Cerebrospinal fluid and serum antiphospholipid antibodies in multiple sclerosis, Guillain-Barré syndrome and systemic lupus arythematosus

Marchiorji, Paulo E.; Reis, Marisa dos; Quevedo, Maria E. Z.; Callegaro, D.; Hirata, M. Teresa A.; Scaff, M.; Oliveira, R. Manoel de

doi:10.1590/S0004-282X1990000400010

Abstracts

Immuneglobulins isotypes (IgG and IgM) for myelin basic protein (MBP), cerebrosides (CER), gangliosides (GANG) and cardiolipin (CARD) were detected in the cerebrospinal fluid (CSF) from 33 patients with multiple sclerosis (MS), 18 with Guillain-Barré syndrome (GBS) and 30 with systemic lupus erythematosus (SLE). In MS patients occurred positive and significant levels of IgG-MBP in 51,5% (p<0.05) and IgM-MBP in only 18.2%, IgG-CARD in 46.2%, as long as CER and GANG were detected in almost 20%. From serum samples of MS patients 20.6% presented IgG-MBP, while 53% showed positive levels foi IgM-MBP. The CSF analysis of patients with GBS showed that 56.3% revealed IgG-MBP (p<0.05), 53% for IgM-MBP. 3&.5% for IgG-CER and 23% for IgM-CER, while 50% of patients had IgG-CARD, as long -as 31% also had IgG-GANG. The serum evaluation from 14 patients showed that 18.8% had positive concentrations of IgG-MBP and 56.3% presented IgM-MBP (p<0.05) Except for 50% of patients with SLE who presented positive CSF levels of IgG-CARD. only 24.1% had positive levels of IgG-MBP. We believe that the presence of antiphosphohoid antibodies in CSF of the above mentioned diseases occurred as immune epiphenomena, but their appearance would permit the maintenance of and perpetuate the immune event.

Isotipos de imunoglobulinas (IgG e IgM) de proteína básica de mielina (PBM), cerebrosídeos (CER), gangliosídeos (GANG) e cardiolipina (CARD) foram investigados em amostras de liqüido cefalorraquidiano (LCR) de 33 pacientes com esclerose múltipla (EM), 18 com síndrome de Guillain-Barré (SGB), e 30 com lúpus eritematoso sistêmico (LES). Pacientes com EM revelaram concentrações positivas e significantes para IgG-PBM em 51,5% (p<0,05), IgM-PBM em 18,2%, IgG-CARD em 46,2%; CER e GANG foram detectados em cerca de 20% dos pacientes. A avaliação dos isotipos de imunoglobulinas no soro de pacientes com EM foi positiva em 20,6% para IgG-PBM e. 53,0% para IgM-PBM. No LCR dos pacientes com SGB a análise mostrou-se positiva em 56,3% para IgG-PBM (p<0,05), 53% para IgM-PBM, 38,5% para IgG-CER e 23% para IgM-CER, 50% para IgG-CARD e 31% para IgM-GANG. Os isotipos avaliados no soro de 14 pacientes com SGB foram positivos em 18,8% para IgG-PBM e 56,3% para IgM-PBM (p<0,05). No LCR, 50% dos pacientes com LES revelaram positividade para IgG-CARD e 241% para IgG-PBM. Os autores acreditam que a presença de anticorpos antifosfolipides seja conseqüente a epifenômeno imune, embora sua presença possa manter e perpetuar o evento imune intrínseco a essas doenças.

Paulo E. Marchiorji; Marisa dos Reis; Maria E. Z. Quevedo; D. Callegaro; M. Teresa A. Hirata; M. Scaff; R. Manoel de Oliveira

Division of Neurology and Medical Investigation Laboratories, São Paulo University Medical School

SUMMARY

Immuneglobulins isotypes (IgG and IgM) for myelin basic protein (MBP), cerebrosides (CER), gangliosides (GANG) and cardiolipin (CARD) were detected in the cerebrospinal fluid (CSF) from 33 patients with multiple sclerosis (MS), 18 with Guillain-Barré syndrome (GBS) and 30 with systemic lupus erythematosus (SLE). In MS patients occurred positive and significant levels of IgG-MBP in 51,5% (p<0.05) and IgM-MBP in only 18.2%, IgG-CARD in 46.2%, as long as CER and GANG were detected in almost 20%. From serum samples of MS patients 20.6% presented IgG-MBP, while 53% showed positive levels foi IgM-MBP. The CSF analysis of patients with GBS showed that 56.3% revealed IgG-MBP (p<0.05), 53% for IgM-MBP. 3&.5% for IgG-CER and 23% for IgM-CER, while 50% of patients had IgG-CARD, as long -as 31% also had IgG-GANG. The serum evaluation from 14 patients showed that 18.8% had positive concentrations of IgG-MBP and 56.3% presented IgM-MBP (p<0.05) Except for 50% of patients with SLE who presented positive CSF levels of IgG-CARD. only 24.1% had positive levels of IgG-MBP. We believe that the presence of antiphosphohoid antibodies in CSF of the above mentioned diseases occurred as immune epiphenomena, but their appearance would permit the maintenance of and perpetuate the immune event.

RESUMO

Isotipos de imunoglobulinas (IgG e IgM) de proteína básica de mielina (PBM), cerebrosídeos (CER), gangliosídeos (GANG) e cardiolipina (CARD) foram investigados em amostras de liqüido cefalorraquidiano (LCR) de 33 pacientes com esclerose múltipla (EM), 18 com síndrome de Guillain-Barré (SGB), e 30 com lúpus eritematoso sistêmico (LES). Pacientes com EM revelaram concentrações positivas e significantes para IgG-PBM em 51,5% (p<0,05), IgM-PBM em 18,2%, IgG-CARD em 46,2%; CER e GANG foram detectados em cerca de 20% dos pacientes. A avaliação dos isotipos de imunoglobulinas no soro de pacientes com EM foi positiva em 20,6% para IgG-PBM e. 53,0% para IgM-PBM. No LCR dos pacientes com SGB a análise mostrou-se positiva em 56,3% para IgG-PBM (p<0,05), 53% para IgM-PBM, 38,5% para IgG-CER e 23% para IgM-CER, 50% para IgG-CARD e 31% para IgM-GANG. Os isotipos avaliados no soro de 14 pacientes com SGB foram positivos em 18,8% para IgG-PBM e 56,3% para IgM-PBM (p<0,05). No LCR, 50% dos pacientes com LES revelaram positividade para IgG-CARD e 241% para IgG-PBM. Os autores acreditam que a presença de anticorpos antifosfolipides seja conseqüente a epifenômeno imune, embora sua presença possa manter e perpetuar o evento imune intrínseco a essas doenças.

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Dr. Paulo E. Marchiori - Clínica Neurológica, Hospital das Clinicas - Caixa Postal 3461 01051 São Paulo SP - Brasil.

1. Alving CR - Natural antibodies against phospholipids and liposomes in humans. Biochem Soc Trans 12:342, 1984.
2. Arnon R, Crisp E, Helley R, Ellison GW, Myers LW, Tourtellotte WW - Anti-ganglioside antibodies in multiple sclerosis. J Neurol Sci 46:179, 1980.
3. Cohen O, Schwartz M, Cohen IR, Sela B, Eshhar N - Multiple sclerosis-like disease induced in rabbits by immunization with brain gangliosides. Isr J Med Sci 17:711, 1981.
4. Colaco CB Scadding G-K, Lockhart B - Anti-cardiolipin antibodies in neurological disorders: cross-reaction with anti-single stranded DNA activity. Clin Exp Immunol 68:313, 1987.
5. Endo T, Scott DD, Stewart SS, Kundu SK, Marcus DM - Antibodies to glycosphingolipids in patients with multiple sclerosis and SLE. J Immunol 132:1793, 1984.
6. Harris EN, Englert H, Derve G, Hughes GRV, Gharavi A - Antiphospholipid antibodies in acute Guillain-Barré syndrome. Lancet 2:1361, 1983.
7. Hawada K, Sakurami T, Imura H, Iwamori M, Nabai Y - Antisialo-GM₁ antibody in sera, from patients with Graves disease and Hashimoto thyroiditis. Lancet 2:198, 1980.
8. Hirano T, Hashimoto H, Shiokawa Y, Iwamori M, Nagiai Y, Kasa M, Ochiai Y, Okumura K - Antiglycolipid autoantibody detected in the sera from systemic lupus erythematosus patients. J Clin Invest 66:1437, 1980.
9. Ryber B - Multiple specificities of antibrain antibodies in multiple sclerosis and chronic myelopathy. J Neurol Sci 38:357, 1982.
10. Yokogawa M, Irmas EG, Brady RO - Sphingolipid antibodies in sera of animals and patients with central nervous system lesions. Proc Soc Exp Biol Med 111:350, 1962.
11. Mendonça EC Neto - Estudo dos isotipos e fixação do complemento anti-nRNP e anti-Sm no lúpus eritematoso sistêmico. Tese. Faculdade de Medicina, Universidade de São Paulo. São Paulo, 1988.
12. Paterson PY - Neuroimmunology: an overwiew and personal perspective. In Aarli JA, Behan WMH, Behan PO (eds): Clinical Neuroimmunology. Blackwell, Oxford, 1987

Cerebrospinal fluid and serum antiphospholipid antibodies in multiple sclerosis, Guillain-Barré syndrome and systemic lupus arythematosus

Anticorpos antifosiolípides no líqüido cefalorraquidiano e no soro em esclerose múltipla, síndrome de Guillain-Barré e lúpus eritematoso sistêmico

Publication Dates

Publication in this collection
19 May 2011
Date of issue
Dec 1990

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Alving CR - Natural antibodies against phospholipids and liposomes in humans. Biochem Soc Trans 12:342, 1984.

[2] 2. Arnon R, Crisp E, Helley R, Ellison GW, Myers LW, Tourtellotte WW - Anti-ganglioside antibodies in multiple sclerosis. J Neurol Sci 46:179, 1980.

[3] 3. Cohen O, Schwartz M, Cohen IR, Sela B, Eshhar N - Multiple sclerosis-like disease induced in rabbits by immunization with brain gangliosides. Isr J Med Sci 17:711, 1981.

[4] 4. Colaco CB Scadding G-K, Lockhart B - Anti-cardiolipin antibodies in neurological disorders: cross-reaction with anti-single stranded DNA activity. Clin Exp Immunol 68:313, 1987.

[5] 5. Endo T, Scott DD, Stewart SS, Kundu SK, Marcus DM - Antibodies to glycosphingolipids in patients with multiple sclerosis and SLE. J Immunol 132:1793, 1984.

[6] 6. Harris EN, Englert H, Derve G, Hughes GRV, Gharavi A - Antiphospholipid antibodies in acute Guillain-Barré syndrome. Lancet 2:1361, 1983.

[7] 7. Hawada K, Sakurami T, Imura H, Iwamori M, Nabai Y - Antisialo-GM₁ antibody in sera, from patients with Graves disease and Hashimoto thyroiditis. Lancet 2:198, 1980.

[8] 8. Hirano T, Hashimoto H, Shiokawa Y, Iwamori M, Nagiai Y, Kasa M, Ochiai Y, Okumura K - Antiglycolipid autoantibody detected in the sera from systemic lupus erythematosus patients. J Clin Invest 66:1437, 1980.

[9] 9. Ryber B - Multiple specificities of antibrain antibodies in multiple sclerosis and chronic myelopathy. J Neurol Sci 38:357, 1982.

[10] 10. Yokogawa M, Irmas EG, Brady RO - Sphingolipid antibodies in sera of animals and patients with central nervous system lesions. Proc Soc Exp Biol Med 111:350, 1962.

[11] 11. Mendonça EC Neto - Estudo dos isotipos e fixação do complemento anti-nRNP e anti-Sm no lúpus eritematoso sistêmico. Tese. Faculdade de Medicina, Universidade de São Paulo. São Paulo, 1988.

[12] 12. Paterson PY - Neuroimmunology: an overwiew and personal perspective. In Aarli JA, Behan WMH, Behan PO (eds): Clinical Neuroimmunology. Blackwell, Oxford, 1987