Polyspecific, antiviral immune response distinguishes multiple sclerosis and neuromyelitis optica
- S Jarius1,2,
- D Franciotta3,
- R Bergamaschi3,
- S Rauer4,
- K P Wandinger5,
- H F Petereit6,
- M Maurer7,
- H Tumani8,
- A Vincent2,
- P Eichhorn9,
- B Wildemann10,
- M Wick9,
- R Voltz1,11
- 1Institute of Clinical Neuroimmunology, Ludwig Maximilians University, Munich, Germany
- 2Neurosciences Group, Weatherall Institute of Molecular Medicine, and Department of Neurology, John Radcliffe Hospital, University of Oxford, Oxford, UK
- 3IRCCS Foundation, “Neurological Institute C Mondino”, University of Pavia, Pavia, Italy
- 4Department of Neurology, University of Freiburg, Freiburg, Germany
- 5Department of Neurology, Charité University Hospital, Berlin, Germany
- 6Department of Neurology, University of Cologne, Cologne, Germany
- 7Department of Neurology, Julius Maximilians University, Wuerzburg, Germany
- 8Department of Neurology, University of Ulm, Ulm, Germany
- 9Department of Clinical Chemistry, Ludwig Maximilians University, Munich, Germany
- 10Division of Molecular Neuroimmunology, Department of Neurology, University of Heidelberg, Heidelberg, Germany
- 11Department of Palliative Medicine, University of Cologne, Cologne, Germany
- Professor R Voltz, Department of Palliative Medicine, University of Cologne, D-50924 Cologne, Germany;
- Received 24 August 2007
- Revised 30 December 2007
- Accepted 10 January 2008
- Published Online First 12 February 2008
Background: A polyspecific, intrathecal humoral immune response against neurotropic viruses such as measles, rubella and varicella zoster virus (MRZ reaction, MRZR) is present in 80–100% of patients with multiple sclerosis (MS), but has not to date been evaluated in patients with neuromyelitis optica (NMO).
Aims: To evaluate whether MRZR distinguishes NMO and MS.
Methods: 20 patients with NMO and 42 with MS were included. The intrathecal synthesis of antibodies against measles, rubella and varicella zoster virus was detected by calculation of the respective antibody indices (AI).
Results: A positive MRZ reaction, as defined by a combination of at least two positive AIs, was found in 37/42 MS, but in only 1/20 NMO patients (p<0.0001). Median AI values differed significantly between the groups (p<0.0005).
Conclusions: The polyspecific antiviral humoral immune response characteristic for MS is widely missing in NMO, irrespective of the NMO-IgG status of the patients. Our findings further strengthen the case for NMO being pathologically distinct from MS.
Funding: This study was supported by Deutsche Forschungsgemeinschaft (SFB571; RV), a Fellowship from the European Neurological Society (ENS) (SJ) and a Fellowship from the University of Cologne, Germany (SJ). The Institute for Clinical Neuroimmunology, Ludwig Maximilians University, Munich, is supported by the Hermann and Lilly Schilling Foundation.
Competing interests: None.
Ethics approval: Ethics approval was obtained.