The Study Of Triose-phosphate Isomerase-reactive Abs In The Cerebrospinal Fluid Of Patients With Multiple Sclerosis

Objective:Multiple sclerosis(MS)is a kind of autoimmune disease of central nervous system, which can involve the system of gray and white matters simultaneously. Foreign experts had confirmed that in the central nervous system of patients with MS, intrathecal B lymphocytes can secrete a certain kind of immunoglobulin.It can specifically bind with Triose-phosphate isomerase (TPI) and Glyceraldehyde-3-phosphate dehydrogenase (GAPDH), which distributed in the neurons and axonal of gray matter. After Antigen-antibody reactions, immunoglobulin destroyed the integrity of the neuronal and axonal. Therefore foreign experts believed that TPI-reactive Abs and GAPDH-reactive Abs may play an important role in the pathogenic process of gray matter lesions in patient with MS. This research used enzyme-linked immunosorbent assay (ELISA) to detect the level of TPI-reactive Abs in cerebrospinal fluid of patients with MS, OIND(other inflammatory diseases of central nervous system)and ONIND(other non-inflammatory diseases of central nervous system). The correlation between the level of TPI-reactive Abs and EDSS of MS was explored and whether TPI-reactive Abs can be used as the clinical monitoring index or auxiliary diagnosis index of MS was identified.Methods:The cerebrospinal fluid (CSF) samples were obtained from23clinically confirmed patients with MS,17patients with other inflammatory neurological diseases (OIND), and13patients with other noninflammatory neurological diseases (ONIND). After the consent of patients with MS, the patients recorded EDSS score by themselves according to their quality of life(Visual impairment or paralysis of limbs patients were assist by fix recorder). The age and sex among the three groups was no significant difference.5ml cerebrospinal fluid specimens were collected at the first time of lumber puncture after patients were in hospital, Loaded into the centrifuge tube, stored at-80℃and avoided repeated freezing and thawing. After specimen collection was completed, enzyme-linked immunosorbent assay (ELISA) method was used to detect the level of TPI-reactive Abs in cerebrospinal fluid in each groups. SPSS13.0statistical analysis software was used for statistical analysis of the measured results.Spearman correlation was used to analysis the correlation between TPI-reactive Abs and EDSS of patients with MS. Using SNK test and chi-square test compared the difference expression levels of TPI-reactive Abs in cerebrospinal fluids among three groups. Using two independent samples t-test compared the difference expression levels of TPI-reactive Abs in cerebrospinal fluids between MS and non-MS group.Results:1Clinical EDSS scores of23MS patients:the highest score was7.5points the lowest score was1point, the average score was (3.35±2.46) points. Fit the skewed distribution.2The OD values of TPI-reactive Abs in cerebrospinal fluids of23MS patients:OD mean’s value was0.187,standard deviation was0.043. Fit the normal distribution.3Scatter plot showed a significant linear trend between EDSS score and TPI-reactive Abs OD values in patients with MS (Fig.2).4Spearman correlation showed that there was a correlation between EDSS score and TPI-reactive Abs OD values of cerebrospinal fluid in patients withMS(P=0.00)(Table1,Fig.2).5There was no significant differences of gender and ages among MS group, ONIND group and OIND group(P>0.05)(Table2).6The mean’s OD value±standard deviation of TPI-reactive Abs in MS,OIND,ONIND groups are respectively0.187±0.043,0.195±0.042,0.164±0.050.There was no significant differences among three groups(P>0.05)(Fig.3). 7The TPI-reactive Abs of Cerebrospinal fluid positive rate in MS group was13.04%,in OIND group and ONIND group were all0%. There was no significant difference among three groups (P>0.05)(Table3).8The mean value±standard deviation of TPI-reactive Abs OD values in MS and non-MS group were0.187±0.043and0.182±0.047. There was no significant differences between two groups(P>0.05).9The positive rate of TPI-reactive Abs in Cerebrospinal fluid in MS group was13.04%,in non-MS group was0%.There was no significant difference between two groups(P>0.05).Conclusions:1The level of TPI-reactive Abs in cerebrospinal fluid of MS has a significant correlation with the degree of neurological dysfunction, which suggests that TPI-reactive Abs in cerebrospinal fluid can be used as a laboratory index of monitoring clinical outcomes and assessment of prognosis in patient with MS.2There is no significant difference between MS group and non-MS group, which infers that TPI-reactive Abs in cerebrospinal fluid is not regareded as an auxiliary diagnosis index of MS currently3TPI-reactive Abs in cerebrospinal fluid may participate in neurons and axonal damage in patients with MS by a certain particular intermediary substance.The specific mechanisms still need further study...