In a recent review published in the Journal of Clinical Investigation, researchers presented their view of the link between Epstein-Barr virus (EBV) infections and the development of multiple sclerosis (MS) based on in a previous study conducted by Bjornevik et al. published in Science.
Study: Falling down the biological rabbit hole: Epstein-Barr virus, biography and multiple sclerosis. Image credit: Kateryna Kon/Shutterstock
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The previous study reported an increased risk of MS among active duty military personnel infected with EBV, supporting the need for EBV vaccinations for soldiers. The authors opined on whether these vaccines are necessary for military personnel and whether lived experiences and biosocial factors [such as anxiety, stress, loneliness, depression, and post-traumatic stress disorder (PTSD)] may affect the association between EBV and MS based on previous research findings.
In the present review, researchers provided their views on the likely association between EBV and MS based on a previous study.
The study
A previous study reported a 24-fold greater likelihood of MS among EBV-infected individuals compared to EBV-uninfected individuals, supporting the need for EBV vaccinations for the prevention of the MS. However, the study authors mentioned drawbacks such as incomplete analysis and misrepresentation of data in the study.
The study involved more than 10 million adults and was based on a human immunodeficiency virus (HIV) screening program conducted by the United States (US) Department of Defense between 1993 and 2013 in which they obtained sera from active duty military at military entry and every other year. . In the study, sera from MS patients (cases, n = 801) and controls (n = 1566) matched for age, sex, ethnicity, branch of service, and date of sample data collection were obtained to assess titers of antibodies among military cadets against EBV. , herpes simplex virus 1 (HSV-1) and HHV-6 (human herpesvirus 6).
Case individuals showed EBV positivity at military entry (group A) or EBV seropositivity during active military service after military entry (group B). The odds ratios (OR) for developing MS for individuals in group A and group B were 1.6 and 25.6, respectively, indicating a significantly greater risk of developing MS after of EBV seroconversion.
Psychological assessments were performed based on the NEO Personality Inventory, the Health Resilience Questionnaire, the Perceived Stress Questionnaire, and the Social Support Questionnaire. Serum samples obtained in the study demonstrated significant elevations in serum antibody titers, consistent with previous studies conducted in individuals with high levels of psychological stress.
The viewpoint
The authors have suggested that several biosocial factors based on exposures, behaviors (especially work-imposed), PTSD, and emotions resulting from social relationships must be considered to explain the study results. Stress and anxiety during active military combat and loss of friends and/or colleagues during military service could affect an individual’s risk of developing MS.
Integrating biological variables such as the microbiome and genetic susceptibility), environmental variables such as latitude changes and toxins, and biosocial variables such as lived experiences or biography associated with traumatic or stressful experiences can improve understanding of the etiopathogenesis of MS.
The authors stated that the study was suitable for serological analysis; however, further quantitative analyzes are needed to gain more insight into the link between EBV and MS. US Department of Defense data could be consolidated with comprehensive data maintained by the military on active-duty personnel, and determining the timing of infection after seroconversion could help identify potential windows of differential vulnerability.
In addition, allostatic load (a physiological measure of the collective stress load on the human body) could be assessed using various biomedical markers to model the risk of developing MS after EBV seroconversion based on the biosocial analysis. The authors cautioned against administering EBV vaccines for MS prevention, as the full scope of the biographic and biological triggers of MS needs to be determined, although EBV infections have been associated with the development of MS.
conclusion
In conclusion, the authors have indicated that several biological and biosocial factors may be associated with the development of post-EBV seroconversion that should be explored in future studies to establish the pathogenesis of MS among military personnel in active duty infected by EBV. They believe that EBV vaccinations may not be necessary to prevent MS among active duty military personnel with a history of EBV infections.