An American neurologist and an Italian epidemiologist whose work revolutionized the treatment of multiple sclerosis (MS) on Saturday won a prestigious Breakthrough Prize, nicknamed the “Oscars of science.”
Stephen Hauser and Alberto Ascherio were recognized for their decades researching the debilitating neurodegenerative disease, which affects nearly 3 million people worldwide and was long considered an impenetrable enigma.
Hauser’s work on MS started more than 45 years ago, when he met Andrea, “an extraordinarily talented young woman who was already an attorney” and working at the White House under then-US president Jimmy Carter, he said.
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“Then MS appeared in an explosive fashion and destroyed her life,” he said.
“I remember seeing her, unable to speak, paralyzed on the right side, unable to swallow and soon, unable to breathe on her own, and I remember thinking that this was the most unfair thing I had ever seen in medicine,” he said.
Then 27 years old, he decided to make it his life’s work.
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“At the time, we had no treatments for MS. In fact, there was also a pessimism that treatments could ever be developed,” said Hauser, now 74 and director of the neuroscience institute at the University of California, San Francisco.
Scientists knew the disease, which damages the central nervous system and leads to paralyzing cognitive and motor problems, was caused by the immune system turning on the body.
However, they thought the white blood cells known as T cells were the lone culprit.
Studying the role played in the disease by B cells, another type of white blood cell, Hauser and his colleagues recreated the damage MS causes to the human nervous system in marmosets.
The US federal body overseeing medical research dismissed the link as “biologically implausible,” and turned down their application for funding for a clinical trial, but Hauser and his team pressed on.
They persuaded pharmaceutical company Genentech to back testing.
In 2006, they found that treatments targeting B cells were associated with “a dramatic, more than 90-percent reduction in brain inflammation,” Hauser said.
That threw open a door to bring new treatments to market that slow the advance of the disease in many people.
However, it raised other questions. For example, what would cause white blood cells to turn against the body?
That puzzled Ascherio, now a professor at Harvard University.
He investigated why MS mostly affected people in the northern hemisphere.
“The geographical distribution of MS was quite striking,” he said. “MS is very uncommon in tropical countries and near the equator.”
He and his team carried out a long-term study following millions of young US military recruits.
After nearly 20 years of research, they came up with an answer. In 2022, they confirmed a link between MS and the Epstein-Barr virus (EBV), a common infection responsible for another well-known disease, infectious mononucleosis, or mono.
“Most people infected with EBV will never develop MS,” but everyone who develops MS has had EBV first, Ascherio, 72, said.
The discovery did not explain why MS occurs, but it fueled hope of finding new treatments and preventive measures for a disease that remains incurable.
Ascherio’s breakthrough could also help treat other conditions.
“We are now trying also to extend our investigation, to investigate the role of viral infection in other neurodegenerative diseases, like Alzheimer’s or amyotrophic lateral sclerosis,” also known as ALS or Lou Gehrig’s disease, he said.
The link remains theoretical, but “there is some evidence,” he said.
“It’s like where we were on MS 20 or 30 years ago,” he added.
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