Research: Myelin-directed antibodies do not correlate with disease activity

Tewarie P, Teunissen CE, Dijkstra CD, D A M H, Vogt M, Balk L, Vrenken H, Polman CH, Killestein J.Cerebrospinal fluid anti-whole myelin antibodies are not correlated to magnetic resonance imaging activity in multiple sclerosis. J Neuroimmunol. 2012 Aug 1. [Epub ahead of print]

BACKGROUND: The role of anti-myelin antibodies as biomarker in multiple sclerosis is subject of debate. Here anti-myelin antibody reactivity against native myelin is studied in CSF and serum.

OBJECTIVE: To compare anti-myelin antibody reactivity between patients with multiple sclerosis (MS) and patients with other neurological diseases in CSF and serum. In addition, MRI measures were studied in relation to antimyelin antibody reactivity.

METHODS:77 MS patients (13 primary progressive, 27 secondary progressive and 37 relapsing remitting), 26 patients with other non-inflammatory neurological diseases and 9 patients with inflammatory neurological diseases other than MS were included. A myelin flow cytometry assay was used to detect anti-myelin antibody levels which were expressed as mean fluorescence intensity (myelin-MFI). MRI outcome measures were new or persistent T2 lesions, gadolinium enhancing T1 lesions and brain atrophy which were assessed by normalized brain volumes.

RESULTS: There was no significant difference between myelin-MFI values in serum and CSF between MS patients and controls (Mann-Whitney test p=0.19 and p=0.51). Myelin-MFI values in CSF were not correlated with number of T2 lesions (Spearman r=-0.023, p=0.85), number of gadolinium enhancing T1 lesions (Spearman r=-0.066, p=0.588) or normalized brain volume (Spearman r=-0.065, p=0.594).

CONCLUSIONS: These results do not confirm an association between anti-myelin antibody reactivity and the presence of MS or MRI measures of disease activity.


This study reports looking for anti-myelin antibodies and see if this correlates with disease activity. They can not find any difference between MSers and controls and no correlation with lesions activity and brain volume. I am not sure why it would even, if disease involved anti-myelin antibody response, which it may not. The assay is not going to tell us anything about the type of antibody which can determine whether it is damaging, it does not tell us what the antibody is directed to. In most cases antibodies can not see the myelin in the myelin sheath because it is hidden. Inhibition of disease with rixtuximab does not after antibody forming cells but has an affect on MS. As we have said myelin may not be the best target even if MS is autoimmune, so it does not add alot to the debate. Most MSers clearly do mount anti-myelin responses.

Labels: