Alvord E C, Hruby S, Shaw C M, Slimp J
Prog Clin Biol Res. 1984;146:359-63.
Our studies have revealed no essential differences between EAE in monkeys and MS and other CNS diseases in humans. High concentrations of BP occur early, especially if no anti-BP antibodies are also present. Lower concentrations of BP follow and may be associated with the presence of anti-BP antibodies. In EAE these antibodies come from the relatively strong peripheral sensitization to BP and enter the CSF through a damaged blood-brain barrier; in MS they come from the relatively weak immunologic stimulation probably evoked by previous attacks of the disease. Proteolytic enzymes also enter the CSF and produce peptide fragments of BP whose differing antigenic compositions permit antibodies to some fragments to coexist with other fragments unrelated antigenically but detected as "BP" in vitro. Since oligoclonal immunoglobulins (IgG) occur more often in MS than in other diseases, one can expect to find BP, anti-BP antibodies and oligoclonal IgG more often in MS, but even the combination is not specific for MS. Consideration of the temporal and immunochemical relationships as well as of the differential diagnosis provides a basis for the understanding of the significance of BP, its antibodies and other immunoglobulins in the CSF.
我们的研究表明,猴子的实验性自身免疫性脑脊髓炎(EAE)与人类的多发性硬化症(MS)及其他中枢神经系统疾病之间没有本质区别。早期会出现高浓度的髓鞘碱性蛋白(BP),尤其是在不存在抗BP抗体的情况下。随后BP浓度会降低,这可能与抗BP抗体的存在有关。在EAE中,这些抗体源于对BP相对较强的外周致敏作用,并通过受损血脑屏障进入脑脊液;在MS中,它们则源于可能由疾病先前发作引发的相对较弱的免疫刺激。蛋白水解酶也会进入脑脊液,并产生BP的肽片段,其不同的抗原组成使得针对某些片段的抗体能够与其他抗原性无关但在体外被检测为“BP”的片段共存。由于寡克隆免疫球蛋白(IgG)在MS中比在其他疾病中更常见,因此人们预期在MS中更常发现BP、抗BP抗体和寡克隆IgG,但即使这些物质同时出现也并非MS所特有。对时间和免疫化学关系以及鉴别诊断的考量,为理解脑脊液中BP及其抗体和其他免疫球蛋白的意义提供了基础。