原发性进行性多发性硬化症中的 MRZ 反应。
The MRZ reaction in primary progressive multiple sclerosis.
机构信息
Department of Neurology and Neurophysiology, University Medical Center Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
Ravo Diagnostika GmbH, Oltmannsstrasse 5, 79100, Freiburg, Germany.
出版信息
Fluids Barriers CNS. 2017 Feb 7;14(1):2. doi: 10.1186/s12987-016-0049-7.
BACKGROUND
The MRZ reaction (MRZR), composed of the three antibody indices (AI) against measles, rubella and varicella zoster virus and found positive in the majority of relapsing-remitting multiple sclerosis (RRMS) patients, is absent in other inflammatory neurological diseases (OIND). So far, it has been uncertain whether its differential diagnostic promise extends to patients with primary-progressive multiple sclerosis (PPMS).
OBJECTIVE
To investigate the prevalence of MRZR in PPMS compared to RRMS and OIND patients.
METHODS
MRZR was assessed in patients with PPMS (n = 103), RRMS (n = 100) and OIND (n = 48). Both stringency levels for MRZR testing, MRZR-1 (≥1 AI positive) and MRZR-2 (≥2 AI positive), were applied.
RESULTS
Prevalence of positive MRZR-1 was 83.5% in PPMS and 67.8% in RRMS (p < 0.05). A positive MRZR-2 was found in 54.4% of PPMS and in 43.0% of RRMS patients (not significant). Compared to both MS subgroups, OIND patients exhibit lower frequencies of positive MRZR (MRZR-1: 22.9%, MRZR-2: 8.3%; p < 0.0001 each).
CONCLUSION
Positive MRZR was at least as frequent in PPMS as in RRMS and much less frequent in OIND, confirming its promise as a potentially useful diagnostic tool for distinguishing both MS course types from OIND.
背景
MRZ 反应（MRZR）由针对麻疹、风疹和水痘带状疱疹病毒的三种抗体指标（AI）组成，在大多数复发缓解型多发性硬化症（RRMS）患者中呈阳性，而在其他炎症性神经系统疾病（OIND）中则不存在。到目前为止，尚不确定其在原发性进展型多发性硬化症（PPMS）患者中的诊断差异是否具有预测价值。
目的
研究 MRZR 在 PPMS 患者中的阳性率与 RRMS 和 OIND 患者的阳性率比较。
方法
评估了 103 例 PPMS 患者、100 例 RRMS 患者和 48 例 OIND 患者的 MRZR。同时应用了 MRZR 检测的两种严格水平，MRZR-1（≥1 项 AI 阳性）和 MRZR-2（≥2 项 AI 阳性）。
结果
PPMS 患者中阳性 MRZR-1 的患病率为 83.5%，RRMS 患者为 67.8%（p<0.05）。阳性 MRZR-2 分别在 54.4%的 PPMS 和 43.0%的 RRMS 患者中发现（无显著差异）。与这两个 MS 亚组相比，OIND 患者的阳性 MRZR 频率较低（MRZR-1：22.9%，MRZR-2：8.3%；p<0.0001）。
结论
阳性 MRZR 在 PPMS 中的频率至少与 RRMS 一样高，而在 OIND 中的频率则低得多，这证实了它作为一种潜在有用的诊断工具，用于区分 MS 两种类型与 OIND。
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