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Research paper
Polyspecific, antiviral immune response distinguishes multiple sclerosis and neuromyelitis optica
  1. S Jarius1,2,
  2. D Franciotta3,
  3. R Bergamaschi3,
  4. S Rauer4,
  5. K P Wandinger5,
  6. H F Petereit6,
  7. M Maurer7,
  8. H Tumani8,
  9. A Vincent2,
  10. P Eichhorn9,
  11. B Wildemann10,
  12. M Wick9,
  13. R Voltz1,11
  1. 1
    Institute of Clinical Neuroimmunology, Ludwig Maximilians University, Munich, Germany
  2. 2
    Neurosciences Group, Weatherall Institute of Molecular Medicine, and Department of Neurology, John Radcliffe Hospital, University of Oxford, Oxford, UK
  3. 3
    IRCCS Foundation, “Neurological Institute C Mondino”, University of Pavia, Pavia, Italy
  4. 4
    Department of Neurology, University of Freiburg, Freiburg, Germany
  5. 5
    Department of Neurology, Charité University Hospital, Berlin, Germany
  6. 6
    Department of Neurology, University of Cologne, Cologne, Germany
  7. 7
    Department of Neurology, Julius Maximilians University, Wuerzburg, Germany
  8. 8
    Department of Neurology, University of Ulm, Ulm, Germany
  9. 9
    Department of Clinical Chemistry, Ludwig Maximilians University, Munich, Germany
  10. 10
    Division of Molecular Neuroimmunology, Department of Neurology, University of Heidelberg, Heidelberg, Germany
  11. 11
    Department of Palliative Medicine, University of Cologne, Cologne, Germany
  1. Professor R Voltz, Department of Palliative Medicine, University of Cologne, D-50924 Cologne, Germany; raymond.voltz{at}uk-koeln.de

Abstract

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.

http://dx.doi.org/10.1136/jnnp.2007.133330

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    Footnotes

    • 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.