![]() The study used 70 consecutive patients with definite MS according to the criteria of Poser and a primary relapsing course. The clinical implications of the immunological findings are discussed. Here we report the results of a follow-up study on 70 MS patients from which at least two CSF analyses including cell count, IgG index, local IgG synthesis, antibody specific index and oligoclonal bands were available. Furthermore, no correlation to the clinical course could be demonstrated. Hence, the findings of these preliminary studies were partially contradictory with regard to the stability of the CSF antibody production. Previous studies attempting to evaluate the long-term evolution of intrathecal viral antibodies were hampered by technical shortcomings such as few sensitive detection methods and an absence of correction for blood-CSF-barrier disturbance. Little is known, however, about the clinical significance of these findings. In up to 96 % of MS patients an intrathecal antibody production against at least one of the three antigens has been found. In contrast, the intrathecal antibody response covers a large number of CNS and non-CNS antigens as well as various pathogens, including the viral antigens such as measles, rubella and varicella zoster. Despite intense investigations, no single antigen against which the antibodies might be directed has been isolated so far. Instead of undergoing apoptosis, the B cells expand clonally within the central nervous system (CNS) giving rise to a persistent antibody production. Intrathecal IgG is thought to be the product of B lymphocytes residing in the brain of MS patients after they have crossed the blood brain barrier in an activated state with the help of various co-stimulatory signals. Although this finding is not specific for MS, 72 % percent of patients present with an elevated IgG index and even 98 % show an oligoclonal distribution of IgG bands exclusively in the CSF. These data stress the importance of activated B cells for the disease process and the clinical outcome in multiple sclerosis.Īn elevated immunoglobulin G (IgG) index and the presence of oligoclonal bands (OCB) in the cerebrospinal fluid (CSF) are a hallmark of multiple sclerosis (MS). Furthermore, an intrathecal measles antibody production was associated with a rapid progression of the disease. In two of seven patients where 5 consecutive CSF samples were available, the intrathecal antibody response expanded from one to three antigens. De novo antibody response against measles virus developed in 7% of the patients between the first and the second spinal tap. Once an intrathecal antibody response was established, it persisted. Results were analysed with regard to clinical characteristics of the patients. CSF cell count, the IgG index, local IgG synthesis, oligoclonal bands and the antibody index for measles, rubella or varicella zoster were calculated. Serum and cerebrospinal fluid sample pairs were obtained from 1 to 5 consecutive lumbar punctures. Here we present a follow-up study of 70 patients with multiple sclerosis over 1 to 106 months. Therefore, we focused in this study on the intrathecal polyspecific antibody response in multiple sclerosis. However, little is known about the evolution of intrathecal antibodies over time and their impact on the disease progress. An intrathecal polyspecific antibody response is a well known finding in multiple sclerosis.
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