ECTRIMS 2024

At the congress, EBV-MS members met up to discuss recent breakthroughs, share progress, and plan future steps. 

The European Multiple Sclerosis Platform (EMSP) showcased the EBV-MS project, emphasizing its potential to transform MS treatment and prevention. From Karolinska Institutet,  Professor Piehl presented “Disease-Modifying Therapy and Risk of Infection” during the Hot Topic 6 session, while Professor Kockum discussed “Lifestyle Risk Factors in MS” in Scientific Session 4. Doctoral candidate Chiara Starvaggi Cucuzza also presented her research on “Strategies for de-escalation with anti-CD20 therapies”. A conference highlight was doctoral candidate Britt-Ellen Rød from Haukeland University Hospital and the University of Bergen, who received the “Young Investigator Award for Best Oral Presentation” for her study comparing rituximab and cladribine treatments for relapsing-remitting MS.

Photo:

Kjell-Morten Myhr

Below, you’ll find three brief blog posts from our consortium members detailing their talks or experiences at the event. Contributions come from Professor Marco Salvetti, Assistant Professor Olivia Thomas, and Patricia Moghames.

On Wednesday, 18th of September 2024, Olivia Thomas from Karolinska Institutet gave a talk Scientific Session 4: Microbiota and environmental risk factors.

Recent research suggests that Epstein-Barr virus (EBV), might be a key factor in developing multiple sclerosis (MS). However, scientists are still trying to figure out exactly how this virus triggers the disease in some people. One hypothesis is that the immune system, which normally fights off infections, might mistakenly attack the brain instead.

Olivia Thomas presented research from the Neuroimmunology Unit and Therapeutic Immune Design groups at Karolinska Institutet which is investigating how immune responses to one protein from EBV called EBNA1 can also target the brain in MS. Their research demonstrates that parts of the immune system called antibody and T cells which attack EBNA1 from EBV are instead mistakenly reacting to a protein found in the brain called anoctamin-2, or ANO2, and that this misdirected immunity was more common in people with MS. In addition, they found that these T cells were present in individuals with MS who carry the strongest genetic risk factor for MS, a gene called HLA-DRB1*15:01. The researchers then used an in vivo model to show that ANO2 T cells and antibodies also responded to EBNA1, and also found that these responses were associated with more severe disease and damaging effects in the brain, similar to what is observed in people with MS.

This work follows several studies in recent years which demonstrated that EBNA1 antibodies generated in response to EBV cross-react with multiple proteins found in the brain: ANO2, GlialCAM and CRYAB. Importantly, this new study provides additional evidence that T cells – which are like soldiers of the immune system – that respond to EBNA1 are also misdirected and can target ANO2. Whilst there are still many remaining questions, we are one step closer to understanding how EBV immune responses may directly lead to brain inflammation in some individuals with MS.

On Thursday, September 19, 2024, Marco Salvetti from Sapienza University and Sant’Andrea University Hospital in Rome presented on the topic of EBV and MS during the Hot Topic 6 session: Infections - Pathogenesis, Risk, and Prevention.

Salvetti’s talk addressed the historical controversies surrounding the role of Epstein-Barr Virus (EBV) in the development of multiple sclerosis (MS). He highlighted how recent epidemiological studies, particularly the influential research by Professor Alberto Ascherio, have clarified that EBV infection is a prerequisite for MS. This pivotal research, along with other important studies from the groups of Professors Tomas Olsson, Puchhammer-Stockl and Lawrence Steinman, has begun to unravel how EBV might contribute to MS.

One key insight is that the immune system in people with MS may mistakenly attack brain proteins while trying to fight the virus, a phenomenon known as "cross-reactivity" or "molecular mimicry." Salvetti suggested that specific EBV sub-strains linked to MS might impair the immune system's ability to fully mature and specifically target the virus, potentially explaining why this cross-reactivity occurs.

Despite these advances, understanding the full range of EBV’s interactions with the immune system remains complex. Salvetti pointed to two promising research avenues: first, exploring the entire EBV genome to identify genetic variations associated with MS, and second, conducting trials with antiviral drugs that could confirm EBV’s causal role in MS and potentially lead to new treatments or even a cure. These goals are central to the work of the EBV-MS consortium.

Patricia Moghames, Program Coordinator at the European Multiple Sclerosis Platform

At this year’s ECTRIMS 2024, the European Multiple Sclerosis Platform (EMSP) proudly took a leading role in sharing the groundbreaking research behind the EBV-MS project, a pivotal EU-funded initiative exploring the link between EBV and the onset of MS.

At the EMSP booth, attendees could pick up detailed brochures outlining the project’s goals and progress and discuss with the team what the project entails. Additionally, during the Patient Community Day of ECTRIMS , where individuals with MS gathered to hear the latest research updates and hot topics discussed during ECTRIMS. EMSP shared insights with interested individuals at the booth area, especially on how the EBV-MS project could revolutionize the future of MS treatment and prevention.

Participants at both events were eager to engage with the team and learn more about the promising developments in EBV-MS research, highlighting the importance of patient involvement in shaping the future of MS research.

Photo:

Patricia Moghdames

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ill.: EU

This project has received funding from the European Union’s Horizon Europe Research and Innovation Actions under grant no. 101136991 (EBV-MS).