HUMORAL IMMUNE-RESPONSE TO MYCOBACTERIAL HEAT-SHOCK-PROTEIN (HSP)65 IN THE CEREBROSPINAL-FLUID OF NEURO-BEHCET PATIENTS

Although systemic immune reactivity to 65-kD mycobacterial hsp65 (m-hs p65) has been shown previously in Behcet's disease (BD), local immune response was not investigated. Mie studied anti-m-hsp65 IgG, IgM and I gA antibodies in the serum and cerebrospinal fluid (CSF) of 25 ED pati ents with cerebral parenchymal involvement (p-NBD), seven ED patients with intracranial hypertension (ih-NBD), eight BD patients without cen tral nervous system (CNS) involvement, 30 patients with multiple scler osis (MS) and 24 patients with non-inflammatory CNS disorders (NIC). S ignificantly higher CSF IgG responses were detected in p-NBD patients (ELISA ratio 1.3 +/- 0.9) compared with NIC (0.7 +/- 0.4, P < 0.01). I n p-NBD patients' IgG, IgM or IgA CSF anti-m-hsp65 positivity rate was 48% (12/25); this was significantly higher when compared with MS (3/3 0; P < 0.03) and NIC (3/24; P < 0.01). CSF anti-m-hsp65 IgG ratios cor related with the duration of ED (r = 0.4, P < 0.04) but not with the d uration of neurological involvement. Serum IBM and IgA responses were elevated in ih-NBD, suggesting a different type of involvement than p- NBD. These results implicate an increased local humoral response to m- hsp65 in the CSF of p-NBD patients, which might be related to the path ogenesis of neurological involvement.