Servicio de Neurología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos IdISSC, Madrid, Spain.
BMC Neurol. 2012 Sep 25;12:107. doi: 10.1186/1471-2377-12-107.
In previous studies we found that MHC2TA +1614 genotype frequency was very different when MS patients with and without human herpesvirus 6 (HHV-6) in serum samples were compared; a different clinical behavior was also described. The purpose of the study was: 1. To evaluate if MHC2TA expression in MS patients was influenced by interferon beta (IFN-beta) treatment. 2. To study MHC2TA expression in MS patients with and without minor allele C. 3. To analyze the relation between MHC2TA mRNA levels and HHV-6 active infection in MS patients.
Blood and serum samples of 154 MS patients were collected in five programmed visits: basal (prior to beginning IFN-beta treatment), six, twelve, eighteen and twenty-four months later. HHV-6 in serum and MHC2TA mRNA levels were evaluated by PCR and RT-PCR, respectively. Neutralizing antibodies (NAbs) against IFN-beta were analyzed by the cytopathic effect assay.
We found that MHC2TA mRNA levels were significantly lower among MS patients with HHV-6 active infection at the basal visit (without treatment) than in those MS patients without HHV-6 active infection at the basal visit (p = 0.012); in all the positive samples we only found variant A. Furthermore, 58/99 (58.6%) MS patients without HHV-6 along the five programmed visits and an increase of MHC2TA expression after two-years of IFN-beta treatment were clinical responders vs. 5/21 (23.8%) among those MS patients with HHV-6 and a decrease of MHC2TA mRNA levels along the two-years with IFN-beta treatment (p = 0.004); no differences were found between patients with and without NAbs.
MHC2TA mRNA levels could be decreased by the active replication of HHV-6; the absence of HHV-6 in serum and the increase of MHC2TA expression could be further studied as markers of good clinical response to IFN-beta treatment.
在之前的研究中,我们发现比较有和没有人类疱疹病毒 6(HHV-6)血清样本的 MS 患者时,MHC2TA+1614 基因型频率差异非常大;也描述了不同的临床行为。本研究的目的是:1. 评估 MS 患者的 MHC2TA 表达是否受干扰素 β(IFN-β)治疗的影响。2. 研究 MS 患者中存在和不存在次要等位基因 C 时 MHC2TA 的表达。3. 分析 MS 患者 MHC2TA mRNA 水平与 HHV-6 活跃感染之间的关系。
在五个预定访问中收集了 154 名 MS 患者的血液和血清样本:基础(开始 IFN-β 治疗前)、六、十二、十八和二十四个月后。通过 PCR 和 RT-PCR 分别评估血清中的 HHV-6 和 MHC2TA mRNA 水平。通过细胞病变效应测定分析针对 IFN-β 的中和抗体(NAb)。
我们发现,在基础(无治疗)时,存在 HHV-6 活跃感染的 MS 患者的 MHC2TA mRNA 水平明显低于不存在 HHV-6 活跃感染的 MS 患者(p=0.012);在所有阳性样本中,我们只发现了变异 A。此外,在五个预定访问中,99 名没有 HHV-6 的 MS 患者中有 58 名(58.6%)和 21 名有 HHV-6 的 MS 患者中有 5 名(23.8%)在 IFN-β 治疗两年后表现出 MHC2TA 表达增加,是临床反应者(p=0.004);在 IFN-β 治疗两年期间,没有发现 MHC2TA mRNA 水平降低的患者与有 NAb 的患者之间存在差异。
HHV-6 的活跃复制可能会降低 MHC2TA mRNA 水平;血清中不存在 HHV-6 和 MHC2TA 表达增加可以进一步作为 IFN-β 治疗良好临床反应的标志物进行研究。