Warren K G, Catz I
Ann Neurol. 1986 Jul;20(1):20-5. doi: 10.1002/ana.410200105.
Prevalence and titer of total, free, and bound cerebrospinal fluid anti-myelin basic protein (MBP) antibodies as well as free/bound ratios were determined in four groups of patients with multiple sclerosis (MS) and three groups of controls. All patients with clinically active MS have elevated levels of total anti-MBP, which may be present in either free or bound form. Patients whose disease is in remission have undetectable anti-MBP levels, and some patients with clinically stable disease with residual disability may have detectable antibody titers. Chronically progressive MS is usually associated with high levels of antibody in the bound rather than the free form, resulting in a low or normal free/bound ratio. In contrast, MS exacerbations are characterized by relatively high levels of free anti-MBP in the cerebrospinal fluid, resulting in a high free/bound antibody ratio. Bound anti-MBP was also detected in elevated levels in 1 patient with subacute sclerosing panencephalitis and 2 of 8 patients with postinfectious encephalomyelitis. Although elevated levels of cerebrospinal fluid anti-MBP are not specific for MS, they are strongly associated with disease activity and may be involved in the pathogenesis of demyelination in patients with MS.
在四组多发性硬化症（MS）患者和三组对照组中，测定了脑脊液中总抗髓鞘碱性蛋白（MBP）抗体、游离抗髓鞘碱性蛋白抗体和结合抗髓鞘碱性蛋白抗体的患病率及滴度，以及游离/结合比率。所有临床活动期的MS患者总抗MBP水平均升高，其可能以游离或结合形式存在。疾病缓解期的患者抗MBP水平检测不到，一些临床病情稳定但有残留残疾的患者可能有可检测到的抗体滴度。慢性进行性MS通常与高水平的结合形式而非游离形式的抗体相关，导致游离/结合比率较低或正常。相比之下，MS病情加重的特征是脑脊液中游离抗MBP水平相对较高，导致游离/结合抗体比率较高。在1例亚急性硬化性全脑炎患者和8例感染后脑脊髓炎患者中的2例中也检测到结合抗MBP水平升高。虽然脑脊液抗MBP水平升高并非MS所特有，但它们与疾病活动密切相关，可能参与了MS患者脱髓鞘的发病机制。
