Before yesterday people may have got away with the punch line “These findings suggest that the association of EBV and MS is specific for MS” This implies there is something very specific for MS and EBV…However this is clearly not true. Yesterday there were reports of links between EBV and lupus and one could make the case for this in other disorders too. This study looks and finds everyone with MS has EBV and the people that didn’t have EBV didnt have MS. However they also looked at people with MS (myasthenia gravis, autoimmune encephalitides, neuromyelitis optica spectrum disorders), patients with systemic/rheumatologic inflammatory diseases (Sjogren’s syndrome, sarcoidosis, systemic lupus erythematosus, rheumatoid arthritis) etc.
Sjogrens has reasonable data and they claimed 98.3% (Sjogren’s syndrome). Did they look through the notes of these people to exclude the negatives? and Lupus was not 100% but in the 90’s percent wise so ditto there too. But it suggests you have to be careful when you have MS and controls because the controls are quite possibly showing the consequences of EBV infection but their infection skewed to a different condition. There were quite high infection rates with Herpes Zoster but they didn’t look for JC Virus. Antibodies to EBV was lower in the CNS …was this because it was stuck to the brain due to cross reactions between EBV and brain proteins. I think many people are prepared to contemplate a role for EBV in MS but the question we all ask is how and when you do something about out it.
Rodomonti M, Pache F, Otto C, Schindler P, Eberspächer B, Geran R, Puthenparampil M, Gallo P, Wildemann B, Jarius S, Erdur H, Ruprecht K. Retrospective In Silico Analysis of Routine Laboratory Data Supports a Specific Association of Epstein-Barr Virus and Multiple Sclerosis. Eur J Neurol. 2025 Nov;32(11):e70430
Background: We conducted a retrospective in silico analysis of routine laboratory data (RISAROLDA) to study the association of Epstein-Barr virus (EBV) and multiple sclerosis (MS).
Methods: Patients with MS and 10 different inflammatory/neoplastic diseases were identified by ICD10 codes. Results of routine laboratory testing for antibodies to EBV, measles, mumps, rubella, herpes simplex virus, varicella zoster virus and cytomegalovirus were extracted using a digital tool.
Results: Among 10,669 patients with MS and 42,222 controls, EBV serologies were available from 492 (4.6%) patients with MS and 1918 (4.5%) controls. While all but three patients with an ICD10 diagnosis of MS were EBV seropositive, closer inspection of the three EBV seronegative patients revealed they were misdiagnosed with MS, resulting in a 100% EBV seroprevalence in the remaining 489 patients with MS. In contrast, EBV seroprevalences were lower in all other diseases (78.6%-97.8%). Serum antibodies to the Epstein-Barr nuclear antigen-1, but not to the viral capsid antigen, were higher in patients with MS than in all other diseases. In patients with MS, seroprevalences of all other common viruses were lower than those of EBV, but the frequency of intrathecal production of antibodies to EBV was lower than that of other common viruses.
Conclusions: These findings suggest that the association of EBV and MS is specific for MS as compared to various other inflammatory/neoplastic diseases and that a negative EBV serology might be a marker for the absence of MS. RISAROLDA is a powerful approach for the screening of real-world laboratory data.
Source: multiple-sclerosis-research.org