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Effect of Methylprednisolone on CSF IgG Parameters, Myelin Basic Protein and Anti-Myelin Basic Protein in Multiple Sclerosis Exacerbations

Published online by Cambridge University Press:  18 September 2015

Kenneth G. Warren ,
Ingrid Catz ,
Verona M. Jeffrey  and
Dorothy J. Carroll
Kenneth G. Warren*
Affiliation:
Department of Medicine (Neurology), Department of Laboratory Medicine (Endocrinology) and Rehabilitation Medicine of the University of Alberta, Edmonton
Ingrid Catz
Affiliation:
Department of Medicine (Neurology), Department of Laboratory Medicine (Endocrinology) and Rehabilitation Medicine of the University of Alberta, Edmonton
Verona M. Jeffrey
Affiliation:
Department of Medicine (Neurology), Department of Laboratory Medicine (Endocrinology) and Rehabilitation Medicine of the University of Alberta, Edmonton
Dorothy J. Carroll
Affiliation:
Department of Medicine (Neurology), Department of Laboratory Medicine (Endocrinology) and Rehabilitation Medicine of the University of Alberta, Edmonton
*
9 - 101 Clinical Sciences Building, 112 Street & 83 Avenue, Edmonton, Alberta, Canada T6G 2G3
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Abstract:

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Clinical exacerbations of multiple sclerosis (MS) are characterized by elevated levels of cerebrospinal fluid (CSF) myelin basic protein (MBP). The purposes of this study were to determine whether anti-MBP antibodies are present in increased titer in CSF of MS patients with exacerbations, and whether they can be suppressed by the administration of immunosuppressive dosages of methylprednisolone (MP). A solid phase radio-immunoassay (RIA) was used to detect free and total anti-MBP antibodies before and after acid hydrolysis of CSF. In MS exacerbations, the majority of elevated anti-MBP is in the free form. With the exception of subacute sclerosing panencephalitis (SSPE) and some cases of post infectious encephalomyelitis, anti-MBP antibodies are not present in either MS patients in remission or in non-MS controls. Anti-MBP levels remained elevated over a 10 day period when patients are managed by bed rest only or when treated with intravenous (IV) ACTH. IV administration of MP in “high” (160 mg/day) or “mega” (2 g/day) dosages produces a highly significant reduction of both MBP (p<0.01) and anti-MBP (p<0.001) levels. Total intrathecal IgG synthesis is also significantly suppressed by IV-MP but not by ACTH.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 13 , Issue 1 , February 1986 , pp. 25 - 30
Copyright
Copyright © Canadian Neurological Sciences Federation 1986

References

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