Antibody Identified as MS Villain

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Antibody Identified as MS Villain

Tue Oct 15, 5:06 PM ET

By Ed Edelson

HealthScoutNews Reporter

TUESDAY, Oct. 15 (HealthScoutNews) -- An immune system molecule that attacks

the protective shield around nerve cells appears to play a critical role in

the most severe form of multiple sclerosis, researchers report.

Unusually high levels of the molecule, an antibody to a major element of the

myelin sheath around nerve cells, are found in patients with the rapidly

moving, progressive form of multiple sclerosis (MS), Dr. Claude Genain

reported today at the annual meeting of the American Neurological

Association in New York City.

" We're not sure, but it appears these antibodies could be causing the nerve

damage, especially in this progressive form of MS, " says Genain, who is an

assistant professor of neurology at the University of California, San

Francisco.

The target of the antibody attack is myelin oligodendrocyte glycoprotein

(MOG). Research in several laboratories has shown the anti-MOG antibody

destroys myelin in an animal model of MS, but its role in the nerve

destruction that causes MS in humans has been unclear.

The disease can start with slow, " relapsing and remitting " destruction of

nerve cells, or the more rapidly moving progressive form. Genain and his

colleagues studied the levels of anti-MOG antibody and of several other

antibodies that have been found to react with components of myelin in 27

patients with slower-moving MS, 49 patients with the progressive form, and

18 persons without MS.

" We show that it appears in the progressive form from the beginning, " Genain

says. " In these cases, levels of only one antibody, anti-MOG, are elevated.

My interpretation, very cautious, is that the anti-MOG antibody may cause

the destruction in the progressive form. In the secondary form, it may be a

marker of a general process of nerve cell destruction, but this has not been

proven experimentally. "

The anti-MOG antibody, or the immune system B-cells that make them, could be

a target for MS treatment, Genain says. " We are designing a human study of

that, and we are hoping that it could begin next year, " he adds.

The test of anti-MOG levels used in the study could also be applied to

diagnosis, Genain says. " This appears to be the first simple, reliable and

inexpensive blood test that correlates so strongly with clinical parameters

in studies of MS, " he says. " Its use, in combination with other disease

markers, would significantly advance our understanding of what causes the

different forms of MS and how they should be treated. "

The finding " definitely enlarges an important area of research, " says Dr.

W. Rose, a professor of neurology at the University of Utah and a

spokesman for the National Multiple Sclerosis Society. Human studies of

treatment of MS by plasma exchange, in which blood is " cleansed " of unwanted

substances, have found elevated levels of anti-MOG antibody, he says.

However, the picture is not clear, Rose says. A number of studies, including

the one reported by Genain, have found elevated levels of anti-MOG antibody

in about a third of persons who do not have MS, he notes, and so " it is a

matter of going on and finding out more about how these antibodies work. But

the study points to the possibility not only of plasma exchange but also

targeting antibody-producing cells as part of MS therapy. "

What To Do

You can learn much more about MS from the National Multiple Sclerosis

Society or the National Institute of Neurological Disorders and Stroke.