Multiple sclerosis, Bambino Gesù Hospital: "Confirmed link with mononucleosis in children"

A study by researchers at Rome's Children's Hospital highlights a specific correlation between infection with the mononucleosis virus and the onset of the chronic inflammatory disease of the nervous system . The virus that triggers infectious mononucleosis— the so-called "kissing disease" —plays a direct role in the onset of multiple sclerosis in children and adolescents. This is confirmed by a study conducted by clinicians and researchers from the Developmental Neurology Unit at the Bambino Gesù Children's Hospital on a sample of 219 young patients.

The results of the study , just published in the scientific journal Journal of Neurology , open new perspectives for the understanding of inflammatory disease of the central nervous system and for future prevention strategies, such as vaccination against Epstein-Barr virus (EBV) infection.

It is a chronic inflammatory disease of the central nervous system in which the immune system mistakenly attacks myelin, the sheath that covers nerve fibers . Although most cases appear in adulthood, approximately 1 in 10 patients is a child or adolescent . The causes of the disease remain partly unknown, but the hypothesis that genetic and environmental factors—including viral infections—may contribute to its onset is increasingly strong. In adults, the association between EBV—the virus responsible for infectious mononucleosis—and multiple sclerosis is well documented. Until now, however, this relationship was less evident in cases with onset before age 18.

The study, conducted by clinicians and researchers from the Developmental Neurology Unit at Bambino Gesù Hospital in collaboration with the Department of Neuroscience at Sapienza University of Rome, lasted two years and involved a total of 219 patients between the ages of 6 and 17 (average age 12), 57 of whom had multiple sclerosis. Using chemiluminescence-based laboratory techniques, blood samples from all participants were analyzed for the presence of EBV-specific antibodies. They found that 100% of the children with multiple sclerosis tested positive for the virus, often contracted asymptomatically. To confirm the specificity of this finding, the researchers compared the data from the multiple sclerosis patients with two control groups consisting of children with non-neurological autoimmune diseases and young patients with primary headache, considered immunologically healthy. In the latter groups, only 59% showed signs of a previous EBV infection. The statistically significant difference strengthened the hypothesis of a direct connection between the two diseases. Toward new prevention and treatment strategies

The data emerging from the Bambino Gesù study therefore indicate a causal and specific link between the Epstein-Barr virus and the development of multiple sclerosis in children, paving the way for new approaches to prevention and treatment.

" While the relationship between EBV infection and the onset of multiple sclerosis in adulthood is accepted by the scientific community, its importance for cases with onset before the age of 18 appeared rather dubious . Our results, however, confirm that it is a fundamental risk factor also in children and adolescents," underlines Gabriele Monte, first author of the study .

"Understanding the causes of multiple sclerosis is essential to developing targeted treatments and effective prevention strategies," adds Massimiliano Valeriani , head of Developmental Neurology at Bambino Gesù Hospital and coordinator of the research . "Our study supports the possibility that a vaccine against the virus that triggers mononucleosis could have a significant impact on reducing the incidence of multiple sclerosis in young people." The Multiple Sclerosis Center at Bambino Gesù Children's Hospital is a national reference point for the diagnosis, treatment, and research of this complex disease in children and adolescents. Young patients and their families are monitored throughout their treatment process, including follow-up in adulthood. Although the onset of the disease is rare before age 10 (1%), 10% of cases occur between the ages of 10 and 18, with unique clinical characteristics that require specific protocols and targeted studies. With approximately 70 patients currently being treated, Bambino Gesù manages the largest pediatric caseload in the country.