Intrathecal, polyspecific antiviral immune response in oligoclonal band negative multiple sclerosis.
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, polyspecific antiviral immune response as a potential diagnostic CSF marker for OCB-negative MS patients.


RESULTS
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.


CONCLUSIONS
Determination of the intrathecal, polyspecific antiviral 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.
Department of Neurology, University of Würzburg, Würzburg, Germany.
Isabel
I
Brecht
Benedikt
B
Weissbrich
Julia
J
Braun
Klaus Viktor
KV
Toyka
Andreas
A
Weishaupt
Mathias
M
Buttmann
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000134:cerebrospinal fluid*; D016022:Case-Control Studies; D005260:Female; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D056724:Immunity, Humoral; D008297:Male; D008459:Measles virus / Q000276:immunology; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000134:cerebrospinal fluid* / Q000276:immunology / Q000821:virology; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid*; D012412:Rubella virus / Q000276:immunology; D055815:Young Adult
D000914:Antibodies, Viral; D043025:Oligoclonal Bands