Abstract
The role of autoreactive antibodies in multiple sclerosis (MS) has received intense attention since the discovery of oligoclonal immunoglobulin (Ig) bands in the majority of patients with MS.1 However, many questions remain. We still do not know whether the intrathecal production of Ig is an epiphenomenon of CNS autoimmunity, resulting from growth factor–driven expansion of long-lived B cells in the meningeal compartment or whether Ig production from antigen-driven proliferation of B-cell clones contributes to CNS immunopathology.2 CSF Ig from oligoclonal bands is produced by CSF B lineage cells3 and primarily recognizes epitopes of multiple neurotropic viruses and Epstein-Barr virus antigens.4,5 However, antimyelin antibodies also occur in the serum and CSF of patients with MS.6 In this issue of Neurology ®, Quintana et al.7 describe an array platform that can be used to detect serum and CSF antibodies directed against a large number of linear epitopes of CNS antigens, including not only peptides derived from myelin and astrocytic proteins but also heat shock proteins or even lipid constituents. The intrathecally produced (polyspecific) IgG class response was heterogeneous in individual patients with MS, and steroid treatment was associated with decreased intrathecal autoantibody reactivity. The authors concluded that the antigen array technology is a …
Published Version
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