Anti-myelin basic protein and anti-proteolipid protein antibody-secreting cells in the cerebrospinal fluid of patients with acute optic neuritis
F. T. Sellebjerg, J. L. Frederiksen and T. Olsson
Department of Neurology, Golstrup Hospital, University of Copenhagen, Denmark.
OBJECTIVE: To study the intrathecal synthesis of anti-myelin basic protein
(MBP) and anti-proteolipid protein (PLP) antibodies in patients in the
early stages of multiple sclerosis. DESIGN AND SETTING: A study of
consecutive patients with acute optic neuritis (ON) who were undergoing
lumbar punctures in an ambulatory unit. PATIENTS: Eleven patients with
acute idiopathic ON and 14 patients with acute ON as a symptom of definite
multiple sclerosis (the diagnosis of which was supported by clinical or
laboratory findings). Nineteen patients with other neurological diseases
(10 with inflammatory diseases) served as controls. MAIN OUTCOME MEASURES:
Numbers of anti-MBP and anti-PLP antibody-secreting cells in peripheral
blood and cerebrospinal fluid samples that were enumerated with an
immunospot assay. RESULTS: Cerebrospinal fluid cells that secreted anti-MBP
or anti-PLP antibodies were detected in 10 of 15 and in 21 of 23 patients
with acute ON, while they were detected in nine of 18 and in six of 18
patients with other neurological diseases, respectively. Patients with ON
had significantly more anti-PLP-secreting cells than did patients with
other neurological diseases (P < .01). No difference was observed for
anti-MBP-secreting cells. A significant correlation between the time from
onset and the number of anti-PLP-secreting cells was found in patients with
idiopathic ON (P < .02). CONCLUSIONS: These data suggest that anti-PLP
antibodies are a more specific finding in demyelinating disease than
anti-MBP antibodies. Furthermore, they suggest that anti-PLP antibodies may
arise as a consequence of the demyelinating process.
