b'Doctors NotesThe MS News column includes analysis from Ben Thrower, M.D., MS Focus senior medical advisor. He draws from the top news stories of the quarter and explains what the news means to you, the person with MS.What Did We Learn Infection with EBV was associated with a About MS in 2022?32-fold increase in the risk of developing MS. As a neurologist who focuses on MS, I This increased risk was not seen with other sometimes think back on my training and myviruses. early years of working with the MS community. Serum levels of neurolament light chain Weve come a long way. Obviously, we do notincreased after an EBV infection. Neuro- have the cure that we all pray for, but greatfilament light chain is a biomarker for advances have been made. Lets look at someaxonal damage. of the developments from this past year.In a second study from Stanford University, The Epstein BarrMS connectionresearchers made a huge leap forward in our MS results from the complex interactionunderstanding of how EBV might fool our of genetic risk factors and the environment.immune system and lead to the development One of those suspected environmental riskof MS. This study identied a protein on the factors is the Epstein Barr virus. This virus is partsurface of EBV, called EBNA1, that can mimic of the herpes virus family and is incrediblya protein in the human central nervous system common. Almost all adults have been infectedcalled GlialCAM. People with MS can produce with the virus, but many had no symptoms.antibodies that bind to both. This process of Infectious mononucleosis is one manifestationmistaken identity is called molecular mimicry. of infection with EBV. EBV has also been linkedTwenty-ve percent of people with MS in the to a higher risk for developing nasopharyngealStanford study had these abnormal antibodies, cancer and certain lymphomas. How aboutbut it is suspected the number could be higher. EBV and MS? For decades there has been aWhy are these EBV studies a big deal? They suspected association between EBV and MS.could lead to signicant treatment advances. Sorting out that link has been challenging,Several research groups are hot on the trail however. Ninty-nine percent of people withfor an EBV vaccine. Would that potentially MS have antibodies to EBV consistent with a prior infection, but so does 94 percent of thehelp prevent MS? Could therapies that block general population.the EBNA1/GlialCAM antibodies prevent MS In 2022, two studies shed light on the MS-EBVprogression? connection. In an incredibly large epidemiologicStem cell research providing study, health records for 10 million youngpositive results adults from the U.S. military were reviewed.Our current MS toolbox of disease-modifying Of those, 955 individuals were identied whotherapies stands at 23 options. With early and had developed MS. This study found that:aggressivetherapy, wecanpreventfuture msfocusmagazine.org 51'