Department of Neurology, University of Turku, Turku, Finland.
Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Mult Scler Relat Disord. 2018 Apr;21:11-18. doi: 10.1016/j.msard.2018.02.008. Epub 2018 Feb 9.
Pregnancy induces an immunosuppressive state in the mother to ensure immunological acceptance of the foetus. Impairment of cell-mediated immune responses may render the mother susceptible to intracellular pathogens. It is not presently known whether pregnancy alters the immunosurveillance for John Cunningham virus (JCV), an opportunistic pathogen associated with natalizumab treatment for multiple sclerosis (MS).
To evaluate whether the humoral immune response to JCV is altered during pregnancy among MS patients and healthy controls to get insight to potential pregnancy-induced alterations related to immune response to JCV during pregnancy.
Serum anti-JCV-antibody-indices (JCV-Ab-index) were determined by a two-step second-generation enzyme-linked immunosorbent assay in 49 MS patients during and after pregnancy and in 49 healthy controls during pregnancy. For comparison, total IgG levels and antibodies against Epstein-Barr, cytomegalo and measles viruses were similarly measured.
The JCV-Ab-indices of MS patients were not altered during the pregnancy (1st vs. 3rd trimester, 0.62 vs. 0.77, p = 0.99). Contrary to this, in the healthy controls JCV-Ab-indices (p = 0.005), antibody levels to the other viruses, and total IgG levels (p < 0.0001) decreased significantly during pregnancy.
JCV-Ab levels remain unaltered during MS pregnancy, while the total IgG concentration is reduced/diluted due to increasing plasma volumes during the course of pregnancy. This may imply a biologically significant alteration in the immune response to JCV during MS pregnancy.
妊娠会使母体产生免疫抑制状态，以确保胎儿的免疫接受。细胞介导的免疫反应受损可能使母亲易感染细胞内病原体。目前尚不清楚妊娠是否会改变对约翰·坎宁安病毒（JCV）的免疫监视，JCV 是一种与多发性硬化症（MS）的那他珠单抗治疗相关的机会性病原体。
评估妊娠期间 MS 患者和健康对照者对 JCV 的体液免疫反应是否发生改变，以深入了解与妊娠期间对 JCV 的免疫反应相关的潜在妊娠诱导改变。
通过两步第二代酶联免疫吸附试验，在 49 名妊娠期间和妊娠后以及 49 名健康对照者妊娠期间测定 MS 患者的血清抗 JCV 抗体指数（JCV-Ab-index）。为了进行比较，还类似地测定了总 IgG 水平以及针对 Epstein-Barr、巨细胞病毒和麻疹病毒的抗体。
MS 患者的 JCV-Ab-index 在妊娠期间没有改变（第 1 期与第 3 期，0.62 与 0.77，p=0.99）。与此相反，在健康对照组中，JCV-Ab-index（p=0.005）、针对其他病毒的抗体水平和总 IgG 水平（p<0.0001）在妊娠期间显著下降。
JCV-Ab 水平在 MS 妊娠期间保持不变，而总 IgG 浓度由于妊娠过程中血浆体积的增加而降低/稀释。这可能意味着 MS 妊娠期间对 JCV 的免疫反应发生了生物学上的显著改变。
