The results from a phase 1 study investigating the relationship between MS and the Epstein-Barr virus may show promise of a new type of treatment for progressive multiple sclerosis.
 
Phase 1 studies are designed to evaluate the safety of a treatment and identify side effects, using a small number of participants. The study involved six people with progressive MS with moderate to severe disability. People with progressive MS have a severe condition with slow, steady worsening of symptoms.
 
As part of the normal immune response, immune cells called T cells and B cells work together to protect the body against infectious agents. In some people with MS, the immune response may be altered and T cells may be unable to control EBV-infected B cells, which accumulate in the brain and produce antibodies that attack and destroy myelin, the protective layer that insulates nerves in the brain and spinal cord. This in turn leads to neurologic dysfunction and symptoms. Elimination of the EBV-infected B cells may reduce the destruction of myelin in MS.
 
For the study, researchers removed the participants’ own T cells and stimulated them to boost their ability to recognize and destroy cells infected with Epstein-Barr virus. They then injected participants with infusions of escalating doses of T cells every two weeks for six weeks. They followed the patients through 26 weeks to look for evidence of side effects and possible improvement of symptoms. Three of the participants showed improvement, starting two-to-eight weeks after the first infusion. None of the six participants had serious side effects.
 
“One person with secondary progressive MS showed striking improvement. This participant had a significant increase in ambulation from 100 yards with a walker at the start of the study, and over the previous five years, to three quarters of a mile, and was now also able to walk shorter distances with only one-sided assistance. Lower leg spasms that had persisted for 20 years resolved,” said study author Michael Pender, of the University of Queensland in Brisbane, Australia.
 
Pender said another participant with primary progressive MS showed improved color vision and visual acuity. All three responding participants had improvements in fatigue and ability to perform daily activities.
 
“The best responses were seen in the two people who received T cells with the highest amount of reactivity to the Epstein-Barr virus,” Pender said.
 
This is a small study and the results must be reproduced in further trials before it is known if it is a viable treatment option. Results were presented at the American Academy of Neurology’s 69th Annual Meeting in Boston.