Blood test developed for early detection of MS(multiple sclerosis)

Antibodies against the Epstein-Barr virus indicate risk of multiple sclerosis

Biomarker discovered:

A new blood test can detect the risk of developing multiple sclerosis (MS) years before the first symptoms appear. The test measures the level of antibodies that bind both the body's own structures and the Epstein-Barr virus, which serve as indicators of MS. This could lead to earlier diagnosis and treatment in the future, delaying or preventing the onset of the neurodegenerative disease, as the team reports in "Nature Communications."

Multiple sclerosis is often preceded by an infection with the Epstein-Barr virus (EBV). Antibodies bind to a protein in this virus. © Try Media/GettyImages

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system that affects approximately 2.8 million people worldwide. The immune system mistakenly attacks the body's own structures in the brain and spinal cord: the myelin sheath of the nerve pathways. The result is "naked" neurons, inflammation in the brain, and neurological deficits. Such nerve damage can be detected in MRI scans and in certain proteins in the blood, but only late in the disease's progression. There has been no early detection method available to date.

Various factors can trigger immune system dysfunction in MS, including genes, intestinal bacteria, and clotting factors in the blood. Infection with the Epstein-Barr virus (EBV) is also very common. While almost everyone is infected with this widespread virus at some point in their lives, the virus usually remains unnoticed in the body. Only in some people does it trigger multiple sclerosis, mononucleosis, or other diseases.

Antibodies with a Dual Effect

Early detection of multiple sclerosis may now be possible. Researchers led by Hannes Vietzen from the Medical University of Vienna (MedUni Vienna) have developed a method that detects Epstein-Barr virus infection in patients who later develop MS. To do this, they compared blood samples from 704 people diagnosed with MS and almost 5,400 healthy controls.

The result: In the blood of MS patients, characteristic antibodies that specifically bind to a protein of the Epstein-Barr virus (EBNA-1) are more frequently present. At the same time, such antibodies can also bind to multiple proteins in the human brain, thus destroying neurons. The researchers found such antibodies in the blood of 98 percent of MS patients, but only in 78 percent of control subjects. Furthermore, the levels of these immunoglobulins were significantly elevated in MS patients.

Early detection years before the onset of the disease

This antibody level is therefore suitable as a reliable biomarker for multiple sclerosis, as the team explains. Particularly noteworthy: Such autoantibodies were present in the blood of MS patients between nine months and three years after the virus infection – an average of 5.4 years before clinical symptoms of multiple sclerosis were observed. In some patients, the biomarkers were even detectable up to twelve years before the onset of symptoms.

Accordingly, these antibodies indicate the risk of a later MS diagnosis at an early stage. "Our study shows that a very early phase of MS disease development can be detected immunologically long before the first symptoms appear," says senior author Elisabeth Puchhammer-Stöckl from the Medical University of Vienna.

It was also shown that people with consistently high antibody levels in their blood over three years were more likely to develop MS later on. "Our studies show that individuals in whom these antibodies are detectable at at least two measurement points are highly likely to develop MS in the following years," adds Vietzen. In this group, the disease also progressed more rapidly after the onset.

Earlier detection and treatment of MS

The new biomarker could therefore be used in the future to identify individuals at particularly high risk for MS. One possibility would be to preemptively test the blood of people who developed mononucleosis after an EBV infection. "This would make it possible to examine and treat these individuals early enough to delay or perhaps even prevent the onset of MS," says co-author Paulus Rommer from MedUni Vienna.

The blood test would therefore enable early diagnosis and improve treatment. However, further clinical trials with larger patient numbers are needed before it can be used clinically.

(Nature Communications, 2025; doi: 10.1038/s41467-025-61751-9)

Source: Medical University of Vienna (MedUni Vienna)