March 28, 2022
A Review of the January 2022 Harvard and Stanford Research into a Connection Between Epstein Barr Virus and Multiple Sclerosis
“Infection with Epstein-Barr virus is the trigger for the development of multiple sclerosis.” (Robinson and Steinman, Stanford University)
Prepared by Richard Dowson, B.Ed., Ed. Dip, M.Ed., Moose Jaw, Saskatchewan, CANADA
Proposal: Test the 1977 Cook and Dowling Hypothesis on the Cause of MS.
January 2022 saw the presentation of two outstanding Papers on the relationship between Epstein Barr Virus and MS; one from Harvard and one from Stanford. Both suggest Epstein Barr Virus played a major role in the etiology of Multiple Sclerosis.
On January 14, 2022 Lauran Neergaard, of CTV Montreal summarized the work by quoting the vice president for research at the National Multiple Sclerosis Society who said it was, “… the strongest evidence to date that Epstein-Barr contributes to cause MS”.
Epstein Barr virus is Human Herpes virus 4 (HHV4). It is the primary cause of infectious mononucleosis, usually called Mono and is usually contracted during adolescence (Puberty).
This Paper contrasts the Cook and Dowling Hypothesis and other assumptions with the excellent research done at Harvard and Stanford.
The Cook and Dowling Hypothesis says “Canine Distemper Virus plays a major role in the etiology of MS”. They add, contact with CDV is usually during adolescence (puberty), by way of an indoor pet dog, cat or farm dog.
Harvard University Study
The Harvard University Study, led by Alberto Ascherio examined military medical records and found that an individual’s risk of developing MS increased by 32 times if the individual suffered from ‘Mono’, which is caused by the Epstein Barr Virus (EBV). Chuck Dinerstein, MD, MBA, writing for the American Council on Science and Health, on January 25, 2022 offers this comparison, “… the risk of developing lung cancer among heavy smokers is 21-fold.” ‘32 times’ makes EBV a very significant risk factor for MS.
Epstein Barr Virus (EBV), also known as Human Herpes Virus-4 (HHV-4), is common. Between 90 and 95% of the world’s population are positive for EBV.
Contrast: I established information on 29 people in Alberta and Saskatchewan with MS. Of the early onset group, 100%, had interacted with an indoor pet dog or cat or a farm dog during puberty. One Saskatchewan person in this group never had ‘Mono’.
Alberto Ascherio, in the Harvard Study, argues, “Epstein-Barr Virus is Likely a Leading Cause of Multiple Sclerosis” and suggests preventing EBV could eliminate MS. Very important!
In a 2007 Paper by Ascherio and Munger, “Environmental risk factors for multiple sclerosis. Part I: the role of infection”, (Annals of Neurology, 2007 Apr;61(4):288-99), linked EBV and MS but argued for the addition of an environmental risk factor. Ascherio and Munger suggested Vitamin D as a risk factor.
Contrast: Data for sunlight and “Vitamin D” does not correlate suggesting Vitamin D, a product of sunlight, is not a risk factor. For example, Southern Alberta, Canada has 2544 hours of sunlight a year and a PR for MS of near 330. Nunavut, Canada has 1860 hours and a very low PR for MS.
Ascherio and Munger suggest a genetic link to explain ‘clusters’ of MS in one family.
Contrast: The presence of a common pathogen may be more likely. It is noted that Saskatchewan Hutterites have near zero MS. They do not keep indoor pet dogs or cats.
Stanford University Study
The Stanford University Study, “Epstein-Barr virus and multiple sclerosis” was undertaken by Drs. William H. Robinson and Lawrence Steinman. They wrote, “Infection with Epstein-Barr virus (EBV) is the trigger for the development of multiple sclerosis.”
Contrast: Is the ‘trigger’ being stricken with Mono or is it an interaction between ‘hijacked’ B Lymphocytes? Or, does it ‘trigger’ an unidentified environmental factor such as another virus?
According to Sarah Zhang’s, Atlantic Monthly article, the Stanford study is suggesting EBV as ‘causation’. She writes, “Some multiple-sclerosis patients have antibodies that bind to both an EBV protein and a protein in the brain, which is erroneously targeted by the immune system in multiple sclerosis.” Very significant!
Plantone, in “Concurrence of Multiple Sclerosis and Brain Tumors”, stresses MS is a “chronic demyelinating inflammatory disease” and adds, “Although the co-existence of MS and brain tumors has been long described, many doubts regarding their possible causal association persist.”
Alan Rickerson, formerly of the Institute of Cancer Studies at U of Birmingham, “… only a tiny sliver of people infected with the virus (EBV) end up developing multiple sclerosis, so some other trigger or triggers must also be in play…”. (Zhang – Atlantic Monthly)
8 Human Herpes Virus family members.
HHV1, Herpes Simplex virus 1 (HSV1), causes cold sores.
HHV2, Herpes Simplex virus 2 (HSV2) and causes genital herpes.
HHV3, Varicella-zoster virus, causes chickenpox.
HHV4, Epstein-Barr virus and caused ‘Mono’, 90 to 95% of all humans are positive for EBV
HHV5, Cytomegalovirus (CMV), can also cause mononucleosis and hepatitis.
HHV6, causes Roseola in young children.
HHV7 is a relatively new discovery, causes Roseola and is still being studied.
HHV8 It is relevant for people with AIDS. It is present in tumours known as Kaposi's Sarcoma (KS). It is thought to cause certain lymphomas (cancers).
Special Note: Human Herpes viruses have DNA, not RNA. How DNA Viruses and RNA Viruses interact may be a risk factor for MS, but this is beyond the scope of this Paper.
EBV and Connection to Certain Cancers
Epstein Barr virus is associated with Burkitt Lymphoma, a common cancer in children in Africa that causes tumors in the jaw and facial bones.
Yasin Kaymaz. U of Mass, in her Paper “Epstein-Barr Virus Genomes Reveal Population Structure and Type 1 Association with Endemic Burkitt Lymphoma”, Journal of Virology, 2020 Aug, writes, “Endemic Burkitt lymphoma (eBL), the most prevalent pediatric cancer in sub-Saharan Africa, is distinguished by its inclusion of Epstein-Barr virus (EBV).” The Paper adds, “Improved viral enrichment methods conclusively demonstrate EBV type 1 to be more prevalent in eBL patients than in geographically matched healthy controls.”
Contrast: Multiple Sclerosis is rare in Sub-Saharan Africa.
Inuit and EBV
“The Inuit populations in the Arctic have a remarkable cancer pattern with high frequencies of Epstein–Barr Virus (EBV)‐associated cancers, such as carcinoma of the nasopharynx and salivary gland …” (Boysen). Boysen notes, HHV4 can “… lurk in B lymphocytes…”.
Contrast: Multiple Sclerosis is rare among Inuit.
What are B Lymphocytes?
B lymphocytes are white blood cells, part of the immune system and, among other things, recognize foreign substances and trigger the production of antibodies to protect the body.
Trenton Mel Church et al notes in a Journal of Virology, 2018 Paper, “Epstein-Barr virus (EBV) is linked to the development of both lymphoid and epithelial malignancies worldwide.” (Cancers) They add, “Epstein-Barr virus (EBV) infects more than 90% of the human population, but the incidence of EBV-associated tumors varies greatly in different parts of the world.”
In 2015 Lauren R. Tersa and her team studied EBV as a risk for non-Hodgkin lymphoma and wrote. “Epstein-Barr virus (EBV) causes rare, malignant lymphomas.”
Contrast: EBV’s association with Cancer is well established. There does not appear to be a connection between Demyelination, the hallmark of MS, and EBV.