title: Intrathecal synthesis of IgM measured after a first demyelinating event suggestive of multiple sclerosis is associated with subsequent MRI brain lesion accrual.
abstract: BACKGROUND
  Previous studies have demonstrated that intrathecal synthesis of IgM is observed in multiple sclerosis (MS) and correlates with a worse disease course. These results suggest that IgM participates in the formation of MS lesions.
  
  
  OBJECTIVE
  The aim of the present study was to assess the potential association between the level of intrathecal synthesis of IgM measured after a clinically isolated syndrome (CIS) and the subsequent formation of brain lesions.
  
  
  METHODS
  Fifty seven patients with a CIS and a high risk developing MS were enrolled in a longitudinal study. Examination of cerebrospinal fluid was performed after the CIS and included measures of intrathecal IgM and IgG synthesis. Patients were assessed with the same 1.5 Tesla magnetic resonance imaging (MRI) system at baseline and after a mean follow-up period of 49 months (range 36-60). Spearman Rank correlation was used to assess the potential correlations between levels of intrathecal immunoglobulin synthesis and MRI data.
  
  
  RESULTS
  The level of intrathecal IgM synthesis was correlated with the number of gadolinium-enhancing lesions at baseline (p = 0.01) and with accrual of brain lesions during the follow-up period (p = 0.02). By taking into account brain sub-regions, we demonstrated that the level of intrathecal IgM synthesis was only correlated with the increased number of lesions in the periventricular regions (p = 0.004). The level of intrathecal IgG synthesis was not correlated with any MRI data.
  
  
  CONCLUSIONS
  The present longitudinal study demonstrates that the level of intrathecal IgM synthesis measured after a CIS is associated with subsequent lesion accrual during the first years of MS. This result emphasizes the involvement of IgM in plaque formation.
authors.affiliation: Pôle de Neurosciences cliniques, Service de Neurologie, Assistance publique Hôpitaux de Marseille, Marseille, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Durante
authors.forename: Wafaa
authors.initials: W
authors.lastname: Zaaraoui
authors.forename: Audrey
authors.initials: A
authors.lastname: Rico
authors.forename: Lydie
authors.initials: L
authors.lastname: Crespy
authors.forename: Delphine
authors.initials: D
authors.lastname: Wybrecht
authors.forename: Anthony
authors.initials: A
authors.lastname: Faivre
authors.forename: Françoise
authors.initials: F
authors.lastname: Reuter
authors.forename: Irina
authors.initials: I
authors.lastname: Malikova
authors.forename: Gilbert
authors.initials: G
authors.lastname: Pommier
authors.forename: Sylviane
authors.initials: S
authors.lastname: Confort-Gouny
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Cozzone
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Ranjeva
authors.forename: Jean
authors.initials: J
authors.lastname: Pelletier
authors.forename: Jose
authors.initials: J
authors.lastname: Boucraut
authors.forename: Bertrand
authors.initials: B
authors.lastname: Audoin
mesh_terms: D000328:Adult; D001921:Brain / Q000276:immunology* / Q000473:pathology; D003287:Contrast Media; D003711:Demyelinating Diseases / Q000134:cerebrospinal fluid / Q000276:immunology* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005602:France; D006801:Humans; D007075:Immunoglobulin M / Q000096:biosynthesis* / Q000134:cerebrospinal fluid; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000276:immunology* / Q000473:pathology; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007075:Immunoglobulin M