Possible link between multiple sclerosis and viral infection?

Researchers are looking to learn more about if and how a virus can trigger multiple sclerosis

Categories: For Potential Participants, [Multiple Sclerosis, Autoimmune disease]

Possible link between multiple sclerosis and viral infection?

Researchers have been making strides studying the COVID-19 virus in relation to other or secondary conditions since shortly after the epidemic started. Current efforts point to potential compromising impact of the virus on a person's immune system and its ability to ward off disease onset. Multiple Sclerosis (MS) is one such condition being looked at from this lens, not unlike research seeking to better understand the relationship between infection from Epstein Barr Virus (EBV) and the later development of MS.

In the US, 25,000 people are newly diagnosed with MS every year. It is estimated that today, roughly one million Americans are living with the condition.  Diagnosis often happens in one’s 30s, largely considered the prime of life. Globally, over two million people are affected by MS, making it the most common long-term and gradually worsening neurological disease among young adults.

MS is a chronic, progressive disease of the central nervous system. The condition stems from damaged myelin, which is the insulating sheath surrounding nerve fibers in the brain and spinal cord. This damage is caused by an individual’s own immune system. When this happens, the flow of electrical impulses in the brain and spinal cord is are disrupted, causing a wide range of effects. The most common MS symptoms include mobility and vision issues, fatigue, and muscle spasms. Symptoms may be permanent, or they may come and go. While MS is an unpredictable disease, as it progresses, it can become seriously disabling, and in extreme cases, life-threatening.

MS is classified in three ways:

  • Relapsing-remitting MS (RRMS): the most common form of MS (more than 80% of cases). RRMS involves temporary attacks called relapses. Relapses happen when new symptoms appear, or existing/previous symptoms worsen. Relapses alternate with periods of remission, during which some or all symptoms may disappear.
  • Primary progressive MS (PPMS): an uncommon form of MS with symptoms that slowly worsen over time, with no relapses or remissions.
  • Secondary progressive MS (SPMS): a form of MS in which symptoms worsen steadily over time after an initial relapsing-remitting course. Once this happens, there are no further relapses and remissions. Most people with RRMS transition to SPMS in the long term.

MS and COVID-19

Throughout the pandemic, living with a preexisting condition such as MS often heightened individual anxiety of contracting COVID-19 due to uncertainty around if or how the virus could worsen symptoms.  As time progressed and scientific understanding of COVID increased, connections between the virus and certain neurological and immunological conditions started to emerge.

For starters, having MS has not appeared to raise overall susceptibility to becoming infected with COVID. However, for MS patients that ended up with COVID, there have been reports of worsening symptomology following infection. One study found that thirty percent of people living with MS were still experiencing symptoms more than four weeks after becoming infected with the COVID virus.

Now researchers are starting to look at any potential connection between COVID and the onset of MS. A 2023 study published in Scientific Reports found that in some cases, COVID-19 appeared to trigger the development of MS. This warrants further research given that there are other findings that demonstrate a link between viral illness and the development of MS. Case in point, the Epstein-Barr virus (EBV) has been associated with the onset of MS: a study reported in Science in January 2022 found that people infected with EBV were 32 times as likely to develop MS as uninfected people.

Advances in MS treatment

Therapy for MS has made great strides since the first disease-modifying therapies (DMTs) were introduced 15+ years ago. Ongoing advances in clinical research are increasing the understanding of MS and effective ways to manage this disease.

In December 2022, the Food and Drug Administration (FDA) approved Ublituximab, a DMT used to treat relapsing forms of RRMS and SPMS. This injectable targets B cells, the cells that damage the nervous system. Clinical trials for Ublituximab resulted in less than one MS relapse over a ten-year time span for patients. Ublituximab is given as a one-hour infusion every six months, which is significantly less time consuming that other MS treatments.

Two years prior in 2020, Ofatumumab was approved by the FDA as an injectable that also targets B cells. This drug decreases MS brain lesions and worsening symptoms. Unlike Ublituximab, it is an injectable taken once a month and reduces relapses by about two-thirds.

In today's research pipeline, there are hundreds of potential therapies undergoing clinical trials to test their safety and whether they work as treatments for MS.

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