Robinson-Agramonte M, Reiber H, Cabrera-Gomez J A, Galvizu R
Neuroimmunology Department, International Center for Neurological Restoration, Havana City, Cuba.
Acta Neurol Scand. 2007 May;115(5):312-8. doi: 10.1111/j.1600-0404.2006.00755.x.
Intrathecal measles(M)- rubella(R)- and varicella zoster(Z)-antibody synthesis in German and Cuban multiple sclerosis (MS) patients are compared considering the different rubella epidemiology in the tropics.
Twenty-three Cuban MS patients with a representative age distribution and gender ratio like the group of 177 German MS patients were analysed for albumin, IgG, IgA IgM, oligoclonal IgG and MRZ- antibodies in cerebrospinal fluid (CSF) and serum.
Cuban MS patients show similar CSF data patterns like German patients and high frequencies of intrathecal measles- (78/78%) and varicella zoster- (59/55%) antibody synthesis correspondingly. A lower frequency of intrathecal rubella antibody synthesis (rubella-AI >or= 1.5) in Cuban patients (30%, gender ratio of increased rubella - AI m:f = 1:6) compared with German patients (60%, m:f = 1:1.8) is explained by low incidence of rubella infections in Cuba. Only about 10% of the male population (not immunized before 1986, in contrast to females) had rubella antibodies compared to at least 60% in a European male population, representing the relation of increased rubella-AI in male MS patients.
In MS the frequency of intrathecal antibody synthesis is limited by the fraction of seropositives in the population. Natural infection or vaccination are a necessary and equivalent precondition contributing to the arguments against microorganisms as a cause of MS.
考虑到热带地区风疹流行病学的差异，比较德国和古巴多发性硬化症（MS）患者鞘内麻疹（M）-风疹（R）-水痘带状疱疹（Z）抗体的合成情况。
分析23例古巴MS患者的脑脊液（CSF）和血清中的白蛋白、IgG、IgA、IgM、寡克隆IgG和MRZ抗体，这些患者的年龄分布和性别比例具有代表性，与177例德国MS患者群体相似。
古巴MS患者的脑脊液数据模式与德国患者相似，鞘内麻疹抗体（78/78%）和水痘带状疱疹抗体（59/55%）合成频率相应较高。古巴患者鞘内风疹抗体合成频率较低（风疹-抗体指数>或=1.5）（30%，风疹-抗体指数升高的性别比例为男：女=1:6），而德国患者为60%（男：女=1:1.8），这是由于古巴风疹感染发病率较低。与欧洲男性人群中至少60%相比，古巴男性人群中只有约10%（与女性不同，1986年前未接种疫苗）有风疹抗体，这体现了男性MS患者中风疹-抗体指数升高的关系。
在MS中，鞘内抗体合成频率受人群中血清阳性率的限制。自然感染或疫苗接种是一个必要且等效的前提条件，这为反对微生物作为MS病因的观点提供了依据。
