Ryberg B
J Neurol Sci. 1978 Oct;38(3):357-82. doi: 10.1016/0022-510x(78)90142-9.
The presence of complement-fixing antibodies against brain antigens was tested in paired serum and cerebrospinal fluid (CSF) samples from 60 multiple sclerosis (MS) patients, 15 patients with chronic myelopathy of undetermined cause (CM) and 60 control patients. Six MS sera, 34 MS CSF, 4 CM sera, 3 CM CSF, 4 control sera and 1 control CSF gave positive reactions either with a lipid extract or a saline extract of normal human brain. The proportion of anticomplementary CSF was significantly higher in the MS group than in the control group (15% vs 0%, P less than 0.01). The reactivity of a large number of individual positive samples was further investigated. Seven antibody specificities were discerned in the MS samples. Most samples reacted with non-lipid antigens, the dominating being a heat-labile, nonlipid component associated with CNS myelin. Antibodies to cerebroside and sulfatide were detected in a few patients. A number of samples reacted with cholesterol in combination with a variety of lipids. Positive samples from the CM patients exhibited a similar heterogeneity. In the control group positive reactions were seen in one patient with systemic lupus erythematosus (SLE), two patients with rheumatoid arthritis (RA), and one with a spinal meningioma. The reaction patterns of these patients were different from those commonly seen in MS patients. The complement-fixing antibrain antibodies in MS CSF are usually of IgG class (Ryberg 1976). This applies also to the positive MS sera in this study. The distribution of the antibodies between serum and CSF indicated, in several cases, an intrathecal synthesis. All of a number of human brains, including one MS brain, contained all 6 antigens (haptens) reactive in saline extracts. Antibodies to tissues outside the CNS were rarely detected in MS patients. The varied humoral autoimmune response in MS might reflect a heterogeneity in the MS patients, the disease itself or its causative agent.
在60例多发性硬化症（MS）患者、15例病因不明的慢性脊髓病（CM）患者和60例对照患者的配对血清和脑脊液（CSF）样本中，检测了针对脑抗原的补体结合抗体。6例MS血清、34例MS脑脊液、4例CM血清、3例CM脑脊液、4例对照血清和1例对照脑脊液与正常人脑的脂质提取物或盐水提取物呈阳性反应。MS组中抗补体脑脊液的比例显著高于对照组（15%对0%，P<0.01）。对大量单个阳性样本的反应性进行了进一步研究。在MS样本中识别出7种抗体特异性。大多数样本与非脂质抗原反应，主要是一种与中枢神经系统髓鞘相关的热不稳定非脂质成分。在少数患者中检测到了针对脑苷脂和硫脂的抗体。一些样本与胆固醇及多种脂质结合反应。CM患者的阳性样本表现出类似的异质性。在对照组中，1例系统性红斑狼疮（SLE）患者、2例类风湿性关节炎（RA）患者和1例脊髓膜瘤患者出现了阳性反应。这些患者的反应模式与MS患者常见的不同。MS脑脊液中的补体结合抗脑抗体通常为IgG类（Ryberg，1976）。本研究中的阳性MS血清也是如此。在一些病例中，血清和脑脊液中抗体的分布表明存在鞘内合成。包括1例MS脑在内的许多人脑均含有盐水提取物中具有反应性的所有6种抗原（半抗原）。MS患者很少检测到针对中枢神经系统外组织的抗体。MS中多样的体液自身免疫反应可能反映了MS患者、疾病本身或其病原体的异质性。
