Abstract
BackgroundB cells and humoral immune responses play an important role in the pathogenesis and diagnosis of multiple sclerosis (MS). A characteristic finding in patients with MS is a polyspecific intrathecal B cell response against neurotropic viruses, specifically against measles virus, rubella virus, and varicella zoster virus, also known as an MRZ reaction (MRZR). Here, we correlated from the routine clinical diagnostics individual IgG antibody indices (AIs) of MRZR with magnetic resonance imaging (MRI) findings in patients with first MS diagnosis.Methods/ResultsMRZR was determined in 68 patients with a clinically isolated syndrome (CIS) or early relapsing-remitting MS (RRMS). Absolute AI values for measles virus, rubella virus, and varicella zoster virus were correlated with T2 lesion load and gadolinium enhancing lesions on cerebral MRI (cMRI) and cMRI combined with spinal MRI (sMRI). Measles virus AI correlated significantly with T2 lesion load on cMRI (p = 0.0312, Mann-Whitney U test) and the sum of lesions on cMRI and sMRI (p = 0.0413). Varicella zoster virus AI also showed a correlation with T2 lesion load on cMRI but did not reach statistical significance (p = 0.2893).ConclusionThe results confirm MRZR as part of the polyspecific immune reaction in MS with possible prognostic impact on MRI and clinical parameters.Furthermore, the data indicate that intrathecal measles virus IgG production correlates with disease activity on cMRI and sMRI in patients with early MS.
Highlights
Great effort has done into defining prognostic markers in multiple sclerosis (MS) over recent years
The data indicate that intrathecal measles virus IgG production correlates with disease activity on cerebral MRI (cMRI) and spinal MRI (sMRI) in patients with early MS
To correlate antibody indices (AIs) levels with T2 lesion load on cMRT, the patients were divided into two groups: those with,6 lesions and those with $6 lesions
Summary
Great effort has done into defining prognostic markers in multiple sclerosis (MS) over recent years. Detection of oligoclonal bands in CSF and at least two positive AI against measles virus, rubella virus and varicella zoster virus of $1.5 (MRZR), are important markers in the diagnosis of MS. In 80–100% of patients with MS, a polyspecific intrathecal B cell response in the form of a positive MRZR is detectable in CSF and is accepted as being highly specific for this disease [3,4]. Other studies have shown a correlation between disease activity and both intrathecal IgM synthesis and an elevated B cell monocyte ratio, which emphasizes the importance of humoral response in MS [5,6,7]. A characteristic finding in patients with MS is a polyspecific intrathecal B cell response against neurotropic viruses, against measles virus, rubella virus, and varicella zoster virus, known as an MRZ reaction (MRZR). We correlated from the routine clinical diagnostics individual IgG antibody indices (AIs) of MRZR with magnetic resonance imaging (MRI) findings in patients with first MS diagnosis
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