The intrathecal, polyspecific antiviral immune response in neurosarcoidosis, acute disseminated encephalomyelitis and autoimmune encephalitis compared to multiple sclerosis in a tertiary hospital cohort.
The intrathecal, polyspecific antiviral immune response in neurosarcoidosis, acute disseminated encephalomyelitis and autoimmune encephalitis compared to multiple sclerosis in a tertiary hospital cohort.
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DOI：
10.1186/s12987-015-0024-8
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发表时间：
2015-12-13
影响因子：
7.3
通讯作者：
Stich O
中科院分区：
文献类型：
--
作者：
Hottenrott T;Dersch R;Berger B;Rauer S;Eckenweiler M;Huzly D;Stich O
针对嗜神经病毒、麻疹、风疹和水痘带状疱疹病毒的多特异性鞘内体液免疫反应，称为MRZ反应（MRZR），存在于大多数多发性硬化症（MS）患者中。神经结节病（NS）和急性弥散性脑脊髓炎（ADEM）是ms重要的临床鉴别诊断。自身免疫性脑炎（AIE）是一种特征性的自身免疫性中枢神经系统疾病，伴有鞘内抗体合成。本研究首次探讨MRZR对NS、ADEM和AIE患者MS的特异性，并与寡克隆条带（oligoclonal bands， OCB）的诊断价值进行比较。以NS患者22例、AIE患者17例、ADEM患者8例、MS患者33例为对照，计算各病毒的抗体指数（AI），分析各病毒的OCB和MRZR水平。如果至少两个AIs≥1.5，则认为MRZR为阳性。MRZR阳性在NS（9%）、AIE（11%）和ADEM（0%）中出现的频率显著低于MS （70%, p < 0.001）。在研究队列中，MRZR对MS的特异性为92%。与MRZR相比，OCB对MS的敏感性更高（100%），但特异性较低（69%）。这些结果表明，MRZR似乎是MS最特异性的CSF标志物。
A polyspecific, intrathecal humoral immune response against the neurotropic viruses, measles, rubella and varicella zoster virus, called “MRZ reaction” (MRZR), is present in the majority of patients with multiple sclerosis (MS). Neurosarcoidosis (NS) and acute disseminated encephalomyelitis (ADEM) are important clinical differential diagnoses of MS. Autoimmune encephalitis (AIE) represents a well characterized autoimmune CNS disorder with intrathecal antibody synthesis. The aim of this study was to investigate the specificity of MRZR for MS in patients with NS, ADEM and AIE for the first time, and to compare it with the diagnostic value of oligoclonal bands (OCB). Twenty-two patients with NS, 17 with AIE, 8 with ADEM and 33 with MS serving as controls were analyzed for OCB and MRZR by calculation of the antibody index (AI) for each virus. MRZR was considered as positive if at least two AIs were ≥1.5. A positive MRZR was statistically significantly less frequent in NS (9 %), AIE (11 %) and ADEM (0 %) compared to MS patients (70 %; p < 0.001 each). The specificity of MRZR for MS was 92 % in the study cohort. In comparison to MRZR, the OCB showed a higher sensitivity (100 %), but a lower specificity (69 %) for MS. These results indicate that MRZR seems to be the most specific available CSF marker of MS.