Demonstration of serum IgG antibodies against myelin during the course of relapsing experimental allergic encephalomyelitis in guinea pigs

Autoantibody responses in the cerebrospinal fluid of guinea pigs with chronic relapsing experimental allergic encephalomyelitis

We report the use of the ELISA technique to measure IgG specific for whole cord, myelin, myelin basic protein and Mycobacterium tuberculosis in the cerebrospinal fluid (CSF) of Strain 13 guinea pigs in different stages of chronic relapsing experimental allergic encephalomyelitis (CR-EAE). Specific antibody levels to all 4 antigen preparations were related to the severity of clinical signs, with the highest levels of IgG in the CSF of guinea pigs in relapse or in stable chronic disease. Total IgG levels in the CSF, though elevated throughout the course of CR-EAE, did not show any association with the category of disease. Control animals inoculated with complete Freund's adjuvant (CFA) alone showed CSF IgG levels specific for M. tuberculosis that were not significantly different from those in animals with chronic EAE, indicating that CFA may itself induce a late-acting increase in blood-brain barrier permeability.

Anti-myelin antibodies in cerebrospinal fluid and serum of patients with meningopolyneuritis Garin-Bujadoux-Bannwarth and other neurological diseases

Anti-myelin antibodies (AMA) of IgG, IgM, and IgA class were investigated by ELISA in CSF and serum from patients with meningopolyneuritis Garin-Bujadoux-Bannwarth (GBB), other inflammatory diseases of the nervous system (ID) comprising meningoencephalitis (ME), multiple sclerosis (MS), and Guillain-Barré syndrome (GBS), and various noninflammatory neurological diseases (NID). Anti-Borrelia antibodies (ABA) were determined by ELISA in GBB patients. In CSF, a high incidence of IgG-AMA, IgM-AMA, and IgA-AMA was found in GBB as compared with ID and NID. On average, positive AMA titers were higher in GBB than in ID and NID, IgM-AMA titers in GBB being most prominent. In serum, AMA were found in all but 2 patients investigated. On average, IgM-AMA titers were higher in GBB and MS than in other diseases; IgG-AMA titers in GBB and ME were relatively low. Antibody indices, calculated from titer values and Ig concentrations in CSF and serum, indicate intrathecal synthesis mainly of IgG- and IgA-AMA, and of IgG- and IgM-ABA. Participation of AMA in the pathogenesis of GBB may be envisaged, but needs further confirmation.

Chronic experimental autoimmune encephalomyelitis. Circulating autoantibodies bind predominantly determinants expressed by complexes of basic protein and lipids of myelin

Chronic relapsing experimental autoimmune encephalomyelitis (CREAE) was induced by immunising juvenile strain 13 guinea pigs with homologous spinal cord tissue in adjuvant. Thirteen animals were killed in the early chronic (5-12 weeks post immunisation) and 8 in the late chronic phase (after 15 weeks pi). Plasma titres of antibodies to an isolated myelin preparation were determined by enzyme linked immunoassay. Elevated titres of these antibodies were detected between 5-26 weeks pi, varied by 10-fold between different individuals, and had no direct relationship to clinical status or time pi. Of 20 CREAE plasma with anti-myelin immunoglobulins (Igs), only 3 contained substantial amounts of antibodies to myelin lipid and these were all from animals in the late chronic phase. By contrast 15/20 of the samples contained antibodies which appeared to require lipid-protein interactions for optimal binding to antigens in isolated myelin. There was a close correlation between plasma titres of antibodies to isolated myelin and to purified myelin basic protein (MBP). Even in samples with a moderately high lipid requirement for binding to isolated myelin, purified MBP could inhibit at least 50% of the binding. These observations suggest that MBP-lipid complexes are dominant immunogens in CREAE. Gross inflammation and myelin loss in spinal cords from these CREAE guinea pigs were determined by light microscopy. Substantial inflammation was apparent in some animals between 7 and 26 weeks pi. The most severe myelin loss was observed in late chronic phase animals having plasma anti-myelin Igs with a variety of specificities. The data suggest that circulating antibodies to myelin lipids or MBP-lipid complexes could contribute to demyelination in CREAE but their titres do not correlate with the extent of this process.

Severity of demyelination in vivo correlates with serum myelination inhibition activity in guinea pigs having a new form of experimental allergic encephalomyelitis

Guinea pigs received a suboptimal transfer of lymphocytes sensitized to myelin basic protein (BP) and were then immunized with guinea pig BP, BP plus chicken brain or chicken myelin, or chicken brain alone. Sera from these animals were tested for the presence of myelinotoxic antibodies, as detected by the myelination inhibition assay. Myelination inhibition activity correlated with the histologic severity of demyelination.

Chronic relapsing experimental allergic encephalomyelitis in the Lewis rat

Chronic relapsing experimental allergic encephalomyelitis (CR-EAE) was induced in rats with an emulsion of guinea-pig spinal cord tissue (GPSC) in complete Freund's adjuvant (CFA) enriched with Mycobacterium tuberculosis H37RA (Tbc). 78% of the sensitized rats developed a CR-EAE showing 2 to 3 clinical relapses during the first 40 days. After 60-80 days, approximately half of the rats with CR-EAE had a further relapse which was followed by complete recovery in only 35% of the cases. The remaining 65% of these animals showed a progressive state of the disease, characterized by paralysis or severe motor deficit, eventually leading to death. CR-EAE in rats showed some similarities to multiple sclerosis in man (MS) and it may be a useful model for the study of this disease.

In vitro synthesis of immunoglobulins and autoantibodies by lymphocytes from various body compartments during chronic relapsing experimental allergic encephalomyelitis

Mononuclear cells extracted from regional lymph nodes, blood, spleen and central nervous system of guinea pigs with chronic relapsing experimental allergic encephalomyelitis (r-EAE), adjuvant immunized and untreated controls were cultured for 16 h in microtitre plates, and culture supernatants were then used to measure IgG and IgM, as well as IgG class anti-myelin antibody production by enzyme-linked immunosorbent assays. Increased synthesis of these immunoglobulins and antibodies was found during the course of r-EAE both in intra- and extrathecal compartments. Long-term cultures carried out for 7 days gave similar results but anti-myelin, anti-myelin basic protein and IgG synthesis was most pronounced intrathecally. Agarose isoelectric focusing of supernatants from these cultures showed oligoclonal IgG. These findings indicate in vivo synthesis of autoantibodies within the target for immune attack and a partial sequestration of the immune response to this compartment.

Chronic relapsing EAE in guinea pigs: IgG index and oligoclonal bands in cerebrospinal fluid and sera

IgG and albumin levels were quantitated in cerebrospinal fluid (CSF) and sera from chronic relapsing (R)-EAE animals using the enzyme linked immunosorbent assay. The animals showed increased CSF IgG compared to that of age-matched animals injected with complete Freund's adjuvant. However, the CSF IgG index suggested no significant increase in IgG synthesis within the central nervous system of R-EAE animals. Matching CSF and sera from R-EAE animals, when compared in immunofixation after isoelectric focusing, showed identical oligoclonal IgG band patterns. Although the clinical and morphologic findings in R-EAE are similar to those seen in multiple sclerosis, the site of IgG synthesis in these two diseases appears to be different.

Relapsing experimental allergic encephalomyelitis. An autoimmune model of multiple sclerosis

R-EAE is a valuable model for human MS. Table 2 outlines the similarities between R-EAE and MS. The clinical course and pathologic changes seen in this model accurately reflect the pattern of MS. The immunologic changes seen in animals with R-EAE also are similar to those seen in MS. Therefore, the clinicopathologic features of MS can be duplicated with a purely autoimmune model. Although this is of considerable pathogenic significance in understanding MS, we do not know what the inciting event is in MS that would be the equivalent of immunizing an animal with neural antigen. Despite this, R-EAE has and should continue to provide experimental data of considerable importance to an understanding of the mechanisms involved in the evolution of inflammatory demyelination. Other important models of MS utilize viral-induced demyelination. Although the clinical picture of most of the chronic demyelinating viral infections does not show as clear a relapsing or remitting pattern as seen in R-EAE, viral etiologies better fit the epidemiology of MS [16]. Several studies have demonstrated development of an acute EAE-like disease with sensitization to neural antigens following viral infection [12, 30, 56]. Thus, one can hypothesize an initial viral illness causing sensitization of the host to a neural antigen (?MBP) with a subsequent immunopathogenic course similar to that seen in R-EAE. Whether this will in fact be the case remains unproven as yet. Our understanding of the immunopathogenic mechanisms underlying inflammatory demyelination has been enlarged through studies of R-EAE. It is now clear that the minimal myelin antigen necessary for production of the disease is MBP, although this may differ in some species. The relapsing nature of this disorder is mediated in part through lymphocytes, as demonstrated in transfer studies, and thus does not require persistent antigenic depots. There is a genetic susceptibility to development of the CNS autoimmune state, and we speculate that an as yet unidentified perturbation of the host immune system allows for the occurrence of relapsing disease (Table 3).

IgM and IgG responses during chronic relapsing experimental allergic encephalomyelitis (r-EAE)

During chronic relapsing experimental allergic encephalomyelitis (r-EAE) in guinea pigs, serum IgM and IgG concentrations increased markedly early in disease. Serum IgM and IgG increased similarly in control animals immunized with Freund's incomplete adjuvant (FIA) and Mycobacterium tuberculosis (MT). In the chronic phase of r-EAE but not in control animals, elevated IgM was also found in central nervous system (CNS) extracts, suggesting intrathecal IgM synthesis. IgG antibodies against myelin and myelin basic protein (MBP) were regularly detected in r-EAE sera from day 21 post inoculation (p.i.), reaching maximum levels in the early chronic phase. IgG antibodies against galactocerebroside (GC) and galactose appeared in some r-EAE sera. Oligoclonal IgG bands were demonstrated in all r-EAE guinea pig sera 21-26 days p.i. The bands in serum decreased in number and strength in the chronic phase. They could be traced to antibodies against MT in 4 of 10 animals, but not to antibodies against myelin, MBP, GC or galactose. Oligoclonal IgG bands were also regularly visualized in r-EAE CNS 124 days p.i., suggesting persistent intrathecal IgG synthesis. They varied in number and migration between different regions of individual CNS. Oligoclonal CNS IgG was related to antibodies against MT in only one of 7 animals, and in no case to antibodies against myelin.

Blood-brain barrier in chronic relapsing experimental allergic encephalomyelitis: a correlative study between cerebrospinal fluid protein concentrations and tracer leakage in the central nervous system

Blood-brain barrier (BBB) permeability in chronic relapsing experimental allergic encephalomyelitis was studied morphologically in tracer studies with horseradish peroxidase (HRP) as well as by quantitative determination of HRP, albumin, and IgG in serum and cerebrospinal fluid (CSF). BBB damage was found to be localized in demyelinating plaques and in blood vessels with vasculitis. Actively demyelinating lesions showed massive increase in BBB permeability, whereas in inactive or remyelinated lesions BBB damage was either minimal or absent. Determination of serum proteins in the CSF of animals with severe disease and a high incidence of actively demyelinating lesions showed evidence of BBB damage (reduction of Q-albumin) and an IgG-index in the normal range. In animals with only inactive lesions the Q-albumin was normal, the IgG index, however, was elevated. This finding indicates intrathecal IgG synthesis. A correlation between morphologically visualized tracer leakage in the central nervous system (CNS) with serum protein concentrations in the CSF revealed that elevated CSF albumin is a reliable indicator for BBB damage in lesions, located near the inner or outer surface of the brain and spinal cord. However, singular focal lesions with BBB damage located in the depth of the CNS parenchyma may not be accompanied by CSF protein alterations. The invariable presence of BBB damage in active inflammatory demyelinating lesions and its absence in inactive plaques or in the unaffected nervous tissue may be important in therapy, not only in experimental allergic encephalomyelitis but also in multiple sclerosis (MS).