Myelin basic protein intramolecular spreading without disease progression in a patient with multiple sclerosis

A case with stable multiple sclerosis (MS) and T cell responses which initi ally focused on peptide 16-38 of myelin basic protein (MBP) allowed us to i nvestigate the dynamics of the MBP-specific T cell repertoire and its relat ionship with disease progression. Epitope mapping experiments and T cell re ceptor usage of MBP-reactive T cell lines (obtained at four distinct time p oints over a 7-year period) showed a spreading of the response. Transient e xpansions and persistence of T cells recognizing different MBP epitopes wer e also detected. The patient's expanded disability status scale and magneti c resonance imaging lesion load remained stable. Our case shows both persis tent self-recognitions and determinant spreading in stable MS. This finding suggests that the relationship between dynamics of self-recognition and di sease progression is highly complex. (C) 2000 Elsevier Science B.V. All rig hts reserved.