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Published on: September 21, 2021
Frequency of an intrathecal IgM synthesis and MRZ reaction in children with MS
S Chen1, Bertolini A1, G Koukou1
1Department of Pediatric Neurology, Vestische Kinder- und Jugendklinik Datteln, University Witten/Herdecke, Datteln, Germany.
Background:
Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the CNS. An intrathecal IgM synthesis is associated with a more rapid progression of MS and the intrathecal immune response to measles -, rubella -and varicella zoster virus (MRZR) which, if present, increases the likelihood of a diagnosis of MS in adults.
Objective:
To evaluate the frequency of an intrathecal IgM synthesis and MRZR in children with MS. MethodsChildren with MS and a data set including clinical and treatment history, MRI at onset, in addition to a CSF analysis, and determination of antibody index (AI) of measles, rubella, and zoster antibodies, were eligible. The presence of an intrathecal IgM synthesis and/or a positive MRZ reaction were compared to biomarkers of a more progressive disease course.
Results:
In 75 children with MS, OCBs were present in 93.3 %). 49,2 % experienced their first relapse within 6 months. 50.7 % had a total lesion load of more than 10 lesions in the first brain MRI. Spinal lesions were identified in 64 %. 23.5 % had a positive MRZR and 40.3 % an intrathecal IgM synthesis. No significant associations were detected between the presence of an intrathecal IgM synthesis and MRZR and parameters including the relapse rate in the first two years.
Conclusion:
An intrathecal IgM synthesis and a positive MRZR are found in a subset of MS children but are not associated with markers associated with a poor prognosis.
Insights
Intrathecal IgM synthesis and measles, rubella, and varicella zoster virus (MRZR) responses occur in some pediatric multiple sclerosis (MS) patients. However, these markers do not predict a more severe disease course in children with MS.
Area of Science:
- Neurology
- Immunology
Background:
- Multiple sclerosis (MS) is a chronic CNS inflammatory and demyelinating disease.
- Intrathecal IgM synthesis and intrathecal immune responses to measles, rubella, and varicella zoster virus (MRZR) are linked to MS progression in adults.
Purpose of the Study:
- To determine the frequency of intrathecal IgM synthesis and MRZR in children diagnosed with MS.
- To compare these immune markers with indicators of a more aggressive disease in pediatric MS patients.
Main Methods:
- Analyzed data from 75 children with MS, including clinical history, MRI, and CSF analysis.
- Measured antibody index for measles, rubella, and zoster antibodies to assess intrathecal synthesis and MRZ reaction.
- Compared intrathecal IgM synthesis and MRZR presence with disease progression markers.
Main Results:
- 93.3% of children had oligoclonal bands (OCBs).
- 23.5% showed a positive MRZR, and 40.3% had intrathecal IgM synthesis.
- No significant association was found between intrathecal IgM synthesis/MRZR and relapse rates or MRI lesion load.
Conclusions:
- Intrathecal IgM synthesis and positive MRZR are present in a subset of pediatric MS cases.
- These immune markers in children with MS are not associated with poor prognostic indicators.
