MYELIN BASIC-PROTEIN IN CSF AS INDICATOR OF DISEASE-ACTIVITY IN MULTIPLE-SCLEROSIS

There is on evident need for a quantitative laboratory marker for asce rtaining disease activity and treatment effects in multiple sclerosis (MS) patients. Activity of the disease process in MS is accompanied by myelin breakdown and appearance of myelin basic protein (MBP) in cere brospinal fluid (CSF). In this paper MBP in CSF of relapsing-remitting (RR) MS patients is reviewed. MBP in CSF is a fragment containing an epitope corresponding to aminoacid residues 45-89 of the native molecu le. From several relevant studies about CSF MBP in RR MS the following relations can be concluded: CSF MBP levels in active MS patients ore frequently increased (45 - 100%), remain increased until 5 to 6 week; after onset symptoms and ore higher in polysymptomotic exacerbations a nd correlate with number of gadolinium-enhanced (Gd) lesions on MRI, s everity of relapses, EDSS score and CSF intrathecal IgM synthesis. Aft er an intravenous methylprednisolone treatment the increased CSF MBP l evels return to normal values and reduction in CSF MBP is related to r eduction in EDSS score, number of Gd lesions and CSF intrathecal IgM s ynthesis.