CSF myelin basic protein in multiple sclerosis
Corresponding Author
A. J. Thomson
Department of Neurology, St. Vincent's and Adelaide Hospitals and
Dr. Alan J. Thomson M.B. M.R.C.P.I. Research Registrar Department of Neurology St. Vincent's Hospital Dublin 4 IrelandSearch for more papers by this authorJ. Brazil
Department of Immunology, St. James's Hospital, Dublin, Ireland
Search for more papers by this authorC. Feighery
Department of Immunology, St. James's Hospital, Dublin, Ireland
Search for more papers by this authorA. Whelan
Department of Neurology, St. Vincent's and Adelaide Hospitals and
Search for more papers by this authorJ. Kellet
Department of Immunology, St. James's Hospital, Dublin, Ireland
Search for more papers by this authorE. A. Martin
Department of Neurology, St. Vincent's and Adelaide Hospitals and
Search for more papers by this authorM. Hutchinson
Department of Neurology, St. Vincent's and Adelaide Hospitals and
Search for more papers by this authorCorresponding Author
A. J. Thomson
Department of Neurology, St. Vincent's and Adelaide Hospitals and
Dr. Alan J. Thomson M.B. M.R.C.P.I. Research Registrar Department of Neurology St. Vincent's Hospital Dublin 4 IrelandSearch for more papers by this authorJ. Brazil
Department of Immunology, St. James's Hospital, Dublin, Ireland
Search for more papers by this authorC. Feighery
Department of Immunology, St. James's Hospital, Dublin, Ireland
Search for more papers by this authorA. Whelan
Department of Neurology, St. Vincent's and Adelaide Hospitals and
Search for more papers by this authorJ. Kellet
Department of Immunology, St. James's Hospital, Dublin, Ireland
Search for more papers by this authorE. A. Martin
Department of Neurology, St. Vincent's and Adelaide Hospitals and
Search for more papers by this authorM. Hutchinson
Department of Neurology, St. Vincent's and Adelaide Hospitals and
Search for more papers by this authorAbstract
Abstract– Cerebrospinal fluid (CSF) from 221 patients with multiple sclerosis (MS) and 85 patients with other neurological disorders (OND) was examined using a competitive radioimmunoassay for myelin basic protein (MBP) immunoreactivity. MBP was found in 46 of 55 MS patients (84%) examined within six weeks of relapse but in only 11 of 85 patients (13%) with OND. There was a significant correlation between the concentration of MBP in the CSF and relapse severity in patients seen within four weeks of the onset of symptoms (p < 0.01). Of 44 patients in remission, MBP was detected in 12, and these patients had a significantly higher tendency to subsequent relapse (p < 0.05). In 72 patients with progressive disease the presence of MBP in the CSF reflected the confidence of clinical diagnosis.
The results of this study suggest that measurement of MBP in the CSF gives an objective method of monitoring disease activity in patient with MS.
References
- 1 Tourtellotte W W, Ma B I. Multiple sclerosis: The blood brain barrier and the measurement of de novo central nervous system IgG synthesis. Neurology 1978: 28: 76–83.
- 2 Stendahl-Brodin L, Link H. Relation between benign course of multiple sclerosis and low grade humoral immune response in cerebrospinal fluid. J Neurol Neurosurg Psychiatry 1980: 43: 102–105.
- 3 Reinherz E L, Weiner H L, Hauser S L, Cohen J A, Distaso J A, Schlossman S F. Loss of suppressor T cells in active multiple sclerosis: analysis with monoclonal antibodies. N Eng J Med 1980: 303: 125–9.
- 4 Sandberg - Wollheim M. Lymphocyte populations in the cerebrospinal fluid and peripheral blood in patients with multiple sclerosis and optic neuritis. Scand J Immunol 1983: 17: 575–81.
- 5 Compston D A S. Lymphocyte subpopulations in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 1983: 46: 105–114.
- 6 Morgan B P, Campbell A K, Compston D A S. Terminal component of complement (C9) in cerebrospinal fluid of patients with multiple sclerosis. Lancet 1984: 2: 251–254.
- 7 Rathke E, Jones M. Serum cerebrosides in multiple sclerosis. J Neurochem 1974: 22: 311–13.
- 8 Michetti F, Massaro A, Russo G et al. The S 100 antigen in cerebrospinal fluid as a possible index of cell injury in the nervous system. J Neurol Sci 1980: 44: 259–263.
- 9 Lowenthal A, Noppe M, Gheuns J et al. Alpha albumin (glial fibrillary acidic protein) in normal and pathological human brain and cerebrospinal fluid. J Neurol 1978: 219: 87–91.
- 10 Cohen S R. Brooks B R, Herndon R M, McKhann G M. A diagnostic index of active demyelination: Myelin basic protein in cerebrospinal fluid. Ann Neurol 1980: 8: 25–31.
- 11 Whitaker J N, Lisak R P, Bashir R M et al. Immunoreactive myelin basic protein in the cerebrospinal fluid in neurological disorders. Ann Neurol 1980: 7: 58–64.
- 12 Biber A, Englert D, Dommasch D, Hempel K. Myelin basic protein in cerebrospinal fluid of patients with multiple sclerosis and other neurological diseases. J Neurol 1981: 225: 231–236.
- 13 Warren K G, Catz I, McPherson T A. Cerebrospinal fluid levels of myelin basic protein in acute optic neuritis and various clinical syndromes of multiple sclerosis. Neurology 1983: 33: (suppl 2): 180.
- 14 Palfreyman J W, Thomas D G T, Ratcliff J G. Radioimmunoassay of human myelin basic protein in tissue extract, cerebrospinal fluid and serum and its clinical application to patients with head injury. Clin Chim Acta 1978: 82: 259–270.
- 15 Palfreyman J W, Johnston R V. Ratcliff J G, Thomas D G T, Forbes C D. Radioimmunoassay of serum myelin basic protein and its application to patients with cerebrovascular accident. Clin Chim Acta 1979: 92: 403–409.
- 16 Herndon R M, Johnson M. A method for the electron microscopic study of CSF. J Neuropathol and Exp Neurol 1970: 29: 320–330.
- 17 McDonald I, Halliday A M. Diagnosis and classification of multiple sclerosis. Br Med Bull 1977: 33: 4–8.
- 18 Millar J H D, Vas C J, Noronha M J, Liversedge S L A, Rawson M D. Long term treatment of multiple sclerosis with corticotrophin. Lancet 1967: 2: 429–431.
- 19
Poser C M,
Paty D W,
Scheinberg L. McDonald I et al.
New diagnostic research criteria for multiple sclerosis: Guidelines for research protocols.
Ann Neurol
1983: 3: 227–231.
10.1002/ana.410130302 Google Scholar
- 20 Deibler G E, Martenson R E, Kies M W. Large scale preparation of myelin basic protein from central nervous tissue of several mammalian species. Prep Biochem 1972: 2: 139–165.
- 21 Alvord E C, Shaw C M, Hruby S, Kies M W. Encephalitogen - induced inhibition of experimental allergic encephalomyelitis: prevention, suppression and therapy. Ann N Y Acad Sci 1965: 122: 333–45.
- 22 Lumsden C E. The neuropathology of multiple sclerosis. In: P J Vinker, G W Bruyn, eds. Handbook of clinical neurology, volume 9 (Multiple sclerosis and other demyelinating diseases). Amsterdam : North-Holland Publishing Co. 1970: 217–309.
- 23 Mackay R P, Hirano A. Forms of benign multiple sclerosis. Arch Neurol 1967: 17: 588–600.
- 24 Phadke J G, Best P V. Atypical and clinically silent multiple sclerosis: a report of 12 cases described unexpectedly at necropsy. J Neurol Neurosurg Psychiatry 1983: 46: 414–420.
- 25 Gilbert J J, Sadler M. Unexpected multiple sclerosis. Arch Neurol 1983: 40: 533–536.
- 26 Young I R, Hall A S, Pallis C A, Bydder G M, Legg N J, Steiner R E. Nuclear magnetic resonance imaging of the brain in multiple sclerosis. Lancet 1981: 2: 1063–1066.
- 27 Jacque C, Delassalle A, Rancurel G, Monique R, Lesourd B, Legrand J C. Myelin Basic Protein in CSF and blood. Relationship between its presence and the occurrence of a destructive process in the brains of encephalitogenic patients. Arch Neurol 1982: 39: 557–560.
- 28 Out J A, Driedyk P C, Baas J. Myelin basic protein-like reactivity in normal serum. Communication: Multiple Sclerosis Research in Europe. CEC Conference, Nijmegen January 1985.