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Multiple sclerosis: “The Epstein-Barr virus is one of the pieces of the puzzle”, assures Professor Gilles Edan
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Multiple sclerosis: “The Epstein-Barr virus is one of the pieces of the puzzle”, assures Professor Gilles Edan
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What do you think of this study

which shows that multiple sclerosis is most likely caused by the Epstein-Barr virus (EBV)?

Prof. Gilles Edan is the head of the neuroscience center at the Rennes University Hospital.

Prof. Gilles Edan is the head of the neuroscience center at the Rennes University Hospital. (Grego Buchhaus)

How can this virus promote the onset of multiple sclerosis?

It is thought that the immune system, in its mechanism of attacking the virus to control it, recognizes a structure of the viral membrane probably very similar to that of myelin, which is located around the nerve fibers of the central nervous system. In other words, by learning to attack the virus, the immune system learns to attack brain tissue.

What other factors increase the risk of developing this disease?

In children, obesity has been pointed out by studies carried out in the United States. Tobacco also plays a role. Associated with a particular genetic background, it multiplies by 15 the risk of multiple sclerosis. Pesticides have also been implicated. Many arguments also point to vitamin D deficiency. 80% of Bretons are deficient in it due to lack of sunshine. Multiple sclerosis is also found in regions of the globe where the climate is temperate.

When we see the feat achieved against covid-19, we no longer dare to say that it is impossible to find a vaccine against a virus. But before being marketed, a vaccine must demonstrate that it is effective and does not induce side effects. There is a long way to go before we can get anything useful out of it. Several questions remain: collectively, is it possible to vaccinate 100% of the population to prevent the emergence of a disease which affects one in 1,000 French people and which is not as threatening for the health system as covid-19? At the individual level, would people accept having their babies vaccinated? Studies must confirm that this vaccine does not cause any complications.

Would vaccination not be particularly indicated for people who present risk factors, in particular genetic, with cases of multiple sclerosis in the family?

It could be justified. Two elements contribute to the construction of multiple sclerosis: environmental elements and a genetic susceptibility which means that we are not at all equal to contracting this disease. Nearly 250 gene variants have been identified that increase the risk of developing multiple sclerosis. For example, this risk is 2% to 3% if you have a brother or sister who triggered it.

Could a vaccine against this virus have a positive effect on patients already suffering from multiple sclerosis?

Once you are infected with EBV, the immune system has learned to react and has developed memory cells that are just waiting to be reactivated. It would be a surprise that the fact of vaccinating against this virus has a beneficial effect on the evolution of multiple sclerosis which has started.

And would antiviral treatments targeting this virus make it possible to treat people affected by this disease?

For the general public, for patients, we must pay attention to messages that say: “We found the person responsible, we will get rid of him and you will no longer have multiple sclerosis”. We have not found, when the disease develops, a viral replication which shows that it is the virus itself which is the cause. The first drug approved for multiple sclerosis was interferon, an antiviral that has become the mainstay treatment. It was invented on the idea that multiple sclerosis was a viral disease and that it worked by reducing the replication of the virus. In fact, this treatment does have a positive effect on the disease, but not by this mechanism.

Where are your own works in Rennes? How are you moving forward to offer better patient care?

The Rennes University Hospital has just won the 5th call for projects “University Hospital Research in Health” (it will receive aid of €8,271,646). It is a private-public partnership that aims to achieve something commercial within five years, likely to change the management, knowledge and treatment of a disease. For our part, it will be a matter of providing neurologists and patients with the experience of 10,000 people who have been followed and treated for multiple sclerosis. The goal is that patients can project themselves and see what has become of people who have the same characteristics as them, according to the different treatments or even the absence of treatment, in the years that followed. It is a personalized medicine that helps to choose therapeutic options in the face of a very heterogeneous disease, and helps the patient to understand what he can reasonably expect from his future. We bring him a truth that is based on real experience thanks to a computing power that we did not have 20 years ago. It is absolutely revolutionary.

Added to this is an automatic MRI reading tool to check whether or not a patient is responding to treatment, in a certain and standardized way, so that good decisions can be made.

The “Health” section

* Thanks to the 20-year follow-up of more than 10 million young Americans enlisted in the army, scientists have been able to establish that the risk of developing multiple sclerosis is 32 times higher after being infected with the Epstein-virus. Barr.

Multiple sclerosis: “The Epstein-Barr virus is one of the pieces of the puzzle”, assures Professor Gilles Edan
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