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首页> 外文期刊>Journal of Neuroimmunology: Official Bulletin of the Research Committee on Neuroimmunology of the World Federation of Neurology >High levels of cerebrospinal fluid IgM binding to myelin basic protein are associated with early benign course in multiple sclerosis.
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High levels of cerebrospinal fluid IgM binding to myelin basic protein are associated with early benign course in multiple sclerosis.

机译：高水平的脑脊髓液IgM与髓鞘碱性蛋白结合与多发性硬化症的早期良性病程有关。

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We assessed human myelin basic protein (MBP) binding IgM levels in CSF. MBP is the most studied putative antigen in multiple sclerosis (MS) and immune responses against it may be involved in the demyelination process. We also correlated these levels with EDSS score and other parameters of disease progression and prognosis, both at the time of CSF analysis and during follow-up. CSF IgM anti-MBP levels were assayed by measuring total IgM levels with solid-phase ELISA in CSF samples from 66 patients with relapsing-remitting MS, 11 subjects without neurological diseases, 20 patients with non-inflammatory neurological diseases and 7 patients with lymphocytic meningitis, before and after immunoabsorption with human MBP. Confirmation of IgM binding specificity was performed by immunoblotting of positive CSF samples onto MBP coated-nitrocellulose sheets. Clinical evaluation (disability score, number and time of attacks) was performed during a mean follow-up of 2.7 +/- 1.1 years. 23 of the 66 relapsing-remitting MS patients (33.8%) had elevated IgM anti-MBP levels. In this patient subgroup, IgM anti-MBP levels correlated with the IgM index (r = 0.71; P = 0.0001), but not with CSF/serum albumin (r = 0.08; P = 0.72). In the first year of follow-up, patients with low IgM anti-MBP suffered from more numerous attacks than those with elevated levels (0.86 +/- 0.63 versus 0.43 +/- 0.58; P = 0.017). Patients with high IgM binding to MBP had a first attack during follow-up in a significantly higher time than those with low binding (28.87 +/- 4.7 versus 17 +/- 2.6 months, respectively; P = 0.005) and reached a decrease of 0.5 EDSS point significantly faster than those with low IgM (16.17 +/- 1.2 versus 29.7 +/- 2.6 months, respectively; P = 0.0002). A similar significant finding was observed when the time to reach low disability score (EDSS < or = 2.0) was analyzed (10.7 +/- 2.57 +/- 3.3 months, respectively; P = 0.014). These findings demonstrate that in a subgroup of MS patients, elevated CSF levels of IgM anti-MBP are associated with early favorable course and therefore suggest that IgM binding to MBP could be a possible prognostic marker in relapsing-remitting MS to select early MS patients for future trials.
机译：我们评估了人脑髓鞘碱性蛋白（MBP）结合CSF中的IgM水平。 MBP是多发性硬化症（MS）中研究最多的推定抗原，针对它的免疫反应可能参与脱髓鞘过程。我们还将这些水平与EDSS评分以及疾病进展和预后的其他参数相关联，无论是在进行CSF分析时还是在随访期间。通过固相ELISA法测定66例复发型MS患者，11例无神经系统疾病的患者，20例非炎性神经系统疾病的患者和7例淋巴细胞性脑膜炎的患者的CSF样品中的总IgM水平，通过固相ELISA测定CSF IgM抗MBP水平，在用人MBP进行免疫吸收之前和之后。 IgM结合特异性的确认是通过将阳性CSF样品免疫印迹到MBP包被的硝酸纤维素片上进行的。在2.7 +/- 1.1年的平均随访期间进行了临床评估（残疾评分，发作次数和时间）。 66名复发缓解型MS患者中，有23名（33.8％）的IgM抗MBP水平升高。在该患者亚组中，IgM抗MBP水平与IgM指数相关（r = 0.71; P = 0.0001），但与CSF /血清白蛋白无关（r = 0.08; P = 0.72）。在随访的第一年，低IgM抗MBP的患者遭受的攻击要多于水平较高的患者（0.86 +/- 0.63对0.43 +/- 0.58; P = 0.017）。 IgM高结合MBP的患者在随访期间首次发作的时间显着高于低结合（分别为28.87 +/- 4.7对17 +/- 2.6个月; P = 0.005），并且降低了0.5 EDSS点显着高于低IgM的点（分别为16.17 +/- 1.2与29.7 +/- 2.6个月; P = 0.0002）。当分析达到低残疾评分（EDSS <或= 2.0）的时间（分别为10.7 +/- 2.57 +/- 3.3个月; P = 0.014）时，观察到了类似的重要发现。这些发现表明，在MS患者的亚组中，脑脊液中IgM抗MBP的升高与早期有利病程有关，因此表明IgM与MBP的结合可能是复发缓解型MS选择早期MS患者的可能的预后标志物。未来的审判。

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