Sperm associated antigens are associated with progressive MS

de Bock L, Fraussen J, Villar LM, Álvarez-Cermeño JC, Van Wijmeersch B, van Pesch V, Stinissen P, Somers V. Anti-SPAG16 antibodies in primary progressive multiple sclerosis are associated with an elevated progression index. Eur J Neurol. 2015. doi: 10.1111/ene.12925. [Epub ahead of print]

BACKGROUND AND PURPOSE: Sperm-associated antigen 16 (SPAG16), a sperm protein which is upregulated in reactive astrocytes in multiple sclerosis (MS) lesions, has recently been identified as a novel autoantibody target in MS. The aim of this study was to investigate whether anti-SPAG16 antibody levels differ between MS subtypes (relapsing-remitting, RR; primary or secondary progressive, PP, SP) and whether antibody positivity is associated with clinical characteristics.
METHODS: Plasma anti-SPAG16 antibody levels were determined by recombinant protein enzyme-linked immunosorbent assay (ELISA) in 374 MS patients (274 RRMS, 39 SPMS and 61 PPMS) and 106 healthy controls.
RESULTS: Significantly elevated anti-SPAG16 antibodies were found in 22% of MS patients with 93% specificity. Anti-SPAG16 seropositivity was associated with an increased Expanded Disability Status Scale (EDSS) in overall MS. A higher proportion of PPMS patients showed anti-SPAG16 antibody reactivity (34%) compared to RRMS (19%) and SPMS (26%), and presented with higher anti-SPAG16 antibody levels. Seropositive PPMS patients had a significantly increased progression index compared to seronegative patients.
CONCLUSIONS: Anti-SPAG16 antibodies are associated with an increased EDSS in overall MS, indicating that they are linked to a worse MS disease outcome. Moreover, the presence of anti-SPAG16 antibodies may be a biomarker for a more severe disease in PPMS patients, as indicated by an increased progression index.

Move-over myelin basic protein here’s another antigen to get your head around and this is Sperm-associated antigen 16 (SPAG16), which is also found in astrocytes and if present was not a good prognostic marker. I suspect this is more chicken rather than egg and indicates astrocytic damage.

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  • Hmm… Feeling confused, clueless here. Does this imply that unprotected sex may initiate development of elevated levels of these antibodies in women and therefore possibly worse progression? Or does the presence of these antibodies have nothing to do with "exposure to sperm"?

  • Good point and I don't know. If unprotected sex was causing astrocytic autoimmunity, then I think we would have seen it by now, but there are women who are allergic to sperm.

    What about CD52 this is on sperm too, does this mean we get autoimmunity to alemtuzumab?

  • After the study of cats in infancy preventing future MS this is for me the strangest …. It might even explain the growing number of MS in women, but how to explain the cases of MS in men? Men "allergic to own sperm, or allergic to sperm another men"? And the child MS? …Crazy huh …

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