Fukazawa T, Kikuchi S, Sasaki H, Hamada K, Hamada T, Miyasaka K, Tashiro K
Hokuyukai Neurology Hospital, Sapporo, Japan.
J Neurol Sci. 1998 Jun 30;158(2):209-14. doi: 10.1016/s0022-510x(98)00127-0.
We compared clinical and demographic features, MRI findings, and HLA profiles of 57 Japanese patients with multiple sclerosis (MS) between groups with and without oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF). Patients with the optic-spinal form of MS (OpS-MS) or acute transverse myelopathy (ATM), which are distinctive and relatively common in Japanese MS, were excluded in this study. The OCB-positive rate was only 56.1% (32/57) among these 57 'conventional' MS patients, of whom clinical features were similar to those of Western MS patients. The demographic features, clinical course, disability, and cerebral abnormalities seen on MRI were similar in the OCB-negative and OCB-positive patient groups. HLA-DR2 antigen, which has been confirmed to be associated with MS in many populations, was more common in the OCB-positive than in the OCB-negative and control groups. Furthermore, DR4 antigen was statistically more common in the OCB-negative patient group. These results raise the possibility that the presence of OCB is related to the immunogenetic background of the patient, and that there may be at least two subpopulations in Japanese patients with 'conventional' MS from the viewpoint of immunogenetics. In one subpopulations, MS is associated with the DR2 antigen, and shows a stronger humoral immune response in the CSF, while in the other MS is associated with DR4, which has a milder humoral response. Further investigations involving more patients are warranted.
我们比较了57例日本多发性硬化症（MS）患者的临床和人口统计学特征、MRI表现以及HLA谱，这些患者被分为脑脊液（CSF）中有或没有寡克隆IgG带（OCB）的两组。本研究排除了视神经脊髓型MS（OpS-MS）或急性横贯性脊髓炎（ATM）患者，这两种类型在日本MS中较为独特且相对常见。在这57例“典型”MS患者中，OCB阳性率仅为56.1%（32/57），其临床特征与西方MS患者相似。OCB阴性和阳性患者组在人口统计学特征、临床病程、残疾程度以及MRI上显示的脑部异常方面相似。在许多人群中已证实与MS相关的HLA-DR2抗原，在OCB阳性组中比在OCB阴性组和对照组中更常见。此外，DR4抗原在OCB阴性患者组中在统计学上更常见。这些结果提示，OCB的存在可能与患者的免疫遗传背景有关，并且从免疫遗传学角度来看，日本“典型”MS患者中可能至少存在两个亚群。在一个亚群中，MS与DR2抗原相关，并且在CSF中表现出更强的体液免疫反应，而在另一个亚群中，MS与DR4相关，其体液反应较轻。有必要对更多患者进行进一步研究。
