McMillan S A, McDonnell G V, Douglas J P, Hawkins S A
Regional Immunology Laboratory, Royal Group of Hospitals, Belfast, Northern Ireland.
Acta Neurol Scand. 2000 Apr;101(4):239-43. doi: 10.1034/j.1600-0404.2000.101004239.x.
Accumulating evidence indicates significant heterogeneity in MS and soluble (s) adhesion molecules are postulated as markers of disease activity. We sought to evaluate intrathecal production of these and other molecules across the clinical spectrum of MS.
CSF indices of IgG, sICAM-1, sVCAM-1, sE-selectin and sCD30 were calculated in 17 primary progressive (PPMS) patients, 15 secondary progressive patients (SPMS), 28 relapsing-remitting patients in relapse (RRMSR) and 14 RRMS patients in remission (RRMSNR) using commercially available ELISA kits. Patients had not received any immunomodulating therapy within the previous 6 months. MS patients were compared with 44 patients with non-inflammatory neurological diseases (NINDs).
The most sensitive CSF index at a 90% level of specificity was for IgG which had 93% sensitivity in RRMSR and 92% sensitivity in RRMSNR. Corresponding sensitivity in PPMS and SPMS was 71% and 73% respectively. None of the other indices had sensitivity >50% apart from sVCAM-1 (64% in RRMSR and 52% RRMSNR) and sCD30 (53% in PPMS).
Unsurprisingly the strongest association in MS was with the intrathecal production of IgG. Similar results in PPMS and SPMS may reflect comparable rates of progression in these 2 groups. Of the other molecules only intrathecal sVCAM-1 production is significantly associated with MS and only in relapsing-remitting disease.
越来越多的证据表明多发性硬化症（MS）存在显著异质性，可溶性（s）黏附分子被认为是疾病活动的标志物。我们试图评估这些分子以及其他分子在MS临床谱系中的鞘内产生情况。
使用市售酶联免疫吸附测定（ELISA）试剂盒，计算17例原发性进展型（PPMS）患者、15例继发性进展型患者（SPMS）、28例复发缓解型复发期患者（RRMSR）和14例复发缓解型缓解期患者（RRMSNR）脑脊液中IgG、sICAM-1、sVCAM-1、sE-选择素和sCD30的指标。患者在过去6个月内未接受任何免疫调节治疗。将MS患者与44例非炎性神经系统疾病（NINDs）患者进行比较。
在特异性为90%时，最敏感的脑脊液指标是IgG，其在RRMSR中的敏感性为93%，在RRMSNR中的敏感性为92%。PPMS和SPMS中的相应敏感性分别为71%和73%。除sVCAM-1（RRMSR中为64%，RRMSNR中为52%）和sCD30（PPMS中为53%）外，其他指标的敏感性均未超过50%。
不出所料，MS中最强的关联是与IgG的鞘内产生有关。PPMS和SPMS中的相似结果可能反映了这两组中可比的进展率。在其他分子中，只有鞘内sVCAM-1的产生与MS显著相关，且仅在复发缓解型疾病中如此。
