The MRZ reaction in primary progressive multiple sclerosis.
BACKGROUND
The MRZ reaction (MRZR), composed of the three antibody indices (AI) against measles, rubella and varicella zoster virus and found positive in the majority of relapsing-remitting multiple sclerosis (RRMS) patients, is absent in other inflammatory neurological diseases (OIND). So far, it has been uncertain whether its differential diagnostic promise extends to patients with primary-progressive multiple sclerosis (PPMS).


OBJECTIVE
To investigate the prevalence of MRZR in PPMS compared to RRMS and OIND patients.


METHODS
MRZR was assessed in patients with PPMS (n = 103), RRMS (n = 100) and OIND (n = 48). Both stringency levels for MRZR testing, MRZR-1 (≥1 AI positive) and MRZR-2 (≥2 AI positive), were applied.


RESULTS
Prevalence of positive MRZR-1 was 83.5% in PPMS and 67.8% in RRMS (p < 0.05). A positive MRZR-2 was found in 54.4% of PPMS and in 43.0% of RRMS patients (not significant). Compared to both MS subgroups, OIND patients exhibit lower frequencies of positive MRZR (MRZR-1: 22.9%, MRZR-2: 8.3%; p < 0.0001 each).


CONCLUSIONS
Positive MRZR was at least as frequent in PPMS as in RRMS and much less frequent in OIND, confirming its promise as a potentially useful diagnostic tool for distinguishing both MS course types from OIND.
Department of Neurology and Neurophysiology, University Medical Center Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany. tilman.hottenrott@uniklinik-freiburg.de.
Tilman
T
Hottenrott
Department of Neurology and Neurophysiology, University Medical Center Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
Rick
R
Dersch
Department of Neurology and Neurophysiology, University Medical Center Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
Benjamin
B
Berger
Department of Neurology and Neurophysiology, University Medical Center Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.|Ravo Diagnostika GmbH, Oltmannsstrasse 5, 79100, Freiburg, Germany.
Sebastian
S
Rauer
University Medical Center Freiburg, Institute of Virology, Hermann-Herder-Strasse 11, 79104, Freiburg, Germany.
Daniela
D
Huzly
Department of Neurology and Neurophysiology, University Medical Center Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
Oliver
O
Stich
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D014645:Herpesvirus 3, Human / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid* / Q000276:immunology; D008297:Male; D008459:Measles virus / Q000276:immunology* / Q000378:metabolism; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000134:cerebrospinal fluid / Q000276:immunology / Q000821:virology; D012189:Retrospective Studies; D012412:Rubella virus / Q000276:immunology* / Q000378:metabolism; D014764:Viral Proteins / Q000276:immunology*; D055815:Young Adult
D007074:Immunoglobulin G; D014764:Viral Proteins
Intrathecal polyspecific antiviral immune response; MRZ reaction; MRZR; OCB; Oligoclonal bands; PPMS; Primary progressive multiple sclerosis