Kg. Warren et al., ANTIMYELIN BASIC-PROTEIN AND ANTI-PROTEOLIPID PROTEIN-SPECIFIC FORMS OF MULTIPLE-SCLEROSIS, Annals of neurology, 35(3), 1994, pp. 280-289
Human myelin basic protein (hMBP) and proteolipid protein (PLP) were u
sed as antigens in a solid-phase radioimmunoassay to determine relativ
e frequencies of anti-MBP and anti-PLP in cerebrospinal fluid (CSF) of
optic neuritis and multiple sclerosis (MS) patients. Forty-nine of 55
patients with optic neuritis had increased CSF anti-MBP and the remai
ning 6 had increased anti-PLP. Of 385 MS patients, MS relapse: 173 of
180 patients had increased anti-MBP, 5 of the remaining 7 patients had
elevated anti-PLP, and 2 had neither of these autoantibodies. Progres
sive MS: 111 of 116 patients had increased anti-MBP in either free and
/or bound form, of the remaining 5 patients 4 had increased anti-PLP,
and 1 had neither anti-MBP nor anti-PLP. MS remission: 15 of 87 patien
ts had somewhat increased anti-MBP, none had anti-PLP. IgG was purifie
d by affinity chromatography from necropsy central nervous system (CNS
) tissue samples of 4 individual patients with clinically definite and
neuropathologically confirmed MS. Three of these 4 patients who had i
ncreased levels of CSF anti-MBP also had increased anti-MBP titers in
CNS tissue-extracted IgG: The fourth patient who had anti-PLP in CSF a
lso had anti-PLP in brain tissue IgG. These autoantibodies were not de
tected simultaneously in any patient. These results suggest that there
are at least two immunologically distinct forms of MS, i.e., a common
form highly associated with anti-MBP and more frequent prominent infl
ammatory characteristics in CSF and CNS, and an infrequent form associ
ated with anti-PLP in CSF and tissue, and less abundant inflammation.
Anti-MBP purified from CNS tissue IgG by antigen-specific affinity chr
omatography was reacted with synthetic peptides of hMBP. The anti-MBP
epitope on the hMBP molecule was restricted between residues 75 and 10
6. The PLP epitope for anti-PLP has not as yet been determined. These
observations have theoretical implications for anticipated future spec
ific immunotherapy of MS.