The MRZ reaction in primary progressive multiple sclerosis.
The MRZ reaction in primary progressive multiple sclerosis.
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DOI：
10.1186/s12987-016-0049-7
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发表时间：
2017-02-07
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;Huzly D;Stich O
由麻疹、风疹和水痘带状疱疹病毒的三个抗体指数(AI)组成的MRZ反应(MRZR)在大多数复发-缓解型多发性硬化症(RRMS)患者中呈阳性，而在其他炎症性神经疾病(OIND)中则不存在。到目前为止，还不确定它的鉴别诊断前景是否延伸到原发-进行性多发性硬化症(PPMS)患者。[目的]探讨妊娠期高血压综合征(PPMS)患者中MRZR的患病率，并与RRMS和OIND患者进行比较。对PPMS患者(n=103)、RRMS患者(n=100)和OIND患者(n=48)进行MRZR检查。MRZR检测采用MRZR-1(≥1 AI阳性)和MRZR-2(≥2 AI阳性)两种严格等级。MRZR-1阳性率在PPMS组为83.5%，RRMS组为67.8%(P<0.05)。MRZR-2阳性率在PPMS组为54.4%，RRMS组为43.0%，差异无统计学意义(P>0.05)。与MS两个亚组相比，强迫症患者MRZR阳性率较低(MRZR-1：22.9%，MRZR-2：8.3%；P<0.0001)。MRZR阳性在PPMS和RRMS中的出现频率至少与RRMS相同，而在OIND中的出现频率要低得多，这证实了它作为区分MS和OIND两种病程类型的潜在有用的诊断工具的前景。
The MRZ reaction (MRZR), composed of the three antibody indices (AI) against measles, rubella and varicella zoster virus and found positive in the majority of relapsing-remitting multiple sclerosis (RRMS) patients, is absent in other inflammatory neurological diseases (OIND). So far, it has been uncertain whether its differential diagnostic promise extends to patients with primary-progressive multiple sclerosis (PPMS). To investigate the prevalence of MRZR in PPMS compared to RRMS and OIND patients. MRZR was assessed in patients with PPMS (n = 103), RRMS (n = 100) and OIND (n = 48). Both stringency levels for MRZR testing, MRZR-1 (≥1 AI positive) and MRZR-2 (≥2 AI positive), were applied. Prevalence of positive MRZR-1 was 83.5% in PPMS and 67.8% in RRMS (p < 0.05). A positive MRZR-2 was found in 54.4% of PPMS and in 43.0% of RRMS patients (not significant). Compared to both MS subgroups, OIND patients exhibit lower frequencies of positive MRZR (MRZR-1: 22.9%, MRZR-2: 8.3%; p < 0.0001 each). Positive MRZR was at least as frequent in PPMS as in RRMS and much less frequent in OIND, confirming its promise as a potentially useful diagnostic tool for distinguishing both MS course types from OIND.