Intrathecal antibody production against Chlamydia pneumoniae in multiple sclerosis is part of a polyspecific immune response

• Published in: Brain (London, England : 1878) Vol. 124; no. 7; pp. 1325 - 1335
• Main Author: Derfuss, T.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.07.2001; Oxford Publishing Limited (England)
• Subjects: Animals; Antibody Specificity - immunology; Biological and medical sciences; Blotting, Western; Borrelia burgdorferi Group - immunology; Causality; Cell Line; Chlamydophila Infections - cerebrospinal fluid; Chlamydophila Infections - epidemiology; Chlamydophila Infections - immunology; Chlamydophila pneumoniae - genetics; Chlamydophila pneumoniae - immunology; Chlamydophila pneumoniae - isolation & purification; Chromatography, Affinity; Chronic Disease; Comorbidity; Epitopes - immunology; Follow-Up Studies; Humans; Immunoglobulin G - cerebrospinal fluid; Immunoglobulin G - immunology; Isoelectric Focusing; Lyme Neuroborreliosis - immunology; Medical sciences; Multiple Sclerosis - cerebrospinal fluid; Multiple Sclerosis - epidemiology; Multiple Sclerosis - immunology; Multiple Sclerosis - microbiology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Polymerase Chain Reaction; Seroepidemiologic Studies; Human; Oligoclonal immunoglobulin; Nervous system diseases; Chlamydia pneumoniae; Multiple sclerosis; Chlamydiaceae; Antibody; IgG; Cerebrospinal fluid; Inflammatory disease; Etiology; Immunological investigation; Central nervous system disease; Chlamydiales; Bacteria; Serum
• ISSN: 1460-2156; 0006-8950; 1460-2156
• DOI: 10.1093/brain/124.7.1325

Chronic intrathecal immunoglobulin (Ig) production is a hallmark of multiple sclerosis characterized by the presence of oligoclonal IgGs and, in addition, polyspecific recognition of different pathogens such as measles, rubella and herpes zoster virus. While the antigen specificity of the oligoclonal IgGs in multiple sclerosis is largely unknown, the oligoclonal IgGs arising during CNS infectious diseases are reactive against the specific pathogen. Recently, a link between Chlamydia pneumoniae and multiple sclerosis has been claimed. To test the possible role of C. pneumoniae in multiple sclerosis, we analysed (i) whether there is intrathecal IgG production against C. pneumoniae in multiple sclerosis and (ii) if the oligoclonal IgGs in the CSF of multiple sclerosis patients recognize C. pneumoniae. By studying paired serum-CSF samples from 120 subjects (definite multiple sclerosis, 46; probable multiple sclerosis, 12; other inflammatory neurological diseases, 35; other neurological diseases, 27) by enzyme-linked immunosorbent assay, we found that 24% of all patients with definite multiple sclerosis, but only 5% of patients with other inflammatory or non-inflammatory diseases, produced IgGs specific for C. pneumoniae intrathecally (definite multiple sclerosis versus other inflammatory neurological diseases: P = 0.027). The presence of intrathecal IgGs to C. pneumoniae was independent of the duration of disease and relatively stable over time. The major CSF oligoclonal IgG bands from multiple sclerosis patients with an intrathecal Ig production to C. pneumoniae did not react towards purified elementary bodies and reticulate bodies of C. pneumoniae on affinity-mediated immunoblot following isoelectric focusing (IEF-western blots). In contrast, the IgGs in the CSF of control patients with neuroborreliosis strongly reacted with their specific pathogen, Borrelia burgdorferi, by IEF-western blot analysis. Concomitant analysis of the CSF of 23 patients with a nested polymerase chain reaction for C. pneumoniae was negative in all cases. Together, our findings strongly suggest that the immune response to C. pneumoniae is part of a polyspecific intrathecal Ig production, as is commonly observed with other pathogens. This argues against a specific role for C. pneumoniae in multiple sclerosis.