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Sádaba MC, Rothhammer V, Muñoz Ú, Sebal C, Escudero E, Kivisäkk P, Garcia Sanchez MI, Izquierdo G, Hauser SL, Baranzini SE, Oksenberg JR, Álvarez-Lafuente R, Bakshi R, Weiner HL, Quintana FJ. Serum antibodies to phosphatidylcholine in MS. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:e765. [PMID: 32518205 PMCID: PMC7309529 DOI: 10.1212/nxi.0000000000000765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/09/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the value of serum immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies reactive with phosphatidylcholine (PC) and lactosylceramide (LC) as biomarkers in MS. METHODS We developed an ultrasensitive ELISA technique to analyze serum IgG and IgM antibodies to LC and PC, which we used to analyze samples from 362 patients with MS, 10 patients with non-MS myelin diseases (Non-MSMYDs), 11 patients with nonmyelin neurologic diseases (Non-MYNDs), and 80 controls. MS serum samples included clinically isolated syndrome (CIS, n = 17), relapsing-remitting MS (RRMS, n = 62), secondary progressive MS (SPMS, n = 50), primary progressive MS (PPMS, n = 37), and benign MS (BENMS, n = 36). RESULTS We detected higher levels of serum IgM antibodies to PC (IgM-PC) in MS than control samples; patients with CIS and RRMS showed higher IgM-PC levels than patients with SPMS, PPMS, and BENMS and controls. MS and control samples did not differ in serum levels of IgM antibodies reactive with LC, nor in IgG antibodies reactive with LC or PC. CONCLUSIONS Serum IgM-PC antibodies are elevated in patients with MS, particularly during the CIS and RRMS phases of the disease. Thus, serum IgM-PC is a candidate biomarker for early inflammatory stages of MS. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that serum antibodies to PC are elevated in patients with MS. The study is rated Class III because of the case control design and the risk of spectrum bias: antibody levels in patients with MS were compared with healthy controls.
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Affiliation(s)
- Maria Cruz Sádaba
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA.
| | - Veit Rothhammer
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Úrsula Muñoz
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Cristina Sebal
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Esther Escudero
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Pia Kivisäkk
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Maria Isabel Garcia Sanchez
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Guillermo Izquierdo
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Stephen L Hauser
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Sergio E Baranzini
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Jorge R Oksenberg
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Roberto Álvarez-Lafuente
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Rohit Bakshi
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Howard L Weiner
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA
| | - Francisco J Quintana
- From the Ann Romney Center for Neurologic Diseases (M.C.S., V.R., P.K., R.B., H.L.W., F.J.Q.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Facultad de Medicina (M.C.S., U.M., C.S., E.E.), Instituto de Medicina Molecular Aplicada (INMA), Universidad San Pablo-CEU, CEU Universities, Madrid; Molecular Biology Service and MS Unit (M.I.G.S., G.I.), University of Sevilla; Department of Neurology (S.L.H., S.E.B., J.R.O.), University of California, San Francisco; Instituto de Investigación Sanitaria San Carlos (IdISSC) (R.Á.-L.), Hospital Clínico San Carlos, Madrid, Spain; and The Broad Institute of Harvard and MIT (F.J.Q.), Cambridge, MA.
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