Tuesday, 16 June 2015

EBV infects all MSers in Iran

Karampoor et al. Serostatus of Epstein-Barr virus in Iranian MS patients. Acta Neurol Belg. 2015 . [Epub ahead of print]

Multiple sclerosis (MS) is a common, complex disorder. Associations of MS with Epstein-Barr virus (EBV) infection in Caucasian populations are well documented. However, in the Iranian population, previous studies have been conflicting. Sixty patients with MS and 50 healthy controls were tested for anti-EBV antibodies using chemiluminescent assays. All MS patients to be seropositive for EBV as compared to 82 % of controls (p = 0.0006). A strong, significant association of MS with EBV infection was documented, similar to studies in first world populations. Future studies should investigate the temporal sequence of infection to try to understand the cause of the recent increase in MS risk in Iran.



More logs for the fire and confirms studies in other places that most people in the population have been exposed to EBV but virtually all MSers have.

31 comments:

  1. Very interesting, as far as I know -on the whole - Iranians are of Caucasian descent. Just not European Caucasian and over the years this has changed, however in the areas of Iran that have the MS pockets (Pars province, Istafan) are more Caucasian. The Parsi community of India fled persecution from these areas and have kept themselves pretty much to themselves in India and a few other parts of the world. And guess which population in India has the highest rates of MS. I've always been interested in this, because my grandmother's family were Parsi.

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    1. Iranians and North Indians are of Aryan decent (hence swastika symbolisms) who hail from Central Asia. One group went north and developed blond hair and blue eyes, while the others headed south east.

      Hitler was very aware of this and sent anthropologists to Asia to take measurements, seeking to understand the perfect Aryan specimen. Punjabis are pretty much all Aryan descendants.

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    2. Tony: in some ways this poster is correct such as Hitler did send anthropologists to investigate and Persians are Ayran in the strictest definition but it's not the terminology used these days. Iranian is a nationality not a race. Note I said Persian were/are Aryan not Iranian, because Iranians are made up of many races. The Parsis are Persian as were the Iranis (just denotes the term given to the particular diaspora), both were persecuted because of their religion -Zorastrian and in the diasporas fled to India and other parts of the world (Freddy Mercury was Parsi, his family fled to Tanzania). These are the groups with the most prevalence of MS, at least until recently. I've no idea if it remains this in Iran, where some Zoroastrians remain. Predominantly in the areas with MS clusters. Interestingly, up until the very late 1970s in Iran, Zoroastrians did not -on the whole -wear head coverings. Nor do they, on the whole, in India. Because my grandmother was Parsi and I studied anthropology I've always been interested in this but not up to date enough on Iran demographics to know more about this relationship to the current MS 'epidemic'.

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  2. How many years and how many tests do you need to do before its agreed that Ebv is involved? I don't get it
    Also is there any further info on your ebv charcot test, I spoke to 'your competitor' as its been stated, GeNeuro, who have confirmed the phase IIb tests will be launched by late 2015 in Europe for their anti ebv drug gnbac1.
    One further question, why is is echinacea and other immune boosting supplements are used to treat ebv, yet we use immunosuppressive approaches in Ms.

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    1. Although I am not say thisis the case here but....

      Summer projects maybe. You have a clinical research placement for a few months and the student has to do something, you find a project that will give sure fire results but at the same time something you don't know, and something that does not cost much money...The student learns phlebotomy taking blood and maybe doing some assays. This gives the student the taste of research, data handling and hopefully gives them a paper so they learn how to write and that enthuses the student into clinical science and the oyster opens as the most powerful people to make a change are academic clinical scientists as they do the trials

      Gnbac1 is not an anti-EBV drug it is an anti HERV drug. The idea may be that EBV transactivates HERVs as a trigger.....it could be all pie in the sky as it is not addressing EBV

      No idea about Echinacea....a nutriceutical lacking evidence

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    2. "No idea about Echinacea....a nutriceutical lacking evidence"

      Eeek, in my opinion keep well away. I don't think it boosts the immune system in a way that will help MS but rather may risk making things worse. I don't normally comment on alternative medicine (I have a post grad in herbal medicine, so I do believe some may help to some degree but it has also made me more wary too) but I feel compelled to do so on this occasion as it is so unlikely to help and may cause harm.

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    3. Keep away from echinacea - it gave me relapses.

      Use something else herbal if you need to - I needed to boost my lymphos knowing full well that I risked a relapse and it happen but I won't do it often.

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    4. "No idea about Echinacea....a nutriceutical lacking evidence"

      As the old saying goes, anecdotal data is no data.

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    5. Page 13 of MS Society produced booklet mentions echinacea (can view online).....

      http://www.mssociety.org.uk/sites/default/files/Documents/Essentials/Complementary-and-alternative-medicine-May-12_0.pdf

      'Some herbs may also provoke MS symptoms or interact with
      medications commonly used in MS. In addition, some herbs, such
      as echinacea and an Ayurvedic herb, ashwagandha, appear to
      activate the immune system and could pose a theoretical risk for
      people with MS'.

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  3. Excuse my ignorance I thought that by attacking hervs it would have an affect on ebv
    What do you think regarding treating EBV though? Haven't they shown high dose vitamin C to help lower Ebv antibodies etc? But then wouldn't this be counterproductive to the standard immune suppression stance that is currently used
    Ie to treat ebv you need a strong fully functioning immune system yet many of the Ms drugs do the complete opposite?
    Is it chicken and egg? Treat ebv and you stop the need to suppress the immune system

    Ps when are we seeing charcot results

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    1. If there was an effective vaccine against EBV, it would solve the conundrum as to whether EBV is the cause of MS or not but it would take 30 years or so before the results would be revealed!

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    2. As EBV makes its home in B cells, we do not know if the MS drugs are lowering the immune system or preferentially killing/suppressing the infected B cells, or something completely different.

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  4. 30 years a go my friend had Bells Palsy - I went with her to see the neuro. My friend had glandular fever the year before. The neuro pointed out that glandular fever / ebv can be associated with MS. So the link has been known for a long time. What's got in the way is something call EAE. EAE is the reason why so little progress has been made in uncovering the viral cause of MS. I bet Alemtuzumab wasn't found via EAE experiments on mice. Nor the anti-CD 20 therapies in the pipeline. I bet The mice doctors weren't involved in the Charcot Project. EAE is not a good model for finding out the cause of MS - mice don't get glandular fever. When an anti-ebv vaccine appears it will,have a major impact on MS. I will personally free the thousands of mice who have suffered at the hands if the EAE-ologists. No one will hold up their hands and admit this. They will point to great drugs such as betainterferon. I don't blame the mice doctors, but it's a bit like asking Bradley Wiggins to win the tour de France on a penny farthing. EAE is not MS, mice don't get glandular fever = EAE will never identify the cause of MS.

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    1. No -one is (or ever has) claimed that EAE is a perfect model of MS but it does share many of the pathological hallmarks of MS which has been of use in developing some MS therapeutics such as Gilenya, Tysabri and potentially symptom controlling agents for spasticity.
      Yes, EAE has its limitations but you should always be wary of chucking out the baby with the bathwater.
      As I mentioned above it would take about 30 years to deduce whether an EBV vaccine (if it existed) stopped the development of MS. What would we do for pwMS in the meantime?

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    2. Here's an article showing how useful EAE has been in the development of therapies for MS and discussion of its limitations (free to view) if you're interested.
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981554/

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    3. EAE = papers, EAE translates to modestly effective therapies. Modestly effective therapies are not curative but lead to huge monetary windfalls for pharma. EAE is good for academia and pharma but as MD2 states it is not a perfect model. For a cure to be found a causative factor(s) need to be found. Could AIDS be cured if HIV was not isolated and found to be the causative agent? Until then it seems we are just spinning are wheels.

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    4. MD2,

      It's a rubbish model. It was invented so that researchers could produce research papers. According to this site the risk factors for MS are EBV, female gender, smoking, Vit D deficiency. Does EAE cover any of the above? We still don't know the cause of MS, we still don't no the mechanisms behind neuro-degeneration. The breakthroughs in the disease have come from places like Cambridge - they tried Campath on humans based on their well thought through hypotheses. Likewise, the Charcot project is being tested on humans. EAE is for the researchers who don't venture out of the lab. At some point the endless research being done on mice (mouse model of MS) will end and we will start to see some real breakthroughs.

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    5. Well as the dude in the Big lebowski so rightly said, "Well that's just your opinion, dude".
      Your mind is obviously made up so I won't waste my time trying to change your opinion, I've got rubbish experiments to do.

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    6. MD2 - they're not rubbish experiments, they cure mice of EAE! My opinion is based on watching MS research for 15 years. EAE is not fit for purpose as a way to understand the cause of MS. It has a role is understanding how the cns is damaged if immune cells start attacking it. Hopefully, the real value of mice experiments will be seen when we enter the era of neuro-protection and repair. PS I'm still angry with you MD2 for getting me excited earlier this year (suggestion that good things are on their way). Phenytoin results published, but I won't be able to get a prescription. I really thought 2015 would be a good year.

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    7. I agree with you that our EAE neuroprotection studies are going to be of real value.
      Re phenytoin, we've got to start somewhere and I hope this will be just the beginning of neuroprotectants being taken seriously for MS.
      We can cast the bread on the water but it's up to the pharma fish to bite.
      I think 2015 has been a good year so far hopefully there's more to come.

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    8. well well Anon 1:14

      EAE is rubbish. I hear MS makes papers. Papers make a research blog.....research blog allows you to moan.

      No animal experiments = no breakthroughs from Cambridge.

      I think alemtuzumab was made in rat based on mouse studies testing a hypothesis grounded in mice work. Furthermore Herman Waldmann had tested lymphocyte depletion and CAMPATH in a whole host of conditions including autoimmune diseases. The work with Prof Compston went somewhere.

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  5. True story, but what about treating ebv and other hervs now in people with Ms wouldn't this help at least partially solve the conundrum?
    We know there's been enough evidence to suggest at least a link somewhere with ebv
    Then you have anecdotal claims of people with Ms who contract hiv and find themselves in remission once they start the HAART.
    You have Michael Pender and his study in Australia
    Prof Gold with his study
    And now you guys holding on with your charcot study
    We all know there's a link there and while pepople are sat around there's more and more people getting diagnosed and or getting worse
    This link has long been hypothesised and even established, it's time to get to the bottom of it rather than allowing the pharma companies to get wealthy
    Heck I even seen a market analysis using Ms treating pharma companies to forecast who's shares to buy for the next four years!! How does he know yet we don't!!

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  6. There's a big Hollywood studio comedy coming out this summer called Train Wreck, and one of the charters in it is an MS sufferer.

    If you live in New York there is a comedy event in association with the National Multiple Sclerosis Society where main cast will be raising money for MS research (https://www.crowdrise.com/NewYorkTrainwreck).

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    1. Yes, I heard that Amy Schumer's character's dad has MS in the picture and her and her sister are kind of caring/ worried for him, and the costs incurred.

      About time Hollywood woke up to MS.

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    2. Let's not forget that President Bartlett had MS in the West Wing.

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    3. An according to ProfG Mrs Bartlet was the inventor of the term "Brain Shredder".

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  7. Could all this ebv related stuff explain why LDN works for some?
    I know it was initially used to treat hiv patients after a doctor had found they had chronically low endorphin levels, once these were boosted their immin systems jumped and many found benefits to treating their hiv
    Would this be why it has been claimed to work in Ms and if so why?

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    1. Naltrexone shown to antagonise TLR4 and someone posted in this blog on HERV/TLR4 interaction

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    2. Kris - if you read more extensively on LDN you will find that the jury is still out in some respects as to whether it "stimulates" the immune system or not. The other theory as to how it works is that for some reason which has not been ascertained it actually "allows" your own body to "re-regulate" its immune system. This actually makes sense to my non-scientific brain, as if MS is being driven by an over active immune system then stimulating the immune system should worsen MS.

      It is acknowledged that for some people who suffer muscle spasms (not spasticity) it can make this particular symptom worse, Apart from muscle spasms problems for some, I have found no-one who has reported LDN making their MS worse, there are some for whom it does not appear to provide much or any benefit, and some who claim that it has made a real difference for them.
      I thought I was one of the people who had worse muscle spasms due to LDN, but amazingly, and very unexpectedly, all of my leg spasms (which were a painful daily occurrence) disappeared almost completely within ten days of stopping IFN-Beta-1A. I have now had eight months virtually completely free from spasms, with only an occasional twitch to remind me that I had them at all. I continue to take LDN at 4mg a night - it is doing me no harm, and may even be doing some good.

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