T cells trained to attack Epstein Barr virus may be an effective treatment against multiple sclerosis.
The results of a small clinical trial suggest that an experimental therapy may be effective in treating patients with progressive multiple sclerosis (MS). The promising findings were presented at the American Academy of Neurology’s 69th Annual Meeting.
Although the goal of the phase 1 study was to determine if the novel treatment was safe for patients with MS, the authors observed an improvement in symptoms for 3 of the 6 patients.
"While these results are very preliminary and much more research is needed, we are excited there were no serious side effects," said study author Michael Pender, MD, PhD.
The study explored the link between MS and Epstein-Barr virus (EBV). The virus is a common herpes virus that generally does not elicit symptoms, but when it is contracted as a teenager or adult, it can result in mononucleosis. Previous research has suggested an association between MS and EBV.
MS is characterized by an immune attack against nerves in the central nervous system. In a healthy immune response, T cells and B cells protect the body against pathogens, but in MS, the immune response may be altered. Immune cells may be unable to control EBV-infected B cells, which aggregate in the brain and create antibodies that destroy myelin, according to the study.
The authors hypothesized that eliminating EBV-infected B cells may reduce neurologic dysfunction and symptoms in patients with MS by reducing myelin damage.
Included in the study were 6 patients with progressive MS who had moderate-to-severe disability. Patients with progressive disease experience a slow worsening of symptoms.
The investigators started by removing patients’ T cells and then boosted their ability to recognize and destroy EBV-infected cells. Every 2 weeks, patients received infusions with increasing doses of T cells for a period of 6 weeks. Patients were followed for 26 weeks to determine side effects and symptom improvement.
The authors noted that 1 of the participants experienced symptom improvement, with 2 reporting improvement only 8 weeks after the first infusion, according to the study.
"One person with secondary progressive MS showed striking improvement," Dr Pender said. "This participant had a significant increase in ambulation from 100 yards with a walker at the start of the study, and over the previous 5 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."
The authors said that another patient with primary progressive MS reported improved color vision and visual acuity.
All patients who experienced symptom improvement reported lessened fatigue and increased ability to complete day-to-day activities, according to the study.
"The best responses were seen in the 2 people who received T cells with the highest amount of reactivity to the Epstein-Barr virus," Dr Pender said.
Overall, no patients experienced any serious side effects, suggesting T cells targeting EBV may be an effective treatment approach, according to the study.
"Of course, much more research needs to be done with larger numbers of participants to confirm and further evaluate these findings," Dr Pender said. "But the results add to the mounting evidence for a role of the Epstein-Barr virus infection in MS and set the stage for further clinical trials."