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The MRZ reaction in primary progressive multiple sclerosis
Tilman Hottenrott1, Rick Dersch2, Benjamin Berger2
1Department of Neurology and Neurophysiology, University Medical Center Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany. tilman.hottenrott@uniklinik-freiburg.de.
Background:
The MRZ reaction (MRZR), composed of the three antibody indices (AI) against measles, rubella and varicella zoster virus and found positive in the majority of relapsing-remitting multiple sclerosis (RRMS) patients, is absent in other inflammatory neurological diseases (OIND). So far, it has been uncertain whether its differential diagnostic promise extends to patients with primary-progressive multiple sclerosis (PPMS).
Objective:
To investigate the prevalence of MRZR in PPMS compared to RRMS and OIND patients.
Methods:
MRZR was assessed in patients with PPMS (n = 103), RRMS (n = 100) and OIND (n = 48). Both stringency levels for MRZR testing, MRZR-1 (≥1 AI positive) and MRZR-2 (≥2 AI positive), were applied.
Results:
Prevalence of positive MRZR-1 was 83.5% in PPMS and 67.8% in RRMS (p < 0.05). A positive MRZR-2 was found in 54.4% of PPMS and in 43.0% of RRMS patients (not significant). Compared to both MS subgroups, OIND patients exhibit lower frequencies of positive MRZR (MRZR-1: 22.9%, MRZR-2: 8.3%; p < 0.0001 each).
Conclusion:
Positive MRZR was at least as frequent in PPMS as in RRMS and much less frequent in OIND, confirming its promise as a potentially useful diagnostic tool for distinguishing both MS course types from OIND.
Insights
The MRZ reaction (MRZR) is as common in primary-progressive multiple sclerosis (PPMS) as in relapsing-remitting multiple sclerosis (RRMS). This diagnostic marker is significantly less frequent in other inflammatory neurological diseases (OIND).
Area of Science:
- Neurology
- Immunology
- Diagnostic Markers
Background:
- The MRZ reaction (MRZR), a panel of antibody indices against measles, rubella, and varicella zoster virus, is frequently positive in relapsing-remitting multiple sclerosis (RRMS).
- Its diagnostic utility in primary-progressive multiple sclerosis (PPMS) and other inflammatory neurological diseases (OIND) remains less understood.
Purpose of the Study:
- To determine the prevalence of the MRZ reaction (MRZR) in patients with primary-progressive multiple sclerosis (PPMS).
- To compare MRZR positivity rates between PPMS, relapsing-remitting multiple sclerosis (RRMS), and other inflammatory neurological diseases (OIND).
Main Methods:
- MRZR was assessed in 103 PPMS patients, 100 RRMS patients, and 48 OIND patients.
- Two stringency levels were used: MRZR-1 (≥1 positive antibody index) and MRZR-2 (≥2 positive antibody indices).
Main Results:
- MRZR-1 positivity was 83.5% in PPMS and 67.8% in RRMS (p < 0.05).
- MRZR-2 positivity was 54.4% in PPMS and 43.0% in RRMS (not significant).
- OIND patients showed significantly lower MRZR positivity rates (MRZR-1: 22.9%, MRZR-2: 8.3%; p < 0.0001).
Conclusions:
- The MRZ reaction (MRZR) is highly prevalent in both PPMS and RRMS patients.
- MRZR positivity is significantly lower in OIND, supporting its role in differentiating MS subtypes from other neurological inflammatory conditions.
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