Álvarez-Cermeño José C, Muñoz-Negrete Francisco J, Costa-Frossard Lucienne, Sainz de la Maza Susana, Villar Luisa M, Rebolleda Gema
Department of Neurology, Multiple Sclerosis Unit, Ramón y Cajal University Hospital, IRYCIS, University of Alcalá de Henares, Madrid, Spain.
Department of Ophthalmology, Multiple Sclerosis Unit, Ramón y Cajal University Hospital, IRYCIS, University of Alcalá de Henares, Madrid, Spain.
J Neurol Sci. 2016 Jan 15;360:41-4. doi: 10.1016/j.jns.2015.11.030. Epub 2015 Nov 18.
It has been suggested that autoantibodies may induce axonal damage in multiple sclerosis (MS). Optical coherence tomography (OCT) showed that thinning of peripapillary retinal nerve fiber layer (RNFL) and ganglion cell layer/inner plexiform (GCIPL) measurements reflect axonal loss in the disease. We investigated whether the intrathecal synthesis of lipid-specific oligoclonal IgM bands (LS-OCMB) associates with thinning of these structures in MS patients.
58 consecutive MS patients and 70 age-matched healthy controls were assessed. LS-OCMB was studied in cerebrospinal fluid by isoelectric focusing and immunoblotting. RNFL and GCIPL imaging were quantified by spectral domain OCT.
RNFL and GCIPL were significantly reduced in MS patients compared to controls (p<0.01). RNFL thickness was further reduced in LS-OCMB positive MS patients compared to LS-OCMB negative MS subjects mainly in papillomacular bundle (p<0.05), temporal and inferior quadrants (p<0.05) and inferotemporal sector (p=0.01).
The presence of LS-OCMB associates with increased retinal axonal loss in MS. This reinforces the relationship found between the intrathecal synthesis of IgM and the axonal damage observed in immunological and pathological studies even in normal-appearing white matter. OCT seems an optimal tool to monitor axonal damage in LS-OCMB positive patients, relevant for therapeutic decisions and quantification of the effects of new neuroprotective treatments.
有人提出自身抗体可能在多发性硬化症（MS）中诱发轴突损伤。光学相干断层扫描（OCT）显示，视乳头周围视网膜神经纤维层（RNFL）变薄以及神经节细胞层/内丛状层（GCIPL）测量值反映了该疾病中的轴突损失。我们研究了脂质特异性寡克隆IgM带（LS-OCMB）的鞘内合成是否与MS患者这些结构的变薄有关。
对58例连续的MS患者和70例年龄匹配的健康对照者进行评估。通过等电聚焦和免疫印迹法研究脑脊液中的LS-OCMB。通过光谱域OCT对RNFL和GCIPL成像进行定量分析。
与对照组相比，MS患者的RNFL和GCIPL明显减少（p<0.01）。与LS-OCMB阴性的MS患者相比，LS-OCMB阳性的MS患者的RNFL厚度进一步降低，主要在黄斑乳头束（p<0.05）、颞侧和下方象限（p<0.05）以及颞下扇形区（p=0.01）。
LS-OCMB的存在与MS患者视网膜轴突损失增加有关。这强化了在免疫学和病理学研究中发现的IgM鞘内合成与轴突损伤之间的关系，即使在外观正常的白质中也是如此。OCT似乎是监测LS-OCMB阳性患者轴突损伤的最佳工具，这对于治疗决策和新神经保护治疗效果的量化具有重要意义。
