Could we eradicate or avoid contracting multiple sclerosis (MS)? This major question is the one raised by Professor Jean Pelletier, neurologist at La Timone University Hospital in Marseille and president of the medical-scientific committee of the ARSEP foundation (foundation for aid in research on multiple sclerosis) at the occasion of World MS Day, May 30. Interview.
Eradicate multiple sclerosis, really?
We are still far from it, but the most recent discoveries indeed imply that we might act to avoid contracting it. This is the first time we’ve talked regarding prevention!
How might we prevent?
Several studies now confirm that it is not possible to trigger MS if you have not encountered the Epstein-Barr virus (EBV). Please note, 90% of the French population has encountered this virus and not everyone will have multiple sclerosis: among the 68 million French people, 120000 have MS.
EBV is clearly not the cause of the disease, but it is an essential condition for its development. It is also incriminated in the same way in other autoimmune diseases. This implies that we might perhaps act to avoid contracting this virus, by developing a vaccine once morest the Esptein-Barr virus. Thus protected, first you shouldn’t be able to trigger MS.
Has research begun to find this vaccine?
Several companies have embarked on the adventure, including the Moderna laboratory, which has the most advanced position with an RNA vaccine. But it’s complicated for two reasons. First, if it is an RNA vaccine, given the experience we have with Covid, this vaccine would have to have a much longer duration of effectiveness to avoid non-stop reminders. And the second question that goes with it is when should you vaccinate for a child to avoid contracting EBV?
Has progress been made on these issues?
Current studies highlight two important points. The first is that the risk of triggering MS is higher if you have developed infectious mononucleosis, a disease also linked to EBV.
The second relates to the fact that mononucleosis is rather a benign disease that is encountered in adolescence. The simplest way to avoid MS would therefore be to find a long-lasting vaccine once morest EBV, which makes it possible to vaccinate children very early to protect them definitively, as with the vaccine once morest tetanus. The other option would be to vaccinate in middle childhood to protect adolescents who will contract the virus from developing mononucleosis and thus reduce the risk of developing MS.
We’re not there yet, but it’s still the first time we’ve talked regarding avoiding the disease.
Could we also act on the virus inside the body?
This virus, when we contract it, stays in our body for our whole life, and not just anywhere: it lodges in a class of cells, the B lymphocytes, which are certainly involved in MS and other autonomic diseases. immune. Among the treatments that are very effective in preventing flare-ups, there is a class of drugs, the anti-CD20, which acts very specifically on the B lymphocytes. This is a lead.
Another avenue is to ask whether the virus, once installed in the B lymphocytes, does not participate directly in the evolution of the disease? Could it cause the breakouts? If we showed that this is the case, we might try to act directly on EBV inside the body with antiviral treatments that would target it and prevent its reactivation in B lymphocytes. There is ongoing research to develop this type of antiviral which we do not yet have.
