CSF Immunoglobulins and Clinical Course

Abstract

Establishment of a relation between any clinical variable of MS such as disease activity or duration, and aberrations of CSF immunoglobulins is hampered by several difficulties. Clinical variables are often difficult to define. Thus, an exacerbation may be simulated by changes of body temperature, or plaques may develop in areas of white matter without presenting any clinical signs and symptoms. One or two strategically located plaques may induce profound disability while, in other patients, extensive dissemination of plaques may be accompanied by no or only slight disability. Furthermore, various “treatment” protocols nowadays used in many centres include drugs which modulate the immune response and have long-lasting effects on e.g. Ig levels in CSF. These may be some of the reasons why, in the vast literature on MS, few studies deal with relation between clinical variables and Ig aberrations in CSF even though these aberrations after all might have importance for the pathogenesis of the disease. Thus, modern laboratory tests such as nuclear magnetic resonance studies or determinations of myelin basic protein levels in CSF in MS patients in order to establish disease activity more appropriately, have hitherto not been related to Ig concentrations in CSF.