Last year the Epstein-Barr virus (EBV) made news in a couple of ways that could aid researchers in determining the root cause of interstitial cystitis in some patients. EBV is one of the most common human viruses and is found globally.(1) It most often causes infectious mononucleosis, which you might know better as mono or even “the kissing disease.”

While it might sound odd to think that a virus known for symptoms such as a sore throat, fever, fatigue, swollen lymph nodes, rash, enlarged spleen and swollen liver could be connected to the bladder, research is showing it’s possible.

How Epstein-Barr works

The way EBV works in the human body is quite interesting. It takes over the immune system and invades B cells, which are the very cells that produce antibodies to fight off infections.(2) But the invasion doesn’t end when you start feeling better. EBV is a virus that stays inactive in your body for the rest of your life once you’ve contracted it – similar to chicken pox.

Some researchers think EBV colludes with B cells and changes the ways that our human genome works. So if we have a genetic predisposition to certain diseases, EBV might activate the previously dormant genes.(2)

Another factor with EBV is how our bodies fight it off by using T-cells, which are part of the body’s immune response. Other researchers believe that defective T-cells might be the root of many autoimmune diseases.(3) Whether that’s true or not, one thing is known. The T-cells that help fight off viruses like EBV are highest when we are young and significantly decrease as we age.(3) Infants have the highest level of these cells. From age 2 to 16, the number of cells drops by 2/3! So, an infant infected with EBV is likely to have very few symptoms if any, while a teenager infected with the same virus would be more symptomatic. And adults infected with it would show even greater symptoms.(3)

Who is impacted?

Nearly everyone will have had EBV by the time they are an adult, because it is so prevalent and easy to transmit. EBV spreads through bodily fluids, especially saliva.(1) When someone is first infected with EBV, he or she can spread it for weeks before symptoms even begin. And if EBV should reactivate later, you can also spread the virus yet again.(1)

The emphasis on cleanliness in the United States and other developed countries is actually pushing exposure to EPV back farther, which means that because our bodies have less defenses for it, we are being impacted by it greater than ever before.(3) By comparison, in developed countries, less than half of children had been exposed to EPV by the age of 10. In developing countries, most children have been exposed to EBV by age 3 and all of them have been exposed by age 10.(3)

The bottom line is, whether you’ve ever been diagnosed with mono, chances are astronomically good that you’ve had an encounter with EPV and have the virus lying dormant in your body.

How does it connect to IC?

Because of the virus’ longevity and suspicion by researchers about the role it plays in autoimmune and other diseases, researchers in Taiwan took a look at EPV and IC. They presented their findings at the American Urological Association’s annual meeting last year. What they found was a whopping 87.5 percent of IC patients with Hunner’s lesions had an active EPV infection.(4) Overall, 46.2 percent of the IC patients studied had evidence of EBV infection in the bladder. They found that patients with EBV infection had more pain and less bladder capacity than their counterparts without the infection.(4) Their conclusion was that EPV infection in T-cells may be linked to chronic inflammation in IC patients.(4)

Those researchers weren’t alone. The other big EPV finding last year came out of the Cincinnati Children’s Hospital. Researchers there found a connection between EBV and seven serious diseases.(2) While IC was not on the list of diseases, one of its common comorbid conditions was: irritable bowel syndrome. Other conditions were lupus, multiple sclerosis, rheumatoid arthritis, juvenile arthritis, celiac disease and type 1 diabetes.(2) The study found that EBV binds to locations along the human genome that are associated with the seven diseases studied as well as 94 other conditions.(2) The researchers narrowed their focus in on the seven in particular but also released their software in hopes that other researchers will do their own work to examine other conditions with the goal being to develop therapies to stop EBV from interacting with the human genome.(2)

What does this mean for IC patients?

Right now, it doesn’t mean a whole lot. Though, if you suspect you might have an active EPV infection, see your doctor. He or she can do blood work to check for an infection and talk about what might work to treat it.

Otherwise, it means we are a bit closer to determining the root cause of at least some patients’ IC. And figuring out any sort of etiology of IC is a step in the direction of figuring out more effective treatments. At the very least, it sure is interesting that one virus is looking like it has such a tremendous impact on the body!

 

References:

  1. Centers for Disease Control and Prevention. Epstein-Barr Virus and Infections Mononucleosis. May 8, 2018.
  2. Cincinnati Children’s Hospital Medical Center. Epstein-Barr Virus Linked to Seven Serious Diseases. Medical Xpress. April 16, 2018.
  3. Johnson C. Could the Epstein-Barr Virus – Autoimmunity Hypothesis Help Explain Chronic Fatigue Syndrome? Simmaron Research. May 3, 2014.
  4. Jhang JF, et. al. Epstein-Barr Virus as a Potential Etiology of Persistent Bladder Inflammation in Human Interstitial Cystits/Bladder Pain Syndrome. J Urol Sept. 2019, Vol. 200, No. 3.