Rifai N, Christenson R H, Gelman B B, Silverman L M
Clin Chem. 1987 Jul;33(7):1155-7.
Approximately 85% of patients with multiple sclerosis (MS) can be diagnosed by using magnetic resonance imaging and laboratory tests such as determination of the cerebrospinal fluid (CSF) IgG Index and electrophoresis to detect oligoclonal banding. However, these tests results are abnormal in MS patients whether they are in clinical remission or acute exacerbation. Because apolipoprotein E (apo E) is synthesized in the central and peripheral nervous system, particularly during remyelination, we propose that apo E might be a reliable marker of the remyelination that accompanies clinical remission in MS patients. We studied 33 patients with MS, 22 in remission and 11 in exacerbation, and 26 controls of comparable ages. The apo E Index, calculated from the concentrations of apo E and albumin in CSF and serum, allowed us to discriminate between MS patients in remission and MS patients in exacerbation (P less than 0.001); the IgG Index failed to show similar differences. However, combining the apo E and IgG indices gave maximum discrimination between controls, MS patients in remission, and those in exacerbation. This study suggests that apo E measurements should be included in the laboratory evaluation of MS patients.
大约85%的多发性硬化症（MS）患者可以通过磁共振成像和实验室检查来诊断，比如测定脑脊液（CSF）IgG指数以及进行电泳以检测寡克隆带。然而，无论MS患者处于临床缓解期还是急性加重期，这些检查结果都是异常的。由于载脂蛋白E（apo E）在中枢和外周神经系统中合成，尤其是在髓鞘再生过程中，我们提出apo E可能是MS患者临床缓解期伴随的髓鞘再生的可靠标志物。我们研究了33例MS患者，其中22例处于缓解期，11例处于加重期，以及26名年龄相仿的对照者。通过计算脑脊液和血清中apo E和白蛋白的浓度得出的apo E指数，使我们能够区分缓解期的MS患者和加重期的MS患者（P小于0.001）；而IgG指数未能显示出类似差异。然而，将apo E指数和IgG指数结合起来，能最大程度地区分对照组、缓解期的MS患者和加重期的MS患者。这项研究表明，在对MS患者进行实验室评估时应纳入apo E检测。
