BACKGROUND:Oligoclonal
bands (OCB) are detected in the cerebrospinal fluid (CSF) in more than
95% of patients with multiple sclerosis (MS) in the Western hemisphere.
Here we evaluated the intrathecal, poly-specific anti-viral immune
response as a potential diagnostic CSF marker for OCB-negative MS
patients.
METHODOLOGY/PRINCIPAL
FINDINGS: We tested 46 OCB-negative German patients with paraclinically
well defined, definite MS. Sixteen OCB-negative patients with a clear
diagnosis of other autoimmune CNS disorders and 37 neurological patients
without evidence for autoimmune CNS inflammation served as control
groups. Antibodies against measles, rubella, varicella zoster and herpes
simplex virus in paired serum and CSF samples were determined by ELISA,
and virus-specific immunoglobulin G antibody indices were calculated.
An intrathecal antibody synthesis against at least one neurotropic virus
was detected in 8 of 26 (31%) patients with relapsing-remitting MS, 8
of 12 (67%) with secondary progressive MS and 5 of 8 (63%) with primary
progressive MS, in 3 of 16 (19%) CNS autoimmune and 3 of 37 (8%)
non-autoimmune control patients. Antibody synthesis against two or more
viruses was found in 11 of 46 (24%) MS patients but in neither of the
two control groups. On average, MS patients with a positive antiviral
immune response were older and had a longer disease duration than those
without.
CONCLUSION:Determination
of the intrathecal, polyspecific anti-viral immune response may allow
to establish a CSF-supported diagnosis of MS in OCB-negative patients
when two or more of the four virus antibody indices are elevated.
This
study looks at CSF from MSers without oligoclonalbands and asks if they
look for anti-viral activity in the CSF, whether this could have
diagnositic features. Whilst MSers with longer disease duration had a
higher frequency of this response. This study shows that it can not be
used diagnositcally as the sensitivity of this as an assay is too low.
Labels: CSF