Higher IgG index found in African Americans versus Caucasians with multiple sclerosis
Higher IgG index found in African Americans versus Caucasians with multiple sclerosis
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DOI：
10.1212/01.wnl.0000265057.79843.d9
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发表时间：
2007-07-03
期刊：
影响因子：
9.9
通讯作者：
Cross, Anne H.
中科院分区：
文献类型：
--
作者：
Rinker, John R., II;Trinkaus, Kathryn;Cross, Anne H.
背景：非裔美国人（AAs）与白人美国人（CAs）相比，多发性硬化症（MS）的残疾程度更高。MS的种族间免疫学差异及其与疾病相关残疾的关系尚未被描述。目的：比较AA和CA与MS之间CSF体液免疫的措施。方法：采用病例对照设计，在华盛顿大学MS中心进行CSF免疫研究的所有AA MS患者与随机选择的CA与MS进行了比较。比较各组免疫球蛋白G（IgG）指数和合成率、寡克隆带阳性率、白色细胞计数和CSF蛋白。进行生存分析以比较门诊援助的时间。结果：确定了66例AA病例和132例CA对照。AA组的CSF体液活性指标均较高。AA的平均IgG指数为1.35（SD 0.62），CA的平均IgG指数为1.05（SD 0.55），平均差异为0.30（rho = 0.001）。AA中的中位IgG合成率也较高（13.55 vs 8.20 mg/天），中位差异为5.35 mg/天（rho = 0.010）。生存分析证实了以前的报告，早期门诊援助的需要AA。尽管体液免疫反应和时间的差异，以门诊援助，考克斯比例风险模型没有显示IgG指数作为预测早期门诊assistance.Conclusions：CSF体液免疫反应是更积极的非裔美国人（AAs）比高加索美国人（CA）与多发性硬化症。AAs也比CA更早地进展到门诊辅助，但高免疫球蛋白G指数并不能预测更早地进展到残疾终点。
Background: African Americans (AAs) experience greater disability from multiple sclerosis (MS) compared with Caucasian Americans (CAs). Interethnic immunologic differences in MS and their relationship to disease-related disability have not been described.Objective: To compare measures of CSF humoral immunity between AAs and CAs with MS.Methods: Using a case - control design, all AA MS patients with CSF immune studies at the Washington University MS center were compared with randomly selected CAs with MS. Two CA controls were selected for every AA case. Immunoglobulin G ( IgG) index and synthesis rates, oligoclonal band positivity, white blood cell count, and CSF protein were compared between groups. Survival analysis was conducted to compare times to ambulatory assistance.Results: Sixty-six AA cases and 132 CA controls were identified. Measures of CSF humoral activity were all higher in the AA group. The mean IgG index of AAs was 1.35 (SD 0.62), and that of CAs was 1.05 (SD 0.55), for a mean difference of 0.30 (rho = 0.001). The median IgG synthesis rate was also higher among AAs (13.55 vs 8.20 mg/day), for a median difference of 5.35 mg/day (rho = 0.010). Survival analysis confirmed previous reports of earlier ambulatory assistance requirement among AAs. Despite differences in both humoral immune response and times to ambulatory assistance, Cox proportional hazards modeling did not show IgG index as predictive of earlier ambulatory assistance.Conclusions: The CSF humoral immune response is more active among African Americans (AAs) than among Caucasian Americans (CAs) with multiple sclerosis. AAs also progress to ambulatory assistance earlier than CAs, but high immunoglobulin G index does not predict earlier progression to the disability endpoint.