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Comparative Study
. 2007 Oct 18:7:36.
doi: 10.1186/1471-2377-7-36.

Clinical and neuroimaging correlates of antiphospholipid antibodies in multiple sclerosis: a preliminary study

Carlos J Bidot  1 , Lawrence L Horstman, Wenche Jy, Joaquin J Jimenez, Carlos Bidot Jr, Yeon S Ahn, J Steven Alexander, Eduardo Gonzalez-Toledo, Roger E Kelley, Alireza Minagar
Affiliations
Comparative Study

Clinical and neuroimaging correlates of antiphospholipid antibodies in multiple sclerosis: a preliminary study

Carlos J Bidot et al. BMC Neurol. .

Abstract

Background: The presence of antiphospholipid antibodies (APLA) in multiple sclerosis (MS) patients has been reported frequently but no clear relationship between APLA and the clinical and neuroimaging features of MS have heretofore been shown. We assessed the clinical and neuroimaging features of MS patients with plasma APLA.

Methods: A consecutive cohort of 24 subjects with relapsing-remitting (RR) MS were studied of whom 7 were in remission (Rem) and 17 in exacerbation (Exc). All subjects were examined and underwent MRI of brain. Patients' plasma was tested by standard ELISA for the presence of both IgM and IgG antibodies using a panel of 6 targets: cardiolipin (CL), beta2 glycoprotein I (beta2GPI), Factor VII/VIIa (FVIIa), phosphatidylcholine (PC), phosphatidylserine (PS) and phosphatidylethanolamine (PE).

Results: In exacerbation up to 80% of MS subjects had elevated titers of IgM antibodies directed against the above antigens. However, in remission, less than half of MS patients had elevated titers of IgM antibodies against one or more of the above antigens. This difference was significant, p < 0.01, for all 6 target antigens. Interestingly, none of the MS patients had elevated plasma titers of IgG against any of the target antigens tested. Correlation analysis between MRI enhancing lesions and plasma levels of APLA revealed high correlation for aPC, aPS and aFVIIa (p </= 0.0065), a trend for aPE and aCL (p = 0.056), and no correlation for abeta2GP1. The strongest correlation was for aFVIIa, p = 0.0002.

Conclusion: The findings of this preliminary study show that increased APLA IgM is associated with exacerbations of MS. Currently, the significance of this association in pathogenesis of MS remains unknown. However, systematic longitudinal studies to measure APLA in larger cohorts of patients with relapsing-remitting MS, particularly before and after treatment with immunomodulatory agents, are needed to confirm these preliminary findings.

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Figures

Figure 1
Figure 1
Comparison of positive IgM antibodies (IgM-Ab) in MS subjects, for phospholipids antigens, in exacerbation versus remission. Abbreviations: CL = cardiolipin, PC = phosphatidylcholine, PS = phosphatidylserine, PE = phosphatidylethanolamine.
Figure 2
Figure 2
Comparison of positive APLA-IgM antibodies (IgM-Ab) in MS subjects, for β2 glycoprotein-I (B2GP-I), factor VII/VIIa (FVII/VIIa) and for at least one of the 6 measured antigens, in exacerbation versus remission.
See this image and copyright information in PMC

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