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. 2017 Feb 7;14(1):2.
doi: 10.1186/s12987-016-0049-7.

The MRZ reaction in primary progressive multiple sclerosis

Tilman Hottenrott  1 , Rick Dersch  2 , Benjamin Berger  2 , Sebastian Rauer  2   3 , Daniela Huzly  4 , Oliver Stich  2
Affiliations

The MRZ reaction in primary progressive multiple sclerosis

Tilman Hottenrott et al. Fluids Barriers CNS. .

Abstract

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.

Keywords: Intrathecal polyspecific antiviral immune response; MRZ reaction; MRZR; OCB; Oligoclonal bands; PPMS; Primary progressive multiple sclerosis.

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Figures

Fig. 1
Fig. 1
Frequency of positive MRZR-2 and MRZR-1 in patients with PPMS, RRMS and OIND. Frequency of positive MRZR-2 and MRZR-1 in patients with primary progressive multiple sclerosis (PPMS), relapsing-remitting multiple sclerosis (RRMS) and other autoimmune inflammatory neurological diseases (OIND). MRZR-2 one or more positive AI, MRZR-1 two or more positive AI, n.s. not significant
Fig. 2
Fig. 2
Prevalence of OCB in CSF of patients with PPMS, RRMS and OIND. Prevalence of oligoclonal bands (OCB) in cerebrospinal fluid (CSF) of patients with primary progressive multiple sclerosis (PPMS), relapsing-remitting multiple sclerosis (RRMS) and other autoimmune inflammatory neurological diseases (OIND), n.s. not significant
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