Incidence of CSF abnormalities in siblings of multiple sclerosis patients and unrelated controls

Abstract

We found that 19% (9/47) of healthy siblings of patients with clinically definite multiple sclerosis had an intrathecal immunological reaction with two or more 2 CSF-enriched oligoclonal bands (OCBs), in contrast to (4%) (2/50) unrelated healthy controls. Furthermore, in this group of nine healthy sibs the measles CSF IgG antibody titers were higher than that of the other sibs and that of controls. There were also differences in the serum titers for measles IgG antibody, which were higher in the group of all healthy sibs than in healthy volunteers, and (as with CSF titers) higher in the subgroup of healthy sibs with two or more 2 CSF-enriched OCBs than the other sibs. Thus a significant proportion of healthy siblings to MS patients have a partially hyperimmune condition similar to that occurring in MS, which in 19% manifested itself as an OCB reaction, in 9% as increased CSF measles IgG antibody titers, and in 21% as increased serum measles IgG antibody titers, these phenomena tending to occur in the same individuals. This condition is characterized by CSF-enriched OCBs with undefined specificity, although some increased antiviral reactivity is found both in the serum and CSF. While it needs further characterization, a genetic trait interacting with common infections is suggested. The recurrence risk of this condition is approximately five times higher than the 3-4% recurrence risk for manifest MS reported for sibs.

Neurological signs are common in patients with urodynamically verified “idiopathic” bladder overactivity

“…Six patients were found to have CSF immunopathy (19%). In a recent study performed by the same neurochemistry laboratory, with identical methods, only two of 50 healthy subjects (blood donors) showed CSF immunopathy (4%) [Haghighi et al, 2000].…”

Cerebrospinal fluid secretory Ca2+-dependent phospholipase A2 activity: A biomarker of blood–cerebrospinal fluid barrier permeability

“…In summary, Q Alb determination and oligoclonal IgG-bands identification were used to evaluate the BCB integrity [31] and as an indicator in the diagnosis of multiple sclerosis, respectively. Quantitative determination of both parameters was performed by common approach as previously described [11]. Thus, while Q Alb was calculated as CSF albumin (mg/L)/serum albumin (g/L), identification of CSF-enriched oligoclonal IgG-bands was based on a cutoff level of two or more IgG bands.…”

Cerebrospinal fluid T cell clones from patients with multiple sclerosis: recognition of idiotopes on monoclonal IgG secreted by autologous cerebrospinal fluid B cells

“…Intrathecal production of oligoclonal IgG is an immunological hallmark of MS [34]. The intrathecal B cell expansion seems to occur early, or even prior to the disease [35,36], and established B cell clones are maintained for several years [37]. The V H genes from intrathecal B cells have undergone somatic hypermutation [38][39][40][41][42], which could favor T cell recognition of Ig Id.…”