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Multiple Sclerosis
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Anti-myelin antibodies predict the clinical outcome after a first episode suggestive of MS

V. Tomassini

Department of Neurological Sciences, "La Sapienza" University, Rome, Italy

L. De Giglio

Department of Neurological Sciences, "La Sapienza" University, Rome, Italy

M. Reindl

Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

P. Russo

Department of Critical Area, University of Florence, Florence, Italy

I. Pestalozza

Department of Neurological Sciences, "La Sapienza" University, Rome, Italy

P. Pantano

Department of Neurological Sciences, "La Sapienza" University, Rome, Italy

T. Berger

Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

C. Pozzilli

Department of Neurological Sciences, "La Sapienza" University, Rome, Italy, carlo.pozzilli{at}uniroma1.it

The aim of this study was to test the contribution of anti-myelin antibodies in predicting conversion from clinically isolated syndrome (CIS) to multiple sclerosis (MS) when considering either Poser's or McDonald's diagnostic criteria. Fifty-one patients with CIS and abnormal brain MRI were imaged monthly for six months and then at 12, 18, 24, 36 months. At baseline serum samples testing antibodies against myelin oligodendrocyte glycoprotein (anti-MOG) and myelin basic protein (anti-MBP) were collected. During the 36-month follow-up, 26 (51%) patients developed a relapse thus becoming clinically definite MS (CDMS) according to Poser's criteria; 46 (90.2%) patients converted to MS according to McDonald's criteria. Out of 51 patients, 28 (54.9%) had either double or single positivity for anti-myelin antibodies. Antibody status significantly predicted MS according to Poser's criteria (P = 0.004), but did not according to the McDonald's criteria. When compared to antibody negative patients, the risk of developing a relapse was 8.9 (95% CI: 2.7—29.8; P < 0.001) for anti-MBP positive (anti-MBP+) patients and 1.5 (95% CI: 0.4—5.4; P = 0.564) for those anti-MOG positive (anti-MOG+); double positive patients (ie, anti-MBP+/anti-MOG+) had a risk of relapse's occurrence equal to 3.4 (95% CI: 1.1—10.2; P = 0.031). Also, the antibody status predicted the median time span from CIS to CDMS, that was of 36 months in the anti-MOG-/anti-MBP- group, 33 months in the anti-MOG+/anti-MBP- group, 24 months in the anti-MOG+/anti-MBP+ group and 12 months in the anti-MOG-/anti-MBP+ patients (P = 0.003 by ANOVA). Our data support the prognostic value of anti-myelin antibodies in CIS patients at risk of CDMS, with positive patients showing shorter time interval to relapse occurrence than negative patients. Multiple Sclerosis 2007; 13: 1086—1094. http://msj.sagepub.com

Key Words: clinically isolated syndrome • MBP antibodies • MOG antibodies • MRI • multiple sclerosis • relapse

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This version was published on November 1, 2007

Multiple Sclerosis, Vol. 13, No. 9, 1086-1094 (2007)
DOI: 10.1177/1352458507077622
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