MRZH reaction increases sensitivity for intrathecal IgG synthesis in IgG Oligoclonal band negative Multiple Sclerosis patients

Rafael P C Dias-Carneiro; Felipe von Glehn; Adriel S Moraes; Vinícius O Boldrini; Alfredo Damasceno; Marilia D Andrade; Alliny C D Lima; Cristiane S Casanova; Charles P Tilbery; Benito P Damasceno; Leonilda Mb Dos Santos; Carlos O Brandão

doi:10.1016/j.jneuroim.2016.10.001

MRZH reaction increases sensitivity for intrathecal IgG synthesis in IgG Oligoclonal band negative Multiple Sclerosis patients

J Neuroimmunol. 2016 Nov 15:300:30-35. doi: 10.1016/j.jneuroim.2016.10.001. Epub 2016 Oct 5.

Affiliations

¹ Neuroimmunology Unit, University of Campinas, Campinas, Brazil; CATEM - Multiple Sclerosis Care Center, Santa Casa de São Paulo, São Paulo, Brazil. Electronic address: [email protected].
² Neuroimmunology Unit, University of Campinas, Campinas, Brazil; Department of Neurology, Brigham and Women's Hospital, Ann Romney Center for Neurologic Diseases, Harvard Medical School, Boston, USA. Electronic address: [email protected].
³ Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: [email protected].
⁴ Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: [email protected].
⁵ Department of Neurology, University of Campinas, Campinas, Brazil. Electronic address: [email protected].
⁶ Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: [email protected].
⁷ Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: [email protected].
⁸ Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: [email protected].
⁹ CATEM - Multiple Sclerosis Care Center, Santa Casa de São Paulo, São Paulo, Brazil. Electronic address: [email protected].
¹⁰ Department of Neurology, University of Campinas, Campinas, Brazil. Electronic address: [email protected].
¹¹ Neuroimmunology Unit, University of Campinas, Campinas, Brazil. Electronic address: [email protected].
¹² Neuroimmunology Unit, University of Campinas, Campinas, Brazil; Department of Neurology, University of Campinas, Campinas, Brazil. Electronic address: [email protected].

PMID: 27806873
DOI: 10.1016/j.jneuroim.2016.10.001

Abstract

Given the low detection rates of CSF IgG-Oligoclonal bands (IgG-OCB) in non-European Multiple Sclerosis (MS) patients and higher specificity of the MRZH-reaction, we evaluated whether associating MRZH-reaction to CSF IgG-OCB detection improved investigation of suspected MS. Paired CSF and sera were analyzed for IgG-OCB and polyspecific viral antibodies. IgG-OCB were detected in 72% of MS patients and an MRZH-reaction in 67%. Combining IgG-OCB and MRZH raised detection of IgG abnormalities to 97% of studied MS patients. Detection of IgG-OCB and/or ≥2 MRZH antibodies showed sensitivity of 88% and specificity of 92% for MS, versus 72% and 96% for IgG-OCB alone.

Keywords: Brazil; Cerebrospinal Fluid; Intrathecal synthesis; Multiple Sclerosis; Oligoclonal bands; Polyspecific antibodies.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Antibodies, Viral / cerebrospinal fluid*
Biomarkers / cerebrospinal fluid
Female
Herpesvirus 3, Human / metabolism
Humans
Immunoglobulin G / biosynthesis*
Immunoglobulin G / cerebrospinal fluid*
Male
Measles virus / metabolism
Middle Aged
Multiple Sclerosis / cerebrospinal fluid*
Multiple Sclerosis / diagnosis*
Oligoclonal Bands / cerebrospinal fluid*
Rubella virus / metabolism
Simplexvirus / metabolism
Young Adult

Substances

Antibodies, Viral
Biomarkers
Immunoglobulin G
Oligoclonal Bands