Clinician-researcher awarded $2 million grant to study how Epstein-Barr virus (EBV) increases multiple sclerosis risk

The number of Australians living with multiple sclerosis (MS) is increasing significantly. 

The latest data showed that more than 33,000 Australians lived with MS in 2021. That’s a growth of 30% over the four years since 2017.  

So, what exactly is MS?  

It’s a potentially disabling brain and spinal cord disease. According to MS Australia, Epstein-Barr virus (EBV) is suspected of causing MS, but the evidence so far is inconclusive. 

This is where neurologist and MS specialist Dr Nevin John’s work comes in.  

“Recent research has demonstrated that the Epstein-Barr virus is associated with a 32-fold increase in the risk of developing MS, making it the strongest risk factor. However, we do not understand the mechanisms through which EBV increases the risk of MS,” he says. 

Dr John, who is also the Head of MS Services, says the $2 million grant from the Medical Research Future Fund (MRFF) will be used to conduct a significant 5-year Australia-wide study to improve our understanding of the mechanisms through which EBV causes autoimmunity, ultimately leading to MS. 

Dr John says the team uses multimodal data incorporating genetic information, blood, and immune profiles to predict future conversion of MS following an EBV infection.  

This ambitious study comes with its own challenges that Dr John and his team will work to overcome. 

“I think the challenges are the same for any research project, especially one of this scale. It is the efficient and timely collaboration between many institutions driving towards a common goal.  

“We also need to navigate the fact that this is Australia-wide, and logistics such as moving blood samples for analysis becomes a key consideration,” he says. 

Epstein-Barr Virus 

It’s one of the most common human viruses and is a member of the herpes virus family. Most people get infected with EBV at some point in their lives. EBV spreads most commonly through bodily fluids, primarily saliva. It can also cause infectious mononucleosis, also called mono, and other illnesses. 

Dr John says there are several risk factors for MS, including EBV, smoking, low vitamin D, high body mass index and genetic risk. Of those, EBV is the strongest risk factor by some margin. 

“Over 90% of the population has EBV but only a small proportion of those develop MS. We need to better understand these additional factors and pathogenic mechanisms that link EBV to MS,” he says. 

Dr John says the research aims to also develop an Artificial Intelligence-based tool that can predict the future development of MS. This project will also create an open-source biobank that can be used to answer future research questions in the area.  

“Ultimately, we hope that our mechanistic understandings linking EBV and autoimmunity will lead to the generation of a new pipeline of therapeutic options,” he says. 

Dr Nevin John: Profile of a clinician-researcher 

Born and raised in Melbourne, Dr John completed his medical degree at Adelaide University before returning to Melbourne to commence his physician training at Royal Melbourne Hospital and Monash Health.  

His first role at Monash Health was as a neurology registrar in 2014. He left but later returned in 2021 as a consultant neurologist MS specialist and took over as the Head of MS in 2022.  

His interest in specialising and researching multiple sclerosis grew when he was at Austin Hospital, covering a role and working in the MS clinic there.  

“I developed a passion for neuroinflammatory central nervous system disorders and felt that it was an expanding area with an array of treatment options for people with MS.  

“I then completed a fellowship and PhD at University College London and truly enjoyed clinical research – particularly being at the forefront of bringing new MS therapies to people with MS, data analysis, and constantly learning and developing new skills,” he says. 

He credits his PhD supervisor at University College London (UCL), Prof Jeremy Chataway, as his initial mentor. He was supportive and encouraging and provided opportunities to be involved in clinical trials and magnetic resonance imaging research in the UK. They continue to collaborate on multiple projects between Monash Health and UCL. 

At Monash Health, Head of Neuroscience Research neurologist Prof Thanh Phan has been instrumental in providing a guiding hand and support for all research aspects and navigating the Australian research sphere. 

“I aspire to continue to combine clinical work and research to help people with MS. Our long-term aim is to continue to bring Monash Health to the forefront of MS research to help shape and improve care for Australians with MS,” he says. 

 

Approved by: Angus Henderson, General Manager, Research Strategy 



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