Journal
ARQUIVOS DE NEURO-PSIQUIATRIA
Volume 75, Issue 8, Pages 580-588Publisher
ASSOC ARQUIVOS NEURO- PSIQUIATRIA
DOI: 10.1590/0004-282X20170081
Keywords
cerebrospinal fluid; autoimmune diseases; antibodies; M,R,Z-antibody reaction; multiple sclerosis; Guillain-Barre syndrome, neurolupus
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The polyspecific antibody synthesis in multiple sclerosis (MS) gained diagnostic relevance with the frequent combination of measles-, rubella-and varicella zoster antibodies (MRZ-antibody reaction) but their pathophysiological role remains unknown. This review connects the data for intrathecal polyspecific antibody synthesis in MS and neurolupus with observations in the blood of patients with Guillain-Barre syndrome (GBS). Simultaneously increased antibody and autoantibody titers in GBS blood samples indicate that the polyspecific antibodies are based on a general property of an immune network, supported by the deterministic day-to-day concentration variation of antibodies in normal blood. Strongly correlated measles-and rubella-antibody variations point to a particular connectivity between the MRZ antibodies. The immune network, which provides serological memory in the absence of an antigen, implements the continuous change of the MRZ pattern in blood, not followed by the earlier immigrated B cells without corresponding connectivity in the brain. This may explain the different antibody patterns in cerebrospinal fluid, aqueous humor and blood of the individual MS patient. A complexity approach must implement a different view on causation in chronic diseases and causal therapies.
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