IgG antibodies against measles, rubella, and varicella zoster virus predict conversion to multiple sclerosis in clinically isolated syndrome.

IgG antibodies against measles, rubella, and varicella zoster virus predict conversion to multiple sclerosis in clinically isolated syndrome.
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DOI:
10.1371/journal.pone.0007638
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发表时间:
2009-11-05
期刊:
影响因子:
3.7
通讯作者:
Otto M
Otto M
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Brettschneider J;Tumani H;Kiechle U;Muche R;Richards G;Lehmensiek V;Ludolph AC;Otto M

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多发性硬化症(MS)的特征在于对嗜神经性病毒(如麻疹、风疹和水痘带状疱疹)的多特异性B细胞应答,其中在CSF中可测量相应的抗体作为所谓的“MRZ反应”(MRZR)。我们的目的是评估MRZR预测临床孤立综合征(CIS)患者向MS转化的相关性,并将其与寡克隆带(OCB)和MRI进行比较。在一项为期2年的前瞻性研究中确定了MRZR,该研究包括40例随访期间保持CIS的患者(CIS-CIS)和49例使用ELISA发展为MS的患者(CIS-RRMS)。使用逻辑回归,定义了平衡MRZR中包含的抗体指数预测值的评分(MRZS)(9分麻疹,8分风疹,1分水痘带状疱疹,临界点:评分大于10的总和)。与CIS-CIS相比,CIS-RRMS中MRZR和MRZS的发生率显著更高(p = 0.04和p = 0.02)。    MRZS显示了所有研究参数的最佳阳性预测值(PPV)(79%,95%-CI:54-94%),与MRI联合使用可进一步提高PPV(91%,95%-CI:59-99%)。我们的数据表明MRZR的相关性,以预测转换为MS。它还显示了加权的重要性,包括在MRZR不同的抗体指数,并建议阳性MRZR患者的候选人,为早期开始的免疫调节治疗。
Multiple sclerosis (MS) is characterized by a polyspecific B-cell response to neurotropic viruses such as measles, rubella and varicella zoster, with the corresponding antibodies measurable in CSF as the so-called “MRZ reaction” (MRZR). We aimed to evaluate the relevance of MRZR to predict conversion of patients with clinically isolated syndrome (CIS) to MS, and to compare it to oligoclonal bands (OCB) and MRI. MRZR was determined in a prospective study over 2 years including 40 patients that remained CIS over follow-up (CIS-CIS) and 49 patients that developed MS (CIS-RRMS) using ELISA. Using logistic regression, a score (MRZS) balancing the predictive value of the antibody indices included in MRZR was defined (9 points measles, 8 points rubella, 1 point varicella zoster, cutpoint: sum of scores greater 10). MRZR and MRZS were significantly more frequent in CIS-RRMS as compared to CIS-CIS (p = 0.04 and p = 0.02). MRZS showed the best positive predictive value (PPV) of all parameters investigated (79%, 95%-CI: 54–94%), which could be further increased by combination with MRI (91%, 95%-CI: 59–99%). Our data indicate the relevance of MRZR to predict conversion to MS. It furthermore shows the importance of weighting the different antibody indices included in MRZR and suggest that patients with positive MRZR are candidates for an early begin of immunomodulatory therapy.
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