Contributions
Abstract: EP1500
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 16 Microbiology and Virology
Varicella Zoster Virus (VZV) and Herpes Virus (HSV) are proposed to play a role in the pathogenesis of Multiple Sclerosis. The presence of virus-specific antibodies in the CSF suggests that demyelination in MS is accompanied by antiviral immune responses mounting an altered immune response against viruses, in CNS. The purpose of the study was to evaluate the presence of VZV and HSV antibodies in patients with Multiple Sclerosis (MS) and Clinically Isolated Syndrome (CIS) both in serum and cerebrospinal fluid.
Methods: Ninenty four patients with Multiple Sclerosis were studied. Fifty seven patients had relapsing remitting MS (RRMS), 37 patients had clinically isolated syndrome (CIS) and two with radiologically Isolated Syndrome. The presence of VZV and HSV antibodies was tested in the serum and cerebrospinal fluid (CSF) of all patients
Results: HSV IgG and VZV IgG were detected at increased levels in serum in patients with RRMS (HSV IgG 132.8±44.8, VZV IgG 488.4±165.8) and CIS (HSV IgG 105.2±54.67, VZV IgG 489±165.7). However, the VZV IgM and HSV IgM levels in serum were low.
In CSF, IgG values >1.5 were considered to be indicative of intrathecal IgG production against the respective pathogen. IgG index of HSV and VZV in RRMS was marginally positive in low levels (1.4±0.9 and 0.8±0.9 respectively). IgG index of HSV and VZV in patients with CIS was 1.1±0.9 and 0.6±0.4 respectively. No patient had indication of viral infection in CSF. No HSV IgG was detected in CSF of RIS patients
However, increased ΗSV ΙgG index in CSF (>2) was found in 12/57 patients with RRMS. PCR for VZV and HSV in CSF was negative. 5/12 (41%) had negative oligoclonal bands while from RRMS patients with negative HSV and VZV index in CSF only 4/45 (9%) had negative oligoclonal bands, p=0.01. Five patients with CIS had increased HSV IgG index. 3/5 CIS patients and 7/12 RRMS patients with positive HSV IgG index in CSF were in relapse with gadolinium enhancement in MRI.
Conclusion: The positivity of HSV and VZV IgM antibodies in CSF of MS patients without any sign of infection, might support a role of immune response against viruses in disease pathogenesis.
Disclosure:
Dr. M.E.Evangelopoulos has received travel grants and consulting fees from Biogen, Novartis, Teva
Dr.E. Andreadou has received travel grants and consulting fees from Biogen, Novartis, Teva and Merck-Serono
Dr. G.Koutsis has received travel grants and consulting fees from Biogen, Novartis, Teva and Merck-Serono
Dr.M.Anagnostouli has received travel grants and consulting fees from Biogen, Novartis, and Merck-Serono
Dr.C. Kilidireas has received travel grants and consulting fees from Biogen, Novartis, Teva and Merck-Serono
Abstract: EP1500
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 16 Microbiology and Virology
Varicella Zoster Virus (VZV) and Herpes Virus (HSV) are proposed to play a role in the pathogenesis of Multiple Sclerosis. The presence of virus-specific antibodies in the CSF suggests that demyelination in MS is accompanied by antiviral immune responses mounting an altered immune response against viruses, in CNS. The purpose of the study was to evaluate the presence of VZV and HSV antibodies in patients with Multiple Sclerosis (MS) and Clinically Isolated Syndrome (CIS) both in serum and cerebrospinal fluid.
Methods: Ninenty four patients with Multiple Sclerosis were studied. Fifty seven patients had relapsing remitting MS (RRMS), 37 patients had clinically isolated syndrome (CIS) and two with radiologically Isolated Syndrome. The presence of VZV and HSV antibodies was tested in the serum and cerebrospinal fluid (CSF) of all patients
Results: HSV IgG and VZV IgG were detected at increased levels in serum in patients with RRMS (HSV IgG 132.8±44.8, VZV IgG 488.4±165.8) and CIS (HSV IgG 105.2±54.67, VZV IgG 489±165.7). However, the VZV IgM and HSV IgM levels in serum were low.
In CSF, IgG values >1.5 were considered to be indicative of intrathecal IgG production against the respective pathogen. IgG index of HSV and VZV in RRMS was marginally positive in low levels (1.4±0.9 and 0.8±0.9 respectively). IgG index of HSV and VZV in patients with CIS was 1.1±0.9 and 0.6±0.4 respectively. No patient had indication of viral infection in CSF. No HSV IgG was detected in CSF of RIS patients
However, increased ΗSV ΙgG index in CSF (>2) was found in 12/57 patients with RRMS. PCR for VZV and HSV in CSF was negative. 5/12 (41%) had negative oligoclonal bands while from RRMS patients with negative HSV and VZV index in CSF only 4/45 (9%) had negative oligoclonal bands, p=0.01. Five patients with CIS had increased HSV IgG index. 3/5 CIS patients and 7/12 RRMS patients with positive HSV IgG index in CSF were in relapse with gadolinium enhancement in MRI.
Conclusion: The positivity of HSV and VZV IgM antibodies in CSF of MS patients without any sign of infection, might support a role of immune response against viruses in disease pathogenesis.
Disclosure:
Dr. M.E.Evangelopoulos has received travel grants and consulting fees from Biogen, Novartis, Teva
Dr.E. Andreadou has received travel grants and consulting fees from Biogen, Novartis, Teva and Merck-Serono
Dr. G.Koutsis has received travel grants and consulting fees from Biogen, Novartis, Teva and Merck-Serono
Dr.M.Anagnostouli has received travel grants and consulting fees from Biogen, Novartis, and Merck-Serono
Dr.C. Kilidireas has received travel grants and consulting fees from Biogen, Novartis, Teva and Merck-Serono