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Intrathecal IgM synthesis in neurologic diseases: relationship with disability in MS
L M Villar1, J Masjuan, P González-Porqué
1Department of Immunology, Hospital Ramón y Cajal, Madrid, Spain. lvillar@hrc.insalud.es
Abstract:
The authors studied the intrathecal IgM synthesis (ITMS) in paired sera and CSF samples from 65 patients with MS, 28 with CNS infection, 40 with other neurologic diseases and eight control subjects. ITMS was found in 30 patients with MS and in 20 with CNS infection, but not in patients with other neurologic diseases or in control subjects. In infectious samples, the ITMS is likely a primary response. In MS group, it was associated with higher Expanded Disability Status Scale index (p = 0.017).
Insights
Intrathecal IgM synthesis (ITMS) was detected in patients with multiple sclerosis (MS) and central nervous system (CNS) infections, but not in other neurological diseases or controls. In MS, ITMS correlated with disability.
Area of Science:
- Neuroimmunology
- Clinical Neurology
- Infectious Diseases
Background:
- Intrathecal immunoglobulin M (IgM) synthesis indicates local immune responses within the central nervous system (CNS).
- Understanding the presence and significance of intrathecal IgM synthesis is crucial for diagnosing and understanding various neurological conditions.
Purpose of the Study:
- To investigate the presence and clinical relevance of intrathecal IgM synthesis (ITMS) in patients with multiple sclerosis (MS), CNS infections, other neurological diseases, and healthy controls.
- To determine if ITMS is associated with disease severity in MS.
Main Methods:
- Paired serum and cerebrospinal fluid (CSF) samples were collected from 65 MS patients, 28 CNS infection patients, 40 with other neurologic diseases, and 8 controls.
- Intrathecal IgM synthesis was assessed in these samples.
- Statistical analysis was performed to compare ITMS prevalence and correlate it with clinical parameters, including the Expanded Disability Status Scale (EDSS) in the MS group.
Main Results:
- ITMS was detected in 30 out of 65 MS patients and 20 out of 28 patients with CNS infections.
- No ITMS was observed in patients with other neurological diseases or in control subjects.
- In infectious cases, ITMS was considered a likely primary immune response.
- In the MS cohort, ITMS was significantly associated with a higher EDSS score (p = 0.017).
Conclusions:
- Intrathecal IgM synthesis is a specific marker for CNS inflammatory conditions like MS and infections.
- The presence of ITMS in MS patients suggests an active intrathecal immune response that may contribute to disease progression and disability.