Objective: Multiple sclerosis (MS) is characterized by the local production of antibodies in the CNS and the presence of oligoclonal bands in the CSF. Antigen arrays allow the study of antibody reactivity against a large number of antigens using small volumes of fluid with greater sensitivity than ELISA. We investigated whether there were unique autoantibodies in the CSF of patients with MS as measured by antigen arrays and whether these antibodies differed from those in serum.
Methods:We used antigen arrays to analyze the reactivity of antibodies in matched serum and CSF samples of 20 patients with untreated relapsing-remitting MS (RRMS), 26 methylprednisolone-treated patients with RRMS, and 20 control patients with other noninflammatory neurologic conditions (ONDs) against 334 different antigens including heat shock proteins, lipids, and myelin antigens.
Results:We found different antibody signatures in matched CSF and serum samples The targets of these antibodies included epitopes of the myelin antigens CNP, MBP, MOBP, MOG, and PLP (59%), HSP60 and HSP70 (38%), and the 68-kD neurofilament (3%). The antibody response in patients with MS was heterogeneous; CSF antibodies in individual patients reacted with different autoantigens. These autoantibodies were locally synthesized in the CNS and were of the immunoglobulin G class. Finally, we found that treatment with steroids decreased autoantibody reactivity, epitope spreading, and intrathecal autoantibody synthesis.
Conclusions:These studies provide a new avenue to investigate the local antibody response in the CNS, which may serve as a biomarker to monitor both disease progression and response to therapy in MS. Neurology
Antibodies and B cells play an important role in the pathogenesis of multiple sclerosis (MS).Clonally expanded B cells are found in the lesions and the CSF of patients with MS, 1 and B-cell follicles have been described in the meninges of patients with secondary progressive MS.2 These CNS-resident B cells have been linked to the production of intrathecal antibodies of restricted specificity, detectable as oligoclonal bands. 3,4 Antigen microarrays allow the high-throughput characterization of the antibody response using limited amounts of sample 5,6 with greater sensitivity than ELISA. 6,7 We and others have used antigen arrays to characterize the immune response in MS 7-9 and its experimental model experimental autoimmune encephalomyelitis, 9 -11 other autoimmune conditions, 5,12-15 tumors, 16 and healthy individuals. 17 In our studies on MS, we found patterns of serum antibody reactivity associated with different stages and pathologic subtypes of the disease.7 Moreover, the characterization of the serum antibody response in patients with MS led us to identify the Toll-like receptor-2/