspicions about the role of a virus in the development and progression of MS. Hopefully what this means is that therapies will come along that specifically target proteins only in EBV so that I can get my B cells back, since one of the consequences that a medical study I was in last year revealed is that my body doesn't produce antibodies in response to the COVID vaccine. I'd really like to get antibodies again, since I imagine that could give me more protection than what I get from the other immune cells I have.
reedf1 5y ago
Terrifying - I was EBV positive 4 years ago. It does not mention an association between EBV severity and MS, but I was very symptomatic and had post viral fatigue for around a year. I had no idea about the MS association!
- MaximumYComb 5y ago
  Wow, I was also EBV positive ~4 years ago (45 months), was symptomatic and I had post viral fatigue for around a year. It was 12 months before I could do light physical training and it was around 2.5 years before I could train physically at high intensity.
  - csdvrx 5y ago
    Do you have a baseline to compare or are you only relying on your memory? I got it at 21 and now I fear I may operate at a lower overall potential since I don't have a baseline to compare to
- peter303 5y ago
  Possibly a co-factor, since many get EBV and few MS.
- cjensen 5y ago
  EBV causes more severe symptoms the older you are. So everyone here who remembers getting it and it being terrible? That's because you got it as an adult. If you get it as a kid, it can be asymptomatic. I got it at 36 and had a fever that leveled me for 3 weeks. Between "wait 1 week before bothering your doctor" and multiple rounds of tests, they didn't even diagnose it as EBV until the 3rd week.
  - csdvrx 5y ago
    I got at 21 IIRC and I was in bed for a few weeks and the doctor started fearing I had a blood cancer or something given how abnormal the tests were until he finally got the idea to test for EBV and it came back super positive. Never before was I so happy to get tested positive for something lol It's been a few years and I think I'm fine but due to hedonic adaptation etc maybe for all I know I operate at like 70% of my previous capacity and don't even realize it So I'm super interested in all that new research and I can't wait until we get mRNA vaccines against EBV!!
cheaprentalyeti 5y ago
I saw this news item last night, posted next to that one... "Study finds hydroxychloroquine delays disability for least treatable form of multiple sclerosis" [0] [0]: https://medicalxpress.com/news/2022-01-hydroxychloroquine-disability-treatable-multiple-sclerosis.htm https://medicalxpress.com/news/2022-01-hydroxychloroquine-di...
- xadhominemx 5y ago
  Probably not
- degosuke 5y ago
  The link returns 404.
  - pkaye 5y ago
    The link was missing the final "l". https://medicalxpress.com/news/2022-01-hydroxychloroquine-disability-treatable-multiple-sclerosis.html https://medicalxpress.com/news/2022-01-hydroxychloroquine-di...
  - cheaprentalyeti 5y ago
    Ah, a typo, an 'l' was missing. https://medicalxpress.com/news/2022-01-hydroxychloroquine-disability-treatable-multiple-sclerosis.html https://medicalxpress.com/news/2022-01-hydroxychloroquine-di...
howinteresting 5y ago
This study appears to suggest that MS is essentially "long Epstein-Barr." Terrifying if the same pattern holds for covid, given the number of people who have some sequelae (the most conservative estimates are 2-5% for "serious" post-viral symptoms, which would be hundreds of millions of people worldwide). There will be an extraordinary amount of suffering, not to mention radical shifts in economic and public policy.
- axg11 5y ago
  The study really doesn't suggest that. All it suggests is that EBV seropositive people are much more likely to develop MS than the seronegative minor population. As for long COVID, the data quality is very variable. I'd like to see a controlled study that compares recovery from COVID vs. other respiratory viruses.
  - howinteresting 5y ago
    It's pretty clear that the causal explanation is the only reasonable one here. (Besides, at least for covid, not everyone who contracts the virus develops antibodies for it: https://journals.asm.org/doi/10.1128/Spectrum.00904-21 https://journals.asm.org/doi/10.1128/Spectrum.00904-21 ) There's a reason I quoted conservative estimates of long covid. The 2% is from this ONS study: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/6january2022 https://www.ons.gov.uk/peoplepopulationandcommunity/healthan.... The high end of estimates is 10-30%, which would mean the end of our current era of civilization.
- vintermann 5y ago
  That sounds unlikely. Epstein-Barr is a herpesvirus, and it's persistent - once you catch it, it stays latent in your body and you'll shed it through your saliva periodically for life. As far as I can find, coronaviruses have no way to pull that trick. Once your immune system gets rid of it, it's gone and not coming back unless you're infected again by a sufficiently unrecognizable relative.
dm319 5y ago
Here's a link to the article [0]. Just a bit of background - 95% of humans will experience infection with EBV at some point in their lives. Once you're infected, it remains latent, only flaring up in particular circumstances. MS is an autoimmune disease, like many others, and this paper does not imply that EBV directly causes MS. Obviously, as so many more people have EBV than have MS, EBV infection does not completely explain why people get MS. Just to put a small caveat to the paper. The comparison is to EBV 'seronegative' population - this is a minority of people (i.e. people who do not have evidence of being infected with EBV). You could argue this is an 'unusual' population in the first place and there's something about them that provides protection from MS. Another point is that EBV is a risk factor, there are other risk factors known too. I think the key to understanding a lot of autoimmune diseases is to understand how our adaptive immune system works. Our immune response is a very complex cell-to-cell interaction between millions of cells all with different roles, and how the immune system decides whether something is a threat or not is not, and how to respond to it, is not yet clear. [0] https://www.science.org/doi/10.1126/science.abj8222 https://www.science.org/doi/10.1126/science.abj8222
- user90349083 5y ago
  For anyone dealing with an acute bout of Epstein-Barr Virus, I used 3 teaspoons a day of monolaurin for three weeks to kick it. Research monolaurin, it's fascinating stuff as an antiviral and I can personally attest to its effectiveness.
  - csdvrx 5y ago
    Or get actual antivirals. IIRC the same thing that's prescribed for HSV works on EBV
    - user90349083 5y ago
      Some people prefer God's medicine to man's medicine. To each his own
      - 5y ago
aserdf 5y ago
there is an experimental[0] treatment for MS, the "immune system reboot". i am a layperson but my understanding is stem cells are taken from the patient, the immune system is "destroyed" through immunosuppressants and the stem cells are then used to rebuild a "naive" immune system in the patient. based on the info in the OP, i wonder if the MS result from EBV is random; what is the probability of a rebooted immune system to follow the same path after exposure? [0] - https://www.nih.gov/news-events/nih-research-matters/immune-system-reset-may-halt-multiple-sclerosis-progression https://www.nih.gov/news-events/nih-research-matters/immune-...
- wswope 5y ago
  The initial susceptibility is mostly going to be predetermined by the MHC, and therefore remain the mostly the same. However, the pathological outcome is ostensibly a product of certain strains of pathogens plus luck of the draw on somatic hypermutation in response to said pathogen.
  - whatshisface 5y ago
    For something as rare as MS, "spin again" is ninety percent of a cure.
sabujp 5y ago
I was wondering what the genetic factors are that cause EBV to push people to get MS and found this excellent paper [1] (see the genetic susceptibility section). [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334604/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334604/ [2] https://www.google.com/search?q=genetic+factors+that+cause+EBV+to+cause+MS+in+people&oq=genetic+factors+that+cause+EBV+to+cause+MS+in+people&aqs=chrome..69i57j33i160l2.9249j0j7&sourceid=chrome&ie=UTF-8 https://www.google.com/search?q=genetic+factors+that+cause+E...
sonicggg 5y ago
Cause is still not well explained. EBV is such an ubiquitous virus, more than 90% of all adults worldwide have been infected with it. Most will never know. Why is that just a tiny percentage develop MS?
- killjoywashere 5y ago
  EBV is associated with a lot of things that involve a tiny percentage of the population. Nasopharyngeal carcinoma, Hodgkin's lymphoma. Non-Hodgkin's lymphomas. Post-transplant lymphoproliferative disease. Burkitt's lymphoma. Oral hairy leukoplakia. Related viruses are associated with other diseases, e.g. HHV-8 and Kaposi's Sarcoma, primary effusion lymphoma, and Castleman's disease.
  - jessriedel 5y ago
    Is there an estimate anywhere of the total health burden of EBV, making reasonable assumptions about causality for the diseases you describe? Would be very interesting to know so you could compare it to the risk of a future EBV vaccine.
    - Metacelsus 5y ago
      I calculated it on my blog a few months ago: Every year, it causes the loss of 4.6 million disability-adjusted life years due to cancers alone, and another ~2 million to autoimmune diseases like multiple sclerosis. https://denovo.substack.com/p/epstein-barr-virus-more-maladies https://denovo.substack.com/p/epstein-barr-virus-more-maladi...
    - throwawaylinux 5y ago
      What are the reasonable assumptions about causality?
- jessriedel 5y ago
  This question, though very worthwhile, doesn't necessarily need to be answered. Vaccines for EBV are under development. If we stop most EBV infections, we can stop most MS.
clord 5y ago
I wonder if MS is like the EBV version of shingles: if you don't get it early, when you do, it's a much worse disease. Most people pick it up early, but those who manage to avoid it and then get it late are in danger. Another instance of hygiene hypothesis.
- vintermann 5y ago
  MS isn't, but yes, Epstein-Barr virus is more serious if you first catch it as an adult. That will likely knock you out with mononucleosis, a.k.a kissing sickness, for a few weeks. Fatigue can linger a lot longer.
  - latortuga 5y ago
    Definitely my experience. I had it as an adult at 26 and it absolutely knocked me out for weeks. I lost a ton of weight from having no appetite and having a constant sore throat. Sleeping was also terrible because I couldn't breathe easily. I think I missed 3 or 4 weeks of work and even when I started back I could only work half days for awhile at my not-strenuous desk job.
- deleted 5y ago
  [deleted]
wtetzner 5y ago
An interesting talk about someone who was able to reverse a lot of her MS symptoms with a change in diet: https://www.youtube.com/watch?v=KLjgBLwH3Wc https://www.youtube.com/watch?v=KLjgBLwH3Wc
- moneywoes 5y ago
  So basically no wheat, milk and processed foods?
  - omreaderhn 5y ago
    I skimmed through the presentation and I'm not sure how you arrived at that as your takeaway. The dietary advice given in there is much more complex than that.
- epgui 5y ago
  Biochemist here: I would advise to exercise strong caution when looking at dietary changes in the context of MS. A lot of advice gives people the illusion that they have more control over their illness than they actually do, and a lot of the diets cause unnecessary harm (as a heuristic: the more things you cut out, the higher the potential for harm). That said, healthy eating and regular physical exercise is always a good idea, and even more so if you have any existing illness.
  - Broken_Hippo 5y ago
    Thank you! A lot of scam diets promise to cure MS. Books are sold. But the only real way to lessen the harm of the disease is through a combination of a modern medicine and luck (I've had both). Agree on the general healthy eating and activity, though.
- garganzol 5y ago
  According to numerous observations, neurodegenerative diseases and the lack of energy (adenosine triphosphate, ATP) are tightly interconnected. Thanks for posting. And yes, there is mitochondria involved, once again.
Mezzie 5y ago
I have MS and my first relapse was a pretty textbook case of transverse myelitis of the sort that the EBV can cause. I know some people have been asking about why that might be the case when a ton of people have EBV, and I think the causality may go the other way: Those of us with something wrong are more likely to both have EBV complications and MS. There are other viruses like this as well (ones that most people get/have but aren't dangerous). I was on one medication where I needed to be tested monthly because if I got one particular (normally harmless) virus, the suppression caused by the medication meant I would probably die. There's pretty clearly some sort of relation between the state of one's immune system + how it deals with 'benign' viruses + auto-immunity, and I'm excited to see what the future holds, but for now it's a cool confirmation of something a lot of MSers have talked about amongst ourselves for a while.
- jessriedel 5y ago
  > I think the causality may go the other way: Those of us with something wrong are more likely to both have EBV complications and MS. I'm unsure, but it sounds like you're hypothesizing that EBV infections does not cause MS symptoms, and that instead some some third factor causes both, so that preventing EBV infection would not prevent MS. The paper being discussed specifically considers and rejects this possibility with pretty strong evidence. Indeed, that is the main contribution of the paper. (The fact that 99% of MS sufferers have EBV, way higher than the 90% baseline in the general population, has been known for a while.)
  - Mezzie 5y ago
    That's why I shouldn't read articles instead of taking a nap. Thanks!
  - csdvrx 5y ago
    Or that people who can't clear EBV may be unable to due to some deficiency that also cause them to get MS Still a super interesting paper
  - loudtieblahblah 5y ago
    There's other factors too. All MS suffer-ers have low VitD.(as does just about everyone with an autoimmune issue). They all have low uric acid too. Almost all MS sufferers (same more most autoimmune) can also trace their disorder back to an extreme stress event too - divorce, loss of a loved one, falling into health anxiety, etc.. Are these causes or effects? I'm guessing there's compounding factors.

635 points by nabla9 5y ago

If MS is a faulty immune response from EBV, wouldn't a vaccine theoretically and potentially trigger this same faulty immune response? There are obviously other causative factors influencing MS. One is EBV, the other is likely a specific type of immune system.

croes 5y ago
EBV stays in the human body, a vaccine wouldn't.
- deltaonefour 5y ago
  The immune system upon reacting to EBV or a vaccine should theoretically eliminate EBV on contact so it won't stay in your body? Are you implying that that a vaccine cannot eliminate EBV? Additionally, a faulty immune response also means your immune system can't differentiate between EBV and your nerve cells. So theoretically speaking even if there's no EBV in your body having MS means that your body thinks EBV is in your body even if it's not. A vaccine in my mind could still induce this reaction.
  - croes 5y ago
    I meant that it's unlikely that a EBV vaccine triggers the same response as EBV because EBV stays and the vaccine wouldn't. Same with the Corona vaccines unlike this implies https://news.ycombinator.com/item?id=29942670 https://news.ycombinator.com/item?id=29942670
- Metacelsus 5y ago
  Some vaccines (like VZV vaccine) persist in the body.
  - panabee 5y ago
    are you on twitter? your blog is highly educational. i'm interested in learning more about EBV and other viruses. for instance, given that VZV is common but not every infection causes shingles, how does VZV pass koch's postulates to establish causality? similar question applies to SARS-CoV-2 and CRS.
vintermann 5y ago
Climate is also a known factor. MS is more prevalent in temperate climates. A study from some years back suggested that if you move before the age of 15 or so, you get the risk of your new climate instead.
epgui 5y ago
Short answer is no. Long answer is that the question is premature (we need to answer more mechanistic questions first, and then we need to have an actual potential vaccine strategy to talk about) and there is currently no particular reason to suspect this.
adnmcq999 5y ago
That’s why I won’t MRNA

aljungberg 5y ago

The parallel to Guillan Barré Syndrome seems intuitive. MS and GBS are both autoimmune disorders which damage myelin. MS is slower and chronic while GBS is acute and rarely relapses. What if MS is a low grade persistent immune response to a chronic viral infection such that those bad antibodies are created in small amounts indefinitely?

mirekrusin 5y ago

Is anybody testing for virus/bacteria vs virus/bacteria interactions?

Miner49er 5y ago

From my understanding, the leading theory of what causes autoimmune diseases is viruses. The immune system responds to the virus and ends up mistakenly attacking the body as well. This seems to support that, and shows that different viruses cause different autoimmune diseases. More info: https://www.nature.com/articles/d41586-021-01835-w https://www.nature.com/articles/d41586-021-01835-w

f6v 5y ago
I’ve been reading recent research on MS and other autoimmune conditions. I also study APS1 in my PhD at the moment (caused by AIRE gene deficiency). I’m definitely not an expert, but I don’t think it’s a leading theory. As always in biology, autoimmune diseases probably have dozens different causes. Many of them might be environmental or genetic. Better yet a combination of the two.
jjcon 5y ago
Any thoughts as to why autoimmune diseases are (or at least seem) more prevelent in the 1st world?
- colechristensen 5y ago
  Four candidates: hygiene, better diagnostics, different exposures, longer safer lives.
- Broken_Hippo 5y ago
  If your country doesn't have a medical system that will detect such things in the general population and does not have a system to get the numbers for statistics, how are you going to know how prevalent something is? We don't know how common lots of things are in 1st world countries either, simply because we don't track.
- epgui 5y ago
  Broadly speaking, the hygiene hypothesis is the current leading explanation. To make an analogy, in AI/ML terms, it amounts to a training set problem: you're not exposed to a diverse enough set of microbes and pathogens, or you're exposed to a biased sample, or you're not exposed to enough microbes. Your immune system's role is to act as a classifier to discriminate between good and bad, self and non-self. When you have a bad training set, you increase the odds that good things will be identified as bad, or that self antigen will be recognized as foreign.

NerdyNumbersGuy 5y ago

This featured quite heavily in todays issue of The RECC’E I put out this morning! Worth a quick read if you like quick- fact insights https://email.recce.news/a7i9l9x8y1 https://email.recce.news/a7i9l9x8y1

deleted 5y ago

[deleted]

deltaonefour 5y ago

This is a bit off topic but I have a question about causality. Is causality really a fuzzy concept? For example I assume if action A causes event B I assume the connection is 100%. Can we really say that action A has a 30% chance of causing event B? I ask because the more I think about it, when someone says action A causes a 30% chance of event B occurring what he is technically saying is action A is one causative factor that must occur and that we're missing information about other causative factors. In the case of this article. A causative link is established between EBV and MS to a fuzzy probable degree. This seems to me that technically what's actually occurring is that a fuzzy causal link simply means that there are other causative factors we don't yet know about, and likely this is a specific type of immune system that reacts to EBV in a certain way. Would my assessment be accurate? All causal connections are either 100% and any fuzziness just means we're missing information about other joint causal events that must occur to trigger the outcome. Does anyone who's a statistician know?

echelon 5y ago
> we're missing information about other causative factors. Welcome to biology. Perhaps EBV is particularly immunogenic, but it has to reactivate in the presence of CD8+ T-cells or CD20+ B-cells along with some other self-signal or co-infection. Perhaps there's a chain of immune signaling that must happen upstream in other immune cell populations. Perhaps other agents can trigger autoimmune behavior in these cells, and EBV isn't strictly required. Maybe other viruses in the herpesvirus family (HSV, zoster, etc.) There could be more than one set of causes, and they might not even look similar. In the crazy absurd limit, maybe nothing at all. Maybe autoimmunity sporadically arises with no causal agent. Random radiation hits the cell at the wrong time. All or none of these could be the case. Diseases can have a multitude of causes, sometimes with complex interactions and interdependencies, sometimes not. With cancer it's a progression of increasingly worse state changes, and that could be the case here too.
peter303 5y ago
There was a similar debate in the 1880s. Dr. Robert Koch claimed some diseases were caused by bacteria and developed a procedure to prove it. The germ theory of disease was controversial until then. Its suspected several diseases without known causes may be caused by a bacterium, virus or protein. But lack the evidence to satisfy the Koch postulates. These diseases include some cancers and many human nervous system diseases.

dmitryminkovsky 5y ago

> and the team identified 1566 matched controls for them. Can anyone please shed some light on this? How would this work?

onemoresoop 5y ago

Interestingly, Moderna has some trial for mRna vaccine for Epstein-Barr virus [0] [0]- https://www.clinicaltrialsarena.com/news/moderna-ebv-vaccine-trial/ https://www.clinicaltrialsarena.com/news/moderna-ebv-vaccine...

brechmos 5y ago

What is interesting is that Epstein-Barr has been reported to be related to Multiple Sclerosis since the early 1980s. https://pubmed.ncbi.nlm.nih.gov/?term=epstein+barr+multiple+sclerosis https://pubmed.ncbi.nlm.nih.gov/?term=epstein+barr+multiple+... It is great if there is new information and if this leads to knowledge on how to reduce the chance of getting MS.

Metacelsus 5y ago

For more on EBV, I've discussed it on my blog here: https://denovo.substack.com/p/epstein-barr-virus-more-maladies https://denovo.substack.com/p/epstein-barr-virus-more-maladi... (It doesn't just cause MS!)

xdrone 5y ago

Here's a John McDougall talk, he had some close ties to Dr Swank, known for a lot of early MS research. https://www.youtube.com/watch?v=fmZdI8jinIw https://www.youtube.com/watch?v=fmZdI8jinIw tldw: When your stomach layer is compromised, unprocessed food gets into your body. Food like animal protein, similar to our proteins, get attacked by the immune system, some of your cells are also mistakenly attacked. Anyone with the compromised stomach is at greater risk for auto immune diseases. For example look of rates of ms among celiac or crohn's sufferers. Same goes for type 1 diabetics, also autoimmune. Research suggests casein from dairy gets in the body, your immune system accidentally attacks your pancreas insulin making cells. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518798/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518798/

sumosudo 5y ago
All the health problems of modern society can be diminished greatly by ensuring the proper functioning of the gut.
- bagacrap 5y ago
  please tell me how to ensure proper function of my gut
  - sumosudo 5y ago
    https://health.ucdavis.edu/newsroom/news/headlines/what-is-gut-health-and-why-is-it-important/2019/07 https://health.ucdavis.edu/newsroom/news/headlines/what-is-g... https://www.thegoodgut.org/restore-gut-health/ https://www.thegoodgut.org/restore-gut-health/

kisamoto 5y ago

I will read this but as someone who has had a family member diagnosed with MS if there are other connections or papers people can recommend I would be very grateful.

cjensen 5y ago

It's weird to me that they say 35 of the 801 MS cases were negative then positive before getting MS. The control group had 107 of 1566 were negative, but they don't bother to tell us how many of them ended up positive. I assume enlisting is a high-risk place to get EBV, and without info on the control I don't see how you can draw conclusions. But I'm basing this on the summary rather than the actual article: does the article have the info?

couchand 5y ago
It's well known that (1) most people have EBV some time in their life, and (2) most people don't have MS. The news that any number of people who don't develop MS get EBV would be mundane.

asdfasgasdgasdg 5y ago

Moderna are trialing an EBV vaccine. If it's successful, I wonder if we will see an end to MS. A cure would be great but failing that a prevention is almost as good.

mactournier 5y ago

Contrary to the HN title, the paper is not about causal inference, it is a case-control study. A good primer on the limitations of case-control studies can be found here: https://www.medicalnewstoday.com/articles/280936#limitations https://www.medicalnewstoday.com/articles/280936#limitations

letmevoteplease 5y ago
The abstract of the study states, "These findings cannot be explained by any known risk factor for MS and suggest EBV as the leading cause of MS."
axlee 5y ago
Your contrarian approach is detrimental to proper research. Authors have found a very strong link that cannot be explained by any other risk factors. What risk factors are you suggesting they should look into?

animanoir 5y ago

I wish I was still a virgin.

gregwebs 5y ago

Dr. Terry Walhs was diagnosed with MS and became wheel chair bound. She came up with a protocol that was able to reverse her MS. I recall from previous interviews that her theory was that MS was a disease of the mitochondria. https://terrywahls.com/ https://terrywahls.com/

_qua 5y ago
And what's the theory for why supposedly successful treatment is not embraced by the medical community? Is it not more likely that her diagnosis was incorrect, or her course was atypical than that she independently discovered a cure which is rejected by the medical community at large?
- Broken_Hippo 5y ago
  In many circles, the Wahl's protocol (basically diet) is considered a scam. Diet does not cure MS. Governments and health insurances surely would rather pay for food every month than pay the costs of current medications. On the other hand, medications have greatly improved quality of life for MS patients over the last 20 years or so. Folks diagnosed today aren't in the same dire boat as someone 30 years ago.
  - gregwebs 5y ago
    As a counterpoint example someone close to me was diagnosed with irritable bowel syndrome and told by doctors that there was no treatment and that diet did not help. When she adopted a paleo like diet with no other changes the IBD symptoms went away permanently almost immediately. Another counterpoint is that I was told by doctors when I was younger that diet was not a treatment for acne. This advice being based entirely on a single study with a single dietary intervention. I think you have a mistaken understanding of what it takes to change one’s diet. A government handout wouldn’t help in the slightest. It also doesn’t help for a doctor to give someone a list of foods to eat or not eat.
    - Broken_Hippo 5y ago

holidayacct 5y ago

scotty79 5y ago

I wonder how many viruses infecting humans we know nothing about just because they don't cause any obvious symptoms.

alok-g 5y ago
I had read somewhere that there are about 400 trillion viruses in a healthy human being's body, which is about ten times the number of human cells.

obert 5y ago

Glad that we might eventually get rid of diseases from starting, but when it comes to a cure, research is unbalanced towards treating instead, because it makes more money.

steelframe 5y ago

This might explain why between 1992 and 2017 interferons were the go-to treatment for MS. Interferons (IFNs) are a group of signaling proteins made and released by host cells in response to the presence of several viruses. A virus-infected cell will release interferons causing nearby cells to heighten their anti-viral defenses. After my diagnosis I personally went on Avonex (an interferon) in 2000, which was the only disease-modifying treatment (DMT) for MS at the time. My neurologist told me that they had no idea why interferons worked for MS, but they proved to be relatively safe and effective as slowing both clinical and symptomatic progression of MS. Naturally I asked the question to all my doctors, "Can a virus in the CNS be involved in triggering T-cells to cross the blood-brain barrier?" They would usually respond, "That's as good an explanation as any." So I religiously stayed on interferons through to 2014, when the FDA approved an oral medication for MS. By that time I was really getting tired of the constant injections (I hate needles), and my MS had caused minimal problems for me up to that time, so I decided to give the non-interferon DMT it a try. The clinal trial data for this non-interferon medication looked promising. But in the year I was on the non-interferon DMT my MS progressed, and I didn't go back to interferons until after things culminated in a serious attack (relapse). I currently live with a lot of symptoms from new lesions that formed in my spinal cord in that year I was off interferons. This experience had an impact on how I approach problems in general. These days I'm a lot more likely to stick with technology that is tried and true for any particular problem, even if that older technology is a little painful to set up and use. If it's been working fine up until now, don't rock the boat just because another option has come along. Of course this doesn't mean I'm inclined to always only ever use old technology. If something very clearly superior comes along that has overhelming evidence of effectiveness, I'm open to changing. In 2017 I made the switch to Ocrelizumab, which is a monoclonal antibody that knocks down your B cells. The data from that was so compelling that I realized that was the right thing to move to from interferons. In hindsight, that has been a much better move than my disastrous experiment with the oral meds. This recent study relating to EBV confirms my personal suspicions about the role of a virus in the development and progression of MS. Hopefully what this means is that therapies will come along that specifically target proteins only in EBV so that I can get my B cells back, since one of the consequences that a medical study I was in last year revealed is that my body doesn't produce antibodies in response to the COVID vaccine. I'd really like to get antibodies again, since I imagine that could give me more protection than what I get from the other immune cells I have.

reedf1 5y ago

Terrifying - I was EBV positive 4 years ago. It does not mention an association between EBV severity and MS, but I was very symptomatic and had post viral fatigue for around a year. I had no idea about the MS association!

MaximumYComb 5y ago
Wow, I was also EBV positive ~4 years ago (45 months), was symptomatic and I had post viral fatigue for around a year. It was 12 months before I could do light physical training and it was around 2.5 years before I could train physically at high intensity.
- csdvrx 5y ago
  Do you have a baseline to compare or are you only relying on your memory? I got it at 21 and now I fear I may operate at a lower overall potential since I don't have a baseline to compare to
peter303 5y ago
Possibly a co-factor, since many get EBV and few MS.
cjensen 5y ago
EBV causes more severe symptoms the older you are. So everyone here who remembers getting it and it being terrible? That's because you got it as an adult. If you get it as a kid, it can be asymptomatic. I got it at 36 and had a fever that leveled me for 3 weeks. Between "wait 1 week before bothering your doctor" and multiple rounds of tests, they didn't even diagnose it as EBV until the 3rd week.
- csdvrx 5y ago
  I got at 21 IIRC and I was in bed for a few weeks and the doctor started fearing I had a blood cancer or something given how abnormal the tests were until he finally got the idea to test for EBV and it came back super positive. Never before was I so happy to get tested positive for something lol It's been a few years and I think I'm fine but due to hedonic adaptation etc maybe for all I know I operate at like 70% of my previous capacity and don't even realize it So I'm super interested in all that new research and I can't wait until we get mRNA vaccines against EBV!!

cheaprentalyeti 5y ago

I saw this news item last night, posted next to that one... "Study finds hydroxychloroquine delays disability for least treatable form of multiple sclerosis" [0] [0]: https://medicalxpress.com/news/2022-01-hydroxychloroquine-disability-treatable-multiple-sclerosis.htm https://medicalxpress.com/news/2022-01-hydroxychloroquine-di...

xadhominemx 5y ago
Probably not
degosuke 5y ago
The link returns 404.
- pkaye 5y ago
  The link was missing the final "l". https://medicalxpress.com/news/2022-01-hydroxychloroquine-disability-treatable-multiple-sclerosis.html https://medicalxpress.com/news/2022-01-hydroxychloroquine-di...
- cheaprentalyeti 5y ago
  Ah, a typo, an 'l' was missing. https://medicalxpress.com/news/2022-01-hydroxychloroquine-disability-treatable-multiple-sclerosis.html https://medicalxpress.com/news/2022-01-hydroxychloroquine-di...

howinteresting 5y ago

This study appears to suggest that MS is essentially "long Epstein-Barr." Terrifying if the same pattern holds for covid, given the number of people who have some sequelae (the most conservative estimates are 2-5% for "serious" post-viral symptoms, which would be hundreds of millions of people worldwide). There will be an extraordinary amount of suffering, not to mention radical shifts in economic and public policy.

axg11 5y ago
The study really doesn't suggest that. All it suggests is that EBV seropositive people are much more likely to develop MS than the seronegative minor population. As for long COVID, the data quality is very variable. I'd like to see a controlled study that compares recovery from COVID vs. other respiratory viruses.
- howinteresting 5y ago
  It's pretty clear that the causal explanation is the only reasonable one here. (Besides, at least for covid, not everyone who contracts the virus develops antibodies for it: https://journals.asm.org/doi/10.1128/Spectrum.00904-21 https://journals.asm.org/doi/10.1128/Spectrum.00904-21 ) There's a reason I quoted conservative estimates of long covid. The 2% is from this ONS study: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/6january2022 https://www.ons.gov.uk/peoplepopulationandcommunity/healthan.... The high end of estimates is 10-30%, which would mean the end of our current era of civilization.
vintermann 5y ago
That sounds unlikely. Epstein-Barr is a herpesvirus, and it's persistent - once you catch it, it stays latent in your body and you'll shed it through your saliva periodically for life. As far as I can find, coronaviruses have no way to pull that trick. Once your immune system gets rid of it, it's gone and not coming back unless you're infected again by a sufficiently unrecognizable relative.

dm319 5y ago

Here's a link to the article [0]. Just a bit of background - 95% of humans will experience infection with EBV at some point in their lives. Once you're infected, it remains latent, only flaring up in particular circumstances. MS is an autoimmune disease, like many others, and this paper does not imply that EBV directly causes MS. Obviously, as so many more people have EBV than have MS, EBV infection does not completely explain why people get MS. Just to put a small caveat to the paper. The comparison is to EBV 'seronegative' population - this is a minority of people (i.e. people who do not have evidence of being infected with EBV). You could argue this is an 'unusual' population in the first place and there's something about them that provides protection from MS. Another point is that EBV is a risk factor, there are other risk factors known too. I think the key to understanding a lot of autoimmune diseases is to understand how our adaptive immune system works. Our immune response is a very complex cell-to-cell interaction between millions of cells all with different roles, and how the immune system decides whether something is a threat or not is not, and how to respond to it, is not yet clear. [0] https://www.science.org/doi/10.1126/science.abj8222 https://www.science.org/doi/10.1126/science.abj8222

user90349083 5y ago
For anyone dealing with an acute bout of Epstein-Barr Virus, I used 3 teaspoons a day of monolaurin for three weeks to kick it. Research monolaurin, it's fascinating stuff as an antiviral and I can personally attest to its effectiveness.
- csdvrx 5y ago
  Or get actual antivirals. IIRC the same thing that's prescribed for HSV works on EBV
  - user90349083 5y ago
    Some people prefer God's medicine to man's medicine. To each his own
    - 5y ago

aserdf 5y ago

there is an experimental[0] treatment for MS, the "immune system reboot". i am a layperson but my understanding is stem cells are taken from the patient, the immune system is "destroyed" through immunosuppressants and the stem cells are then used to rebuild a "naive" immune system in the patient. based on the info in the OP, i wonder if the MS result from EBV is random; what is the probability of a rebooted immune system to follow the same path after exposure? [0] - https://www.nih.gov/news-events/nih-research-matters/immune-system-reset-may-halt-multiple-sclerosis-progression https://www.nih.gov/news-events/nih-research-matters/immune-...

wswope 5y ago
The initial susceptibility is mostly going to be predetermined by the MHC, and therefore remain the mostly the same. However, the pathological outcome is ostensibly a product of certain strains of pathogens plus luck of the draw on somatic hypermutation in response to said pathogen.
- whatshisface 5y ago
  For something as rare as MS, "spin again" is ninety percent of a cure.

sabujp 5y ago

I was wondering what the genetic factors are that cause EBV to push people to get MS and found this excellent paper [1] (see the genetic susceptibility section). [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334604/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334604/ [2] https://www.google.com/search?q=genetic+factors+that+cause+EBV+to+cause+MS+in+people&oq=genetic+factors+that+cause+EBV+to+cause+MS+in+people&aqs=chrome..69i57j33i160l2.9249j0j7&sourceid=chrome&ie=UTF-8 https://www.google.com/search?q=genetic+factors+that+cause+E...

sonicggg 5y ago

Cause is still not well explained. EBV is such an ubiquitous virus, more than 90% of all adults worldwide have been infected with it. Most will never know. Why is that just a tiny percentage develop MS?

killjoywashere 5y ago
EBV is associated with a lot of things that involve a tiny percentage of the population. Nasopharyngeal carcinoma, Hodgkin's lymphoma. Non-Hodgkin's lymphomas. Post-transplant lymphoproliferative disease. Burkitt's lymphoma. Oral hairy leukoplakia. Related viruses are associated with other diseases, e.g. HHV-8 and Kaposi's Sarcoma, primary effusion lymphoma, and Castleman's disease.
- jessriedel 5y ago
  Is there an estimate anywhere of the total health burden of EBV, making reasonable assumptions about causality for the diseases you describe? Would be very interesting to know so you could compare it to the risk of a future EBV vaccine.
  - Metacelsus 5y ago
    I calculated it on my blog a few months ago: Every year, it causes the loss of 4.6 million disability-adjusted life years due to cancers alone, and another ~2 million to autoimmune diseases like multiple sclerosis. https://denovo.substack.com/p/epstein-barr-virus-more-maladies https://denovo.substack.com/p/epstein-barr-virus-more-maladi...
  - throwawaylinux 5y ago
    What are the reasonable assumptions about causality?
jessriedel 5y ago
This question, though very worthwhile, doesn't necessarily need to be answered. Vaccines for EBV are under development. If we stop most EBV infections, we can stop most MS.

clord 5y ago

I wonder if MS is like the EBV version of shingles: if you don't get it early, when you do, it's a much worse disease. Most people pick it up early, but those who manage to avoid it and then get it late are in danger. Another instance of hygiene hypothesis.

vintermann 5y ago
MS isn't, but yes, Epstein-Barr virus is more serious if you first catch it as an adult. That will likely knock you out with mononucleosis, a.k.a kissing sickness, for a few weeks. Fatigue can linger a lot longer.
- latortuga 5y ago
  Definitely my experience. I had it as an adult at 26 and it absolutely knocked me out for weeks. I lost a ton of weight from having no appetite and having a constant sore throat. Sleeping was also terrible because I couldn't breathe easily. I think I missed 3 or 4 weeks of work and even when I started back I could only work half days for awhile at my not-strenuous desk job.
deleted 5y ago
[deleted]

wtetzner 5y ago

An interesting talk about someone who was able to reverse a lot of her MS symptoms with a change in diet: https://www.youtube.com/watch?v=KLjgBLwH3Wc https://www.youtube.com/watch?v=KLjgBLwH3Wc

moneywoes 5y ago
So basically no wheat, milk and processed foods?
- omreaderhn 5y ago
  I skimmed through the presentation and I'm not sure how you arrived at that as your takeaway. The dietary advice given in there is much more complex than that.
epgui 5y ago
Biochemist here: I would advise to exercise strong caution when looking at dietary changes in the context of MS. A lot of advice gives people the illusion that they have more control over their illness than they actually do, and a lot of the diets cause unnecessary harm (as a heuristic: the more things you cut out, the higher the potential for harm). That said, healthy eating and regular physical exercise is always a good idea, and even more so if you have any existing illness.
- Broken_Hippo 5y ago
  Thank you! A lot of scam diets promise to cure MS. Books are sold. But the only real way to lessen the harm of the disease is through a combination of a modern medicine and luck (I've had both). Agree on the general healthy eating and activity, though.
garganzol 5y ago
According to numerous observations, neurodegenerative diseases and the lack of energy (adenosine triphosphate, ATP) are tightly interconnected. Thanks for posting. And yes, there is mitochondria involved, once again.

Mezzie 5y ago

I have MS and my first relapse was a pretty textbook case of transverse myelitis of the sort that the EBV can cause. I know some people have been asking about why that might be the case when a ton of people have EBV, and I think the causality may go the other way: Those of us with something wrong are more likely to both have EBV complications and MS. There are other viruses like this as well (ones that most people get/have but aren't dangerous). I was on one medication where I needed to be tested monthly because if I got one particular (normally harmless) virus, the suppression caused by the medication meant I would probably die. There's pretty clearly some sort of relation between the state of one's immune system + how it deals with 'benign' viruses + auto-immunity, and I'm excited to see what the future holds, but for now it's a cool confirmation of something a lot of MSers have talked about amongst ourselves for a while.

jessriedel 5y ago
> I think the causality may go the other way: Those of us with something wrong are more likely to both have EBV complications and MS. I'm unsure, but it sounds like you're hypothesizing that EBV infections does not cause MS symptoms, and that instead some some third factor causes both, so that preventing EBV infection would not prevent MS. The paper being discussed specifically considers and rejects this possibility with pretty strong evidence. Indeed, that is the main contribution of the paper. (The fact that 99% of MS sufferers have EBV, way higher than the 90% baseline in the general population, has been known for a while.)
- Mezzie 5y ago
  That's why I shouldn't read articles instead of taking a nap. Thanks!
- csdvrx 5y ago
  Or that people who can't clear EBV may be unable to due to some deficiency that also cause them to get MS Still a super interesting paper
- loudtieblahblah 5y ago
  There's other factors too. All MS suffer-ers have low VitD.(as does just about everyone with an autoimmune issue). They all have low uric acid too. Almost all MS sufferers (same more most autoimmune) can also trace their disorder back to an extreme stress event too - divorce, loss of a loved one, falling into health anxiety, etc.. Are these causes or effects? I'm guessing there's compounding factors.