Rauer S, Euler B, Reindl M, Berger Th
Department of Neurology, University Hospital Freiburg, Freiburg, Germany.
J Neurol Neurosurg Psychiatry. 2006 Jun;77(6):739-42. doi: 10.1136/jnnp.2005.077784.
To investigate whether the presence of serum antibodies against myelin oligodendrocyte glycoprotein (MOG) and myelin basic protein (MBP) in patients with a clinically isolated syndrome (CIS) predicts the interval to develop more frequently and earlier a first relapse (clinically definite multiple sclerosis: CDMS) than seronegative patients.
Sera from 45 patients with a CIS and positive intrathecal IgG-synthesis were retrospectively tested for the presence of IgM antibodies against both MOG and MBP. Antibodies were detected by immunoblot using recombinant MOG (1-125) and human MBP antigen preparations. Clinical follow ups were performed retrospectively by telephone interviews and documented neurological examination.
Using the Cox proportional hazards model there was no significant increased risk for developing CDMS in anti-MOG and anti-MBP positive patients compared with negative. However regarding the median of the time span between CIS and CDMS over the whole follow up, antibody positive patients (MOG/MBP +/+) developed significantly earlier relapses (median 5.5 months (range 3-20)) than the antibody negative ones (median 25.0 months (range 7-43); p<0.006). On testing sera from 56 apparently healthy students, quite high frequencies of anti-MOG and anti-MBP antibodies (21% and 28% respectively) were detected. This limited specificity of anti-MOG and anti-MBP antibodies has been seen earlier and restricts their diagnostic relevance in MS despite their role as a predictor of relapses after a CIS.
This study confirms previous data only in a subanalysis indicating that patients with positive anti-MOG/MBP antibodies develop earlier relapses than patients who are antibody negative. However, the authors could not verify that the presence of these antibodies anticipates the overall risk of developing CDMS-according to study criteria-after a first demyelinating event within the study period of 21-106 months (mean 60 (SD 25)).
研究临床孤立综合征（CIS）患者血清中抗髓鞘少突胶质细胞糖蛋白（MOG）和髓鞘碱性蛋白（MBP）抗体的存在是否比血清阴性患者更频繁、更早地预测首次复发（临床确诊多发性硬化症：CDMS）的间隔时间。
回顾性检测45例CIS且鞘内IgG合成阳性患者血清中抗MOG和抗MBP的IgM抗体。使用重组MOG（1 - 125）和人MBP抗原制剂通过免疫印迹法检测抗体。通过电话访谈和记录的神经学检查进行回顾性临床随访。
使用Cox比例风险模型，与阴性患者相比，抗MOG和抗MBP阳性患者发生CDMS的风险没有显著增加。然而，关于整个随访期间CIS和CDMS之间的时间跨度中位数，抗体阳性患者（MOG/MBP +/+）复发明显更早（中位数5.5个月（范围3 - 20）），而抗体阴性患者为（中位数25.0个月（范围7 - 43）；p<0.006）。在检测56名明显健康的学生血清时，检测到相当高频率的抗MOG和抗MBP抗体（分别为21%和28%）。抗MOG和抗MBP抗体的这种有限特异性先前已被观察到，尽管它们在CIS后作为复发的预测指标，但限制了它们在MS中的诊断相关性。
本研究仅在一项亚分析中证实了先前的数据，表明抗MOG/MBP抗体阳性的患者比抗体阴性的患者复发更早。然而，作者无法证实这些抗体的存在能预测在21 - 106个月（平均60（标准差25））的研究期内首次脱髓鞘事件后根据研究标准发生CDMS的总体风险。
