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    Epstein-Barr Virus May Trigger MS

    Elevated Antibodies Could Predict Disease

    Multiple Viral Triggers

    But an MS expert who spoke to WebMD says he remains skeptical that Epstein-Barr virus is the single, infectious culprit responsible for the disease.

    "There are probably a dozen or more infectious agents that have been proposed as causative in MS, and for each one there is some evidence to argue the case," says John Richert, MD, who is head of research and clinical programs for the National Multiple Sclerosis Society. "But no one has been able to come up with the definitive proof that their particular agent is the one."

    Richert says it is widely accepted that environmental factors, specifically infections, trigger MS in people who are genetically vulnerable to the disease. But he adds that it is more likely that multiple triggers come into play.

    "When we finally understand everything about MS, it may not be a single virus or other infectious agent that is the trigger," he says. "It may well be that different agents act as triggers in different people."

    He notes that people with MS tend to generate higher immune responses to many different viruses, including those that cause mumps, German measles, and herpes. All of these viruses have been studied as potential causative agents for MS.

    It is not clear from the study if the people who developed multiple sclerosis decades after their blood samples were taken also had elevated immune responses to these viruses.

    Ascherio says he believes Epstein-Barr virus is a uniquely important viral trigger for MS. He points to the mounting evidence linking EBV to other autoimmune diseases, including lupus.

    "I am not saying that other viruses might not be involved, but no other virus has displayed such a strong and persistent association with MS," he says. 'I think this certainly makes the case for stepping up efforts to develop an effective vaccine against this virus."

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