By Dr. Forest Tennant, PNN Columnist

More than one medical professional and a lot of persons with adhesive arachnoiditis (AA) have asked why we have been studying the Epstein Barr Virus (EBV) and its relationship to AA.  After all, almost everyone over age 25 will show EBV antibodies on a blood test. 

Our on-going studies of persons with AA continue to show that essentially all have elevated EBV antibody levels. In addition, AA almost always follows a cascade of conditions known to be associated with autoimmunity. These include fibromyalgia, chronic fatigue syndrome, neuropathies, burning feet or mouth, irritable bowel, Tarlov cyst, thyroiditis, spinal fluid leaks and deteriorated bulging discs. This cascade also appears common in persons with Ehlers-Danlos type syndromes.

Two recent comprehensive reviews on EBV support the findings in our studies. One is “Epstein Barr Virus and Neurological Diseases” by Nan Zhang, et al, and the other is “Epstein Barr Virus (EBV) Reactivation and Therapeutic Inhibitors” by Jonathan Kerr.

Both reports state that EBV infection occurs in 95% or more of people, as the human lymphocyte is its natural, lifelong habitat. Lymphocytes are white blood cells that help our immune systems fight cancer, viruses and bacteria. EBV infections are spread by saliva or other body secretions, and the initial infection usually occurs before age 25, causing a cold, sinusitis, bronchitis or infectious mononucleosis.

Once the initial infection subsides, the virus imbeds itself in lymphocytes and remain there for life. As a result, virtually all humans carry low levels of EBV antibodies. Adults with AA don’t always show a positive test for the initial EBV infection, but they do show high levels of antibodies -- meaning they carry EBV in their lymphocytes that can multiply, reproduce and reactivate at any time.

Kerr reviewed research on medicinal agents that may inhibit this reactivation, which most likely occurs during periods of stress. Our standard 3-component medical protocol contains some of the agents that Kerr believes may be effective in suppressing reactivation. These agents include acyclovir, cimetidine, vitamins A, C, and D, resveratrol, luteolin, apigenin, curcumin, astragalus, L-arginine, delta-9-tetrahydrocannabinol, and green tea.

EBV-infected lymphocytes can cross the blood brain barrier to produce neuroinflammation and tissue deterioration. EBV produces antibodies that contain biologic elements that can produce on-going autoimmune and neurological diseases. The Zhang report states that high levels of EBV antibodies “can be biologic markers that assess the risk of developing” neurologic diseases.

On-going EBV autoimmunity is indicated by high antibody levels. Reactivation of EBV may accelerate inflammation and tissue deterioration. Our longstanding 3-component medical protocol seems to help suppress both the on-going autoimmunity and the reactivation of EBV.

EBV remains harmless and dormant unless our natural resistance becomes deficient, either due to a genetic disease such as Ehlers-Danlos Syndrome or a stressful event that lowers cortisol and raises adrenalin, such as trauma, infection and psychological issues. Medical procedures such as epidural injections, spinal taps, and surgery are stressful and may also reactivate EBV. All persons with AA should determine their EBV autoimmune status.

Forest Tennant, MD, DrPH, is retired from clinical practice but continues his research on the treatment of intractable pain and arachnoiditis. This column is adapted from bulletins recently issued by the Tennant Foundations’s Arachnoiditis Research and Education Project. Readers interested in subscribing to the bulletins should click here.

The Tennant Foundation gives financial support to Pain News Network and sponsors PNN’s Patient Resources section.