Professor Michael Pender, of the University of Queensland School of Medicine, Brisbane, had a notion that patients with advanced multiple sclerosis, otherwise known as secondary progressive multiple sclerosis, have an impaired immunity to the Epstein-Barr virus (EBV). EBV is one of the most common viruses in humans, affecting 9 out of 10 people at some point in their lives, and is a member of the herpes family. Several studies have linked EBV to triggering patients’ MS, as increased levels of EBV antibodies have been found in MS patients’ blood and EBV-infected immune cells have been found in postmortem brains from MS patients. Although no causal relationship has been established, EBV exposure seems to increase an individual’s risk of developing MS.
Piecing together these two pieces of information and drawing from over 30 years of experience in researching MS, Pender and colleagues launched a study that uses the EBV virus as a form of adoptive immunotherapy. The study is detailed in the Multiple Sclerosis Journal. The patient in the study was Gary Allen, one of over 23,000 Australians living with MS, who has the secondary progressive form of MS. Co-author Rajiv Khanna, a professor at the QIMR Berghofer Medical Research Institute in Brisbane, took a sample of Allen’s blood to harvest CD8 T-cells. Khanna then grew Allen’s T-cells in a culture containing EBV vaccine to boost the cells’ ability to fight against EBV. Finally, the boosted cells were transferred back to Allen intravenously.
Summed up by Pender, “The beneficial effect of boosting immunity to EBV by this treatment highlights the importance of impaired immunity to EBV in the development of MS. We believe the treatment corrects the impaired CD8 T cell immunity that allowed EBV infection to cause MS.” This study is the first to use EBV-specific adoptive immunotherapy to treat secondary progressive MS; studies have previously shown benefit of EBV adoptive immunotherapy in cancer patients.
Find out more about secondary progressive MS.
Allen experienced no adverse side effects over the six-week course of treatment. In fact, after only two weeks, symptoms of Allen’s secondary progressive MS began to subside; after 21 weeks, he still showed clinical improvement. Allen was first diagnosed with relapse-remitting MS in 2000 and has been unable to live without assistance since 2008. His leg movement, hand function, attention, memory, and thinking have greatly improved since treatment, and he can work from home more productively than before. “Whether you look at my work, time with family, or resurgent social life, it’s been an amazing change for the better,” said Allen. From a scientific perspective, his symptoms have improved, as well: an MRI brain scan showed decreased disease activity and his cerebrospinal fluid showed fewer antibodies. His success will fuel a clinical trial to test its safety and efficacy in more patients with varying forms of MS, including secondary progressive MS.