Iivanainen M V
J Neuroimmunol. 1981 Jun;1(2):141-72. doi: 10.1016/0165-5728(81)90040-0.
Early diagnosis of multiple sclerosis (MS) may be assisted by tests for the abnormal immune responses of the central nervous system (CNS) including oligoclonal IgG bands in the cerebrospinal fluid (CSF), increased CNS IgG synthesis, increased CNS antibody synthesis against multiple viruses and increased numbers of enlarged lymphoid cells in the CSF. Alterations in immunological responses are important in the pathogenesis of MS. Further studies are needed, however, to identify the antigen(s) and/or antibodies responsible for oligoclonal IgG in the CSF of MS patients. Also, the cause(s) for the other immunological abnormalities with diagnostic importance need to be identified. The increased synthesis of antibodies against multiple unrelated viruses suggests generalized alteration in the immune regulatory system. The etiology of MS might be multifactorial involving abnormal immunological responses, possibly precipitated by infectious agents acquired during childhood by genetically susceptible individuals. The immunological responses including alterations in myelin basic protein concentration, antimyelin antibody and immune complex activities in CSF, and in vitro stimulation, suppression and migration inhibition of blood lymphocytes appear to correlate with stage of MS and severity of CNS damage. Some of the tests may become useful in estimating the prognosis of the disease. Longitudinal studies are needed to clarify the sensitivity of the diagnostic and prognostic immunological tests and etiological significance of these abnormalities in MS.
多发性硬化症（MS）的早期诊断可借助对中枢神经系统（CNS）异常免疫反应的检测，包括脑脊液（CSF）中的寡克隆IgG带、CNS中IgG合成增加、针对多种病毒的CNS抗体合成增加以及CSF中肿大淋巴细胞数量增多。免疫反应的改变在MS的发病机制中很重要。然而，还需要进一步研究来确定导致MS患者CSF中寡克隆IgG的抗原和/或抗体。此外，还需要确定其他具有诊断意义的免疫异常的原因。针对多种不相关病毒的抗体合成增加表明免疫调节系统发生了全身性改变。MS的病因可能是多因素的，涉及异常免疫反应，可能由遗传易感个体在儿童期获得的感染因子引发。免疫反应，包括CSF中髓鞘碱性蛋白浓度的改变、抗髓鞘抗体和免疫复合物活性，以及体外血液淋巴细胞的刺激、抑制和迁移抑制，似乎与MS的阶段和CNS损伤的严重程度相关。其中一些检测可能有助于评估疾病的预后。需要进行纵向研究以阐明诊断和预后免疫检测的敏感性以及这些异常在MS中的病因学意义。
