Myelin Basic Protein In Patients Research Articles

Optic neuritis and multiple sclerosis. An immunological study.

On examination in the first weeks after onset of the disease, an antibody-dependent lymphocyte cytotoxicity (ADLC) against myelin basic protein (MBP) was demonstrated in 32 (71%) of 46 patients with ON/only and in 8 of 10 patients with ON/MS. The findings were positive in 21 out of 22 CSF samples. The intensities of the cytotoxicity in the serum and in the cerebrospinal fluid were largely in agreement. No correlation was found between the cytotoxicity in the CSF and the IgG content. The ADLC against MBP is highly specific for MS. Only 5% of 200 patients with other neurological complaints had positive findings. Active disease phases in MS are positive in 94% of the cases according to earlier investigations. A positive ADLC against MBP in patients with ON/only is in all probability at first sign of MS.

Radioimmunoassay of human myelin basic protein in tissue extract, cerebrospinal fluid and serum and its clinical application to patients with head injury

The development of a double antibody radioimmunoassay for myelin basic protein in tissue extract, cerebrospinal fluid and unextracted serum is described. Detection limits for the assays were: for tissue extract 3.1 ng, for cerebrospinal fluid 30 ng/ml and for serum 13.6 ng/ml. Specificity for myelin basic protein is suggested by lack of cross reactivity by tissues other than brain and presence of immunoactivity in cerebrospinal fluid and serum only in samples from patients with brain damage due to intracranial surgery or head injury. Immunoactivity in brain extracts and serum from patients with severe brain damage was indistinguishable from authentic myelin basic protein on serial dilution. Cross reacting material in cerebrospinal fluid samples differed from the authentic protein on serial dilution and on Sephadex G-100 chromatography, and may represent breakdown products of myelin basic protein. Mean serum concentrations of myelin basic protein in patients one day after head injury were significantly higher than in control patients with or without other neurological disease. Highest serum myelin basic protein concentrations were found in patients with severe primary intracerebral damage, with peak levels occurring 2–3 days after head injury. In patients with extracerebral haematoma, without intracerebral damage, the peak serum myelin basic protein concentrations occurred 7–10 days after injury. It is suggested that the measurement of serum myelin basic protein concentrations may be valuable in the management of patients after head injury.

Retrobulbar neuritis. In vitro evidence of sensitization to myelin basic protein in patients without multiple sclerosis.

Thirty-six normal subjects and 34 patients with retrobulbar neuritis were studied with use of the technique of macrophage migration inhibition factor assay and myelin basic protein as antigen. Serial studies were carried out when possible. Normal subjects gave a mean migration index of 100.9+/-9. Eleven patients with retrobulbar neuritis alone gave a mean migration index of 55+/-16 in the first 3 weeks of illness, 89+/-17.3 during the fourth to the twenty-fourth weeks, and 100.9+/-9.0 after the twenty-fourth week. Ten multiple sclerosis patients with retrobulbar neuritis gave values of 61+/-21 in the first 3 weeks of an attack and 92+/-22.8 during the fourth to the twenty-fourth weeks, and 12 other multiple sclerosis patients 24 weeks or longer after an attack gave a value of 101.9+/-12.6. In a mean follow-up period of 1.9 years, only two patients presenting with retrobulbar neuritis alone have had a diagnosis of multiple sclerosis established; three others have weakness and reflex change in one limb only; and four have minor psychiatric problems. One retrobulbar neuritis patient has a family history of multiple sclerosis, but has no neurologic abnormalities. Comparison of these studies in both groups shows no statistical differences and supports the concept that cell-mediated hypersensitization to central nervous system myelin basic protein, however initiated, is a factor in the pathogenesis of retrobulbar neuritis.