Multiple sclerosis is associated with enhanced B cell responses to the ganglioside GD1a

• The occurrence and role of autoantibodies to gangliosides and other lipid-containing components of the central nervous system in Multiple Sclerosis (MS) are unsettled Using sensitive ELISAs, we measured IgG and JgM antibody titers and absorbances to the three major gangliosides GDIa, GD l b and GM, and to sulfatides, cardiolipin and myelin proteins in paired serum and cerebrospinal fluid (CSF) from patients with untreated MS, optic neuritis (ON), acute aseptic meningo-encephalitis (AM) and other neurological diseases (OND). Twenty-three per cent of 30 MS (P < 0.04) and 18% of 32 ON patient (P <0.05) presented elevated IgG antibody titers to GD) a in serum compared to 9% of patient with OND. Six (40%) of the patient with malignant MS had elevated serum IgG antibody titers to GD) a compared to one (6%) of th e patient with benign MS (P <0.04). In CSF, elevated IgG antibody titers to GDIa were measured in 13% of MS and 20% of ON patient compared to 4% of patient with OND (P < 0.03 and P < 0.02, respectively). The augmented IgG response to GD) a in serum also separated MS from Guillain-Barr6 syndrome. Compared to OND increased JgM absorbances to sulfatides and cardiolipin were observed in CSF of patient with MS, but also in AM. Elevated IgG antibody titers to myelin proteins were found more often in MS patient' serum and MS, ON and AM patient' CSF compared to OND. The data implicate that among the multitude of enhanced B-cell responses occurring in MS and ON, that directed to GD I a is common and more discriminative, and should be evaluated in future MS treatment studies.

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