Bednárová J, Stourac P, Adam P
Department of Clinical Microbiology, Faculty Hospital, Masaryk University, Brno, Czech Republic.
Acta Neurol Scand. 2005 Aug;112(2):97-102. doi: 10.1111/j.1600-0404.2005.00418.x.
The aims were to investigate the frequency of intrathecal synthesis of specific antibodies against measles (M), rubella (R) and varicella zoster (Z) viruses (MRZ reaction) as a diagnostic marker between multiple sclerosis (MS) and neuroborreliosis (NB) groups and to postulate the most typical cerebrospinal fluid (CSF) variables profile of these entities.
Three cohorts of patients were investigated: MS (n = 42), NB (n = 27) and other neurological diseases (OND) (n = 15). Measles, rubella, varicella zoster and borrelia-specific IgG antibodies were measured by ELISA, Q(alb) (CSF/serum albumin ratio) as a marker of blood-CSF barrier function and specific antibody indices (AI) were calculated according to relevant formulae. IgG oligoclonal bands (OB) were detected by isoelectric focusing and immunoenzymatic staining.
Eighty-eight percent of MS patients had positive MRZ reaction and 26.2% had positive anti-borrelia AI. Eighty-nine percent of NB patients had positive anti-borrelia AI and two patients had individually anti-measles and rubella positive AI. MS-CSF variables profile included the presence of IgG OB in 81%, elevated Q(alb) in 31% and normal cell count in 66.7%. Of NB patients IgG OB were positive in 74%, elevated Q(alb) in 81.5% and normal cell count in 7.4%.
MRZ reaction was proved as statistically significant marker in differential diagnosis between MS and NB. Typical CSF variables profile of these two entities is highly supportive, especially when MRZ is included.
旨在研究针对麻疹（M）、风疹（R）和水痘带状疱疹（Z）病毒的鞘内特异性抗体合成频率（MRZ反应），以此作为多发性硬化症（MS）和神经莱姆病（NB）组之间的诊断标志物，并推测这些疾病最典型的脑脊液（CSF）变量特征。
对三组患者进行了研究：MS组（n = 42）、NB组（n = 27）和其他神经系统疾病（OND）组（n = 15）。通过酶联免疫吸附测定法（ELISA）检测麻疹、风疹、水痘带状疱疹和疏螺旋体特异性IgG抗体，将脑脊液/血清白蛋白比值Q(alb)作为血脑脊液屏障功能的标志物，并根据相关公式计算特异性抗体指数（AI）。通过等电聚焦和免疫酶染色检测IgG寡克隆带（OB）。
88%的MS患者MRZ反应呈阳性，26.2%的患者抗疏螺旋体AI呈阳性。89%的NB患者抗疏螺旋体AI呈阳性，两名患者分别出现抗麻疹和风疹AI阳性。MS患者脑脊液变量特征包括81%存在IgG OB，31%的患者Q(alb)升高，66.7%的患者细胞计数正常。NB患者中，74%的患者IgG OB呈阳性，81.5%的患者Q(alb)升高，7.4%的患者细胞计数正常。
MRZ反应被证明是MS和NB鉴别诊断中有统计学意义的标志物。这两种疾病典型的脑脊液变量特征具有高度支持性，尤其是在纳入MRZ反应时。
