Innovative Blood Test Detects Multiple Sclerosis Risk Years Before Symptoms Manifest

Researchers at the Medical University of Vienna have developed a groundbreaking blood test capable of predicting the risk of developing multiple sclerosis (MS) long before clinical symptoms appear. This advancement could enable early intervention, potentially delaying or preventing disease onset. The study, recently published in Nature Communications, was led by Elisabeth Puchhammer-Stöckl and Hannes Vietzen from the Center for Virology, alongside Thomas Berger and Paulus Rommer from the Department of Neurology.

The new diagnostic approach centers on an immunological assay that detects specific antibodies targeting a protein from the Epstein-Barr virus (EBV), which is strongly associated with MS development. Nearly all MS cases have shown evidence of EBV infection, making it a key factor in the disease's pathology. The test specifically measures autoantibodies against EBNA-1, a component of EBV, which can cross-react with structures in the human brain. These autoantibodies appear within three years after EBV infection and are present even before symptoms begin.

By monitoring antibody levels over time, scientists found that individuals with consistently high levels of these antibodies are at a significantly increased risk of developing MS. The research involved analyzing blood samples from over 700 MS patients and more than 5,000 controls, some of whom could be traced back to the initial EBV infection. The findings indicated that high antibody levels correlate with rapid disease onset.

Multiple sclerosis is a chronic neuroinflammatory disorder affecting about 2.8 million people globally. It results from immune system attacks on the central nervous system, often triggered by EBV infection. Most individuals acquire EBV, usually asymptomatically or with infectious mononucleosis, but in some cases, the immune response misfires, leading to MS.

This new antibody test allows for immunological prediction of MS development years before any neurological symptoms, surpassing other markers like neurofilament light chain (NfL) or glial fibrillary acidic protein (GFAP), which only increase later in the disease process. Lead researcher Puchhammer-Stöckl emphasized that this could facilitate early diagnosis and treatment, potentially delaying or preventing the disease.

The team suggests that screening populations at higher risk—such as those with prior infectious mononucleosis—could be an effective approach. However, further research is necessary before implementing this as a routine clinical tool. Overall, the test represents a significant step towards proactive management of multiple sclerosis, focusing on early detection based on immune activity instead of waiting for symptoms to appear.

For more information, refer to the original study by Hannes Vietzen et al. in Nature Communications: [DOI: 10.1038/s41467-025-61751-9].