Generally, we diagnose two different courses of multiple sclerosis: relapsing remitting course (RR-MS) and primary progressive (PP-MS) course. Differences in pathogenesis, immunology, and prognosis are supposed between these entities. A reliable surrogate marker in cerebrospinal fluid and serum for these courses is still missing. The aims of our work were to investigate the frequency of MRZ reaction and oligoclonal IgG bands (IgG-OB) in RR-MS and PP-MS subgroups of patients and to evaluate its diagnostic significance. We examined 29 patients (n–29) with RR-MS and 10 patients with PP-MS (n–10). The intrathecal synthesis of specific antibodies (MRZ reaction) was evaluated in the form of antibody indices calculated according to the Reiber’s formula. Oligoclonal IgG bands were detected by isoelectric focusing using a commercial SEBIA kit. The MRZ reaction was positive in 2/10 patients with PP-MS and in 11/29 patients with RR-MS. IgG-OB were positive in 1/10 patients with PP-MS and in 20/29 patients with RR-MS. The calculated sensitivities for MRZ reaction were 20 % in PP-MS and 37 % in RR-MS; for IgG-OB they were 10 % in PP-MS and 69 % in RR-MS. The different frequencies of both parameters in PP-MS and RR-MS support the hypothesis about different pathogenesis and can be used as reliable surrogate markers for differential diagnosis in the context of clinical settings.

Department of Neurology Faculty of Medicine Masaryk University and Faculty Hospital Brno

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