Antibodies to myelin lipids

Sun X, Bakhti M, Fitzner D, Schnaars M, Kruse N, Coskun Ü, Kremser C, Willecke K, Kappos L, Kuhle J, Simons M.Quantified CSF antibody reactivity against myelin in multiple sclerosis.Ann Clin Transl Neurol. 2015 Nov 9;2(12):1116-23. 

BACKGROUND:Synthesis of clonal IgG is a consistent feature of patients with multiple sclerosis (MS). Whether oligoclonal bands (OCBs) represent unspecific disease bystanders or active components in MS pathology is an open question. The aim of this study was to develop a method to quantify and compare the reactivity of cerebrospinal fluid (CSF) antibodies from patients with and without MS.
METHODS:We collected CSF from 262 patients from two different cohorts, which included 148 patients with MS and 114 with other neurological diseases (OND). We established a highly sensitive electrochemiluminescence (ECL)-based assay to measure CSF antibody reactivity against purified myelin particles and biotin anchored liposomes. The diagnostic value of the ECL score against myelin particles was assessed with receiver operating characteristic curves.
RESULTS:CSF from patients with MS have higher reactivity toward purified myelin particles as compared to those with OND with OCBs. Using liposomes with defined lipid compositions and myelin particles from ceramide synthase 2 (CerS2) knockout mice, we find that some of the CSF antibody reactivity is directed against cerebrosides.
CONCLUSION:The ECL-based assay system expands the currently available toolbox for the detection of autoantibodies in MS and related diseases.

There has been a number of posts recently reporting that within the cerebrospinal fluid there are antibodies that bind to CNS proteins and this report again shows that there are antibodies to CNS lipids within the spinal fluid of people with MS. Whilst they may be a consquence of damage rather than an intial cause, they may have delaterious effects. So Ideally we would not want them in the brain. How can we get rid of them we need to get rid of plasma cells that make antibodies and if they are lurking in the brain it is going to be difficult to get at them with any of the current MS drugs.

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