Neuroradiology Unit, Department of Neurosciences and Rehabilitation, Azienda Ospedaliera-Universitaria, Arcispedale S. Anna, Ferrara, Italy.
J Neurovirol. 2009 Sep;15(5-6):425-33. doi: 10.3109/13550280903475580.
The purpose of this study was to verify the actual involvement of Chlamydia pneumoniae in multiple sclerosis (MS) by the evaluation of its specific intrathecal humoral immune response in MS. We measured by enzyme-linked immunosorbent assay (ELISA) technique cerebrospinal fluid (CSF) and serum levels of anti-C. pneumoniae immunoglobulin G (IgG) in 27 relapsing-remitting (RR), 9 secondary progressive (SP), and 5 primary progressive (PP) MS patients, grouped according to clinical and magnetic resonance imaging (MRI) evidence of disease activity. Twenty-one patients with other inflammatory neurological disorders (OIND) and 21 with noninflammatory neurological disorders (NIND) were used as controls. Quantitative intrathecal synthesis of anti-C. pneumoniae IgG was determined by antibody-specific index (ASI), whereas the presence of C. pneumoniae-specific CSF oligoclonal IgG bands was assessed by antigen-specific immunoblotting. ASI values indicative of C. pneumoniae-specific intrathecal IgG synthesis were present in a small proportion of MS (29.3%), OIND (33.3%), and NIND (4.8%) patients and were significantly more frequent (P < .05) in total MS and in OIND than in NIND and in SP (P < .01) and PP MS (P < .05) than in RR MS. C. pneumoniae-specific CSF-restricted OCB were detected only in three SP, one PP, and one RR MS patients. These findings suggest that an intrathecal production of anti-C. pneumoniae IgG is part of humoral polyreactivity driven by MS chronic brain inflammation. However, an intrathecal release of C. pneumoniae-specific oligoclonal IgG can occur in a subset of patients with MS progressive forms in whom a C. pneumoniae-persistent brain infection may play a pathogenetic role.
本研究旨在通过评估肺炎衣原体（C. pneumoniae）在多发性硬化症（MS）中的特异性鞘内体液免疫反应，来验证其在多发性硬化症中的实际参与。我们通过酶联免疫吸附试验（ELISA）技术检测了 27 例复发缓解型（RR）、9 例继发进展型（SP）和 5 例原发进展型（PP）MS 患者的脑脊液（CSF）和血清中抗 C. pneumoniae 免疫球蛋白 G（IgG）水平，并根据疾病活动的临床和磁共振成像（MRI）证据对其进行分组。21 例其他炎症性神经疾病（OIND）和 21 例非炎症性神经疾病（NIND）患者作为对照。通过抗体特异性指数（ASI）来确定抗 C. pneumoniae IgG 的定量鞘内合成，而通过抗原特异性免疫印迹来评估 C. pneumoniae 特异性 CSF 寡克隆 IgG 带的存在。提示存在 C. pneumoniae 特异性鞘内 IgG 合成的 ASI 值在一小部分 MS（29.3%）、OIND（33.3%）和 NIND（4.8%）患者中存在，且在总 MS 和 OIND 中明显更常见（P <.05）比 NIND 和 SP（P <.01）和 PP MS（P <.05）更常见。仅在 3 例 SP、1 例 PP 和 1 例 RR MS 患者中检测到 C. pneumoniae 特异性 CSF 受限的 OCB。这些发现表明，抗 C. pneumoniae IgG 的鞘内产生是 MS 慢性脑炎症驱动的体液多反应性的一部分。然而，C. pneumoniae 特异性寡克隆 IgG 的鞘内释放可能发生在 MS 进行性形式的患者亚组中，其中 C. pneumoniae 持续脑感染可能发挥致病作用。
