亚低温对实验性脑出血大鼠病死率影响的实验研究

目的观察32℃亚低温对实验性脑出血大鼠24h内病死率和脑组织钙含量的影响。方法将134只大鼠分成两组:①68只大鼠用于病死率观察;②66只大鼠用于脑组织钙含量测定。两组再分成假手术对照组、常温脑出血组及亚低温脑出血组。结果常温组24h内病死率为36.7%,亚低温组为4.6%;脑组织钙含量常温组较对照组和亚低温组为高。结论亚低温治疗能减少脑出血后脑组织钙的增加,减少钙平衡失调,显著减少实验性脑出血大鼠24h内病死率。     

亚低温治疗对实验性大鼠脑出血的保护作用研究

目的　本文观察了３２ ℃亚低温对脑出血大鼠脑 Ｎａ＋ 、 Ｋ＋ 、水含量及超微结构的影响。方法　６６ 只大鼠随机分成三组： （１） 假手术对照组; （２） 常温脑出血组; （３） 亚低温脑出血组。结果常温出血组水、 Ｎａ＋ 含量随时间而增加, 而 Ｋ＋ 含量减少; 亚低温组水、 Ｎａ＋ 含量比常温组低, 而 Ｋ＋含量增加。超微结构显示亚低温组脑超微结构损害较常温组轻。结论　亚低温治疗对脑出血后脑水肿, 脑细胞结构有保护作用。     

头部局部亚低温对实验性脑出血大鼠脑组织TNF-α、NF-κB影响的研究

目的 建立大鼠实验性脑出血(1CH)模型,研究头部局部亚低温对大鼠脑组织炎性细胞因子和核转录因子-κB(NF-κB)表达的影响,从而探讨头部局部亚低温的脑保护作用.方法 选用Wistar大鼠,采用大鼠脑内缓慢注入非肝素化自体血的方法,建立实验性ICH动物模型.随机分为亚低温组、常温组、假手术组.亚低温组在建立模型后立即应用头部局部亚低温治疗48h.48h后用HE染色法观察实验组与对照组脑组织的病理变化,用免疫组化法研究肿瘤坏死因子-α (TNF-α)、NF-κB在各组表达的差异.结果 成功地建立了大鼠实验性ICH模型.ICH后48h,亚低温组血肿周围炎细胞较常温组显著减少,脑组织水肿明显轻于常温组,胶质细胞反应较轻,周围小血管出血现象轻于常温组.常温组血肿周围及注血侧皮质、胼胝体、脉络丛内TNF-α、NF-κB表达较假手术组明显增多(P＜0.01),亚低温组的表达较常温组有显著减少(P＜0.05).结论 (1)大鼠脑内缓慢注入非肝素化自体血,可建立可靠、重复性好的实验性ICH动物模型.(2)大鼠ICH急性期脑组织内NF-κB和前炎性细胞因子TNF-α显著增加.(3)头部局部亚低温治疗可以抑制大鼠ICH后脑组织TNF-α和NF-κB的表达.(4)头部局部亚低温治疗在抑制实验性ICH炎症反应方面的脑保护作用与它抑制NF-κB的表达有关.     

亚低温对局灶性脑缺血大鼠模型C3表达的影响

目的观察亚低温（32～35℃）对局灶性脑缺血后大鼠脑组织C3表达的影响。方法 100只大鼠随机分成假手术组、常温组和亚低温组,各组根据观察时间点分为术后6h、1d、2d、3d、7d五个亚组。建立大鼠左侧大脑中动脉闭塞（MCAO）模型,应用冰袋降温的方法使亚低温组大鼠肛温10min内降至（33℃±1℃）,维持低温6h后复温。假手术组和常温组大鼠保持肛温（37℃±0.5℃）。在各时间点采用神经缺陷评分对各大鼠进行神经功能评分后断头取脑,行苏木素伊红染色观察脑缺血病理学改变,免疫组织化学染色观察不同时间点C3表达情况。结果假手术组大鼠清醒后无神经功能障碍,常温组及亚低温组大鼠清醒后均出现左侧Horner征及不同程度右侧前肢为重的偏瘫,两组大鼠神经功能缺损3d时最明显,7d时均有所减轻。除6h外各时间点亚低温组大鼠神经功能缺损评分均较常温组低（P〈0.05）,各时间点亚低温组大鼠脑组织病理学损伤较常温组轻。在各时间点假手术组大鼠脑组织中C3可见少许表达,各组间比较差异无统计学意义（P〉0.05）。常温组和亚低温组大鼠缺血侧脑组织于缺血后6h补体C3阳性细胞数均开始增加,至3d均达到高峰,到7d时C3阳性细胞数明显减少,与常温组相比,亚低温组各时间点缺血侧脑组织C3表达明显减少（P〈0.05）。结论脑缺血时,缺血侧脑组织C3有表达,亚低温可使C3表达减少。亚低温可能通过降低C3的表达减轻补体级联反应起脑保护作用。     

局部亚低温对脑出血后水肿影响的实验研究

目的探讨局部亚低温对大鼠脑出血后水肿形成的影响及其可能机制。方法雄性Wistar大鼠230只随机分为:对照组;脑出血组;脑出血加局部亚低温组;凝血酶加局部亚低温组。应用Evans-Blue测定血脑屏障(BBB)通透性,应用干湿重法测定脑水含量。结果与对照组相比,大鼠注血后6h开始出现脑组织水含量和BBB通透性的增加,在72h达到高峰,然后逐渐消退。不同时程局部亚低温均可以显著降低脑出血后72h时脑组织水含量及BBB通透性(P<0.01),其中给以4h局部亚低温时,降低最明显。注射凝血酶6h后,脑组织水含量及BBB通透性显著增高(P<0.01),于24~48h达高峰,然后逐渐下降。凝血酶 局部亚低温组在各个时间点与凝血酶组相比,脑组织水含量及BBB通透性明显降低(P<0.01)。结论局部亚低温可能是通过抑制凝血酶的毒性作用来减轻脑出血后水肿的形成及血脑屏障的破坏。     

亚低温治疗对高血压脑出血后水通道蛋白-4表达的影响

目的探讨亚低温治疗对大鼠高血压脑出血后血肿周围脑组织水通道蛋白-4（AQP-4）表达的影响。方法将制成高血压脑出血模型的大鼠随机分为亚低温治疗组（40只）和常温对照组（10只）,其中治疗组又根据从发病至亚低温治疗的时间间隔分为2、4、8、12h四个亚组,每亚组10只动物。大体观察动物行为学变化,3d后处死动物取脑组织进行脑含水量测定（干湿重法）及AQP-4表达的测定。结果对照组的脑含水量为（89．16±0．48）％,治疗组中出血后2h、4h和8h三个亚组的脑含水量分别为（81．42±0．58）％、（83．86±0．28）％和（86．95±0．29）％,与对照组相比有显著性差异（P〈0．05）,而出血后12h亚组的含水量与对照组相比无显著性差异（P〉0．05）。对照组AQP-4的表达（以吸光度表示）明显高于出血后2h、4h及8h三个亚组（P〈0．05）,与出血后12h亚组相比无显著差别（P〉0．05）。结论本研究提示高血压脑出血后早期应用亚低温治疗可以下调AQP-4的表达,并可有效控制脑水肿的发生。     

亚低温对大鼠脑缺血再灌注后MMP-9表达和脑水肿的影响

目的通过研究亚低温对大鼠局灶性脑缺血再灌注后基质金属蛋白酶-9（MMP-9）表达和脑水肿的影响，探讨亚低温脑保护的可能机制。方法雄性SD大鼠72只，随机分为假手术组、亚低温组、常温组，线栓法制备大脑中动脉闭塞（MCAO）再灌注48h模型，缺血时间2h。采用比色法测定脑组织中伊文思蓝（EB）含量反映血脑屏障（BBB）通透性；干-湿重法检测脑组织含水量；免疫组化法检测MMP-9表达。结果与假手术组相比，缺血鼠缺血侧脑组织的EB含量及脑含水量明显增高，可见大量MMP-9免疫阳性细胞（P〈0．05）。亚低温组和常温组大鼠脑EB含量分别为（22．42±1．86）μg/g脑重和（38．67±2．94）μg／g脑重，脑含水量分别为80．07％±0．56％和82．49％±0．97％，皮质缺血区MMP-9阳性细胞IOD值分别为380．33±40．87和695．16±67．67，纹状体区MMP-9阳性细胞IOD值分别为294．19±33．47和451．87±5．77，差异均有显著性意义（P〈0．05）。亚低温明显减轻缺血脑组织病理学损伤。结论推测亚低温可通过抑制MMP-9表达，减轻BBB的破坏，继而减轻脑水肿，从而发挥确实的脑保护作用。     

亚低温对大鼠脑缺血再灌注损伤后热休克蛋白70及胶质纤维酸性蛋白表达的影响

目的观察亚低温对大鼠脑缺血再灌注损伤后热休克蛋白70(HSP70)及胶质纤维酸性蛋白(GFAP)表达的影响。方法将雄性Wistar大鼠30只分为假手术组、常温组和亚低温组。制作右侧大脑中动脉阻塞(MCAO)模型,观察缺血2h再灌注48h后各组大鼠脑组织学改变和HSP70及GFAP的表达。结果常温组大鼠脑皮质下神经元严重坏死,亚低温组皮质下神经元坏死严重程度明显较常温组轻,假手术组未见神经元坏死。常温组大鼠脑组织GFAP和HSP70阳性细胞较多,假手术组、亚低温组GFAP和HSP70阳性细胞少于常温组,假手术组偶见HSP70阳性细胞;图像分析显示,常温组大鼠脑组织GFAP、HSP70表达的平均光密度较假手术组和亚低温组明显增高(均P<0.01)。结论亚低温能减轻大鼠脑缺血再灌注损伤,降低脑组织HSP70及GFAP蛋白的表达。     

亚低温对大鼠脑缺血再灌注损伤的保护研究

目的观察亚低温对大鼠全脑缺血再灌注后海马CAI区神经元凋亡的影响,探讨亚低温对缺血再灌注脑损伤的保护作用。方法SD大鼠30只随机分为对照组（n=10）,常温缺血组（n=10）,亚低温组（n=10）,采用改良的Pulsinelli-Brierley4血管法建立全脑缺血再灌注动物模型,缺血30min后再灌注72h,尼氏体染色观察海马区存活锥体细胞数,TUNEL法检测缺血后海马CAI区神经元凋亡情况,电镜下观察神经细胞形态学改变。结果与对照组比较,常温缺血组的海马CAI区存活的锥体细胞数目减少（P〈0.01）;与常温缺血组比较,亚低温组海马CAI存活的锥体细胞数目明显增多（P〈0.01）。对照组、亚低温组的海马CAI区神经元凋亡数目和凋亡指数明显低于常温缺血组。在电镜下观察亚低温能明显减轻缺血后脑组织病理形态学的损害程度。结论亚低温可以抑制脑缺血再灌注后的神经细胞凋亡,对神经细胞有保护作用。     

局部亚低温对大鼠脑出血后血红素氧合酶1表达的影响

目的观察局部亚低温对大鼠自体血注入法脑出血模型血红素氧合酶(HO-1)表达的影响,探讨局部亚低温减轻脑出血后脑水肿的可能机制。方法雄性Wistar大鼠120只,随机分为脑出血(control)组和脑出血加局部亚低温(LMH)组。每组分为对照和脑出血后6h、24h、72h,5d、7d共6个亚组,亚低温组于注血后给予4h的局部亚低温治疗,应用Evans-blue测定血脑屏障(BBB)通透性,应用干湿重法测定脑水含量以及应用免疫组化对血肿周围脑组织HO-1的表达进行测定。结果对照组大鼠脑组织含水量、BBB通透性以及HO-1表达的增加始于脑出血后6h均至72h达高峰。HO-1表达的变化与脑血肿周围组织水含量的变化成呈正相关(r=0.79)。LMH组的脑组织水含量、BBB通透性和HO-1各时间点与对照组相比明显下降。结论脑出血后红细胞的破坏可以导致HO-1表达上升。局部亚低温可抑制脑出血后HO-1表达,减轻血脑屏障完整性的破坏,减轻脑出血后脑水肿形成。     

多发性硬化症髓鞘素组分特异性抗体分泌细胞

本文用酶联免疫斑点法（Ｅｌｉｓｐｏｔ）检测了２３例临床确诊多发性硬化症（ＭＳ）和１２例无菌性脑膜炎（ＡＭ）患者外周血（ＰＢ）和脑脊液（ＣＳＦ）中髓鞘素碱性蛋白（ＭＢＰ）、髓鞘素结合糖蛋白（ＭＡＧ）和含脂质蛋白（ＰＬＰ）特异性ＩｇＧ抗体分泌细胞。两组患者ＣＳＦ中该３种抗体分泌细胞均呈明显增多趋势，ＭＳ组尤著，但两组ＰＢ中该类细胞数均很少。指示对髓鞘素组分的Ｂ细胞免疫应答主要局限于与中枢神经系统（ＣＮ     

Cell-mediated immunity to myelin-associated glycoprotein, proteolipid protein, and myelin basic protein in multiple sclerosis

Peripheral blood lymphocytes (PBL) from active and stable multiple sclerosis (MS) patients, patients with other neurologic diseases (OND), and control subjects were tested for sensitization to two myelin antigens not previously examined in multiple sclerosis, using a [3H]thymidine incorporation assay. The antigens investigated were myelin-associated glycoprotein (MAG) and proteolipid protein (PLP). In addition, sensitization to myelin basic protein (MBP) was also tested. Lymphocyte stimulation indices in active MS patients that were greater than 2 standard deviations above controls were as follows: 9/30 for MAG, 0/17 for PLP, and 8/81 for MBP. No control subjects responded to MAG or PLP, and only 1/29 control subjects responded to MBP. Three of the patients that responded to MAG also responded to MBP. Although the mean proliferative response to MAG and to MBP was greater in the population of active MS patients than in stable MS, ONDs, or controls, the difference was not statistically significant. The OND group was the only population which proliferated to PLP (6/16). The only statistically significant differences among the groups for all myelin antigens tested were the proportion of individuals with active MS vs. controls that responded to MAG (P less than 0.05), and OND vs. controls and active MS that responded to PLP (P less than 0.025). The greatest individual responses to the three antigens tested were to MBP in active MS patients. Elimination of the T8 (cytotoxic/suppressor) subset amplified the responses to myelin antigens in some patients and ONDs studied. These studies have demonstrated reactivity to MAG but not PLP in some patients with active MS, and reactivity to PLP in some patients with other neurologic diseases.     

Autoimmune T cell repertoire in optic neuritis and multiple sclerosis: T cells recognising multiple myelin proteins are accumulated in cerebrospinal fluid.

Monosymptomatic unilateral optic neuritis is a common first manifestation of multiple sclerosis. Abnormal T cell responses to myelin components including myelin basic protein (MBP), proteolipid protein (PLP), and myelin-associated glycoprotein (MAG) have been implicated in the pathogenesis of multiple sclerosis. Antigen-reactive T helper type 1 (Th1)-like cells that responded by interferon gamma (IFN-gamma) secretion on antigen stimulation in vitro were counted. Untreated patients with optic neuritis and multiple sclerosis had similarly raised levels of T cells recognising MBP, PLP, and MAG in peripheral blood. Such T cells were strongly enriched in CSF. None of these myelin antigens functioned as immunodominant T cell antigen characteristic for optic neuritis or multiple sclerosis. The autoimmune T cell repertoire was not more restricted in optic neuritis (as an example of early multiple sclerosis). The autoreactive T cell repertoires differed in blood compared with CSF in individual patients with optic neuritis and multiple sclerosis. No relations were found between specificity or quantity of autoreactive T cells in blood or CSF, and clinical variables of optic neuritis or multiple sclerosis, or occurrence of oligoclonal IgG bands in CSF. The role of raised MBP, PLP, and MAG reactive Th1-like cells found in optic neuritis and multiple sclerosis remains unexplained.     

Clues to the immunopathogenesis of multiple sclerosis by investigating untreated patients during the very early stage of disease

Plethora of abnormalities of the immune system has been described in multiple sclerosis (MS). They include a number of myelin antigens (e. g. MBP, MOG, PLP, MAG), the presence of reactive T cells in blood and, further enriched, in the cerebrospinal fluid (CSF), large numbers of B cells in the CSF secreting antibodies of multiple but unknown specificities, an increase of mononuclear cells (MNC) expressing and secreting both pro- and anti-inflammatory cytokines, including Th1 cytokines interferon-gamma (IFN-γ) and interleukin (IL)-6, the Th2 related IL-4 and IL-10, and the Th3-driven TGF-β, elevated numbers of MNC in both blood and CSF expressing a spectrum of metalloproteinases and their inhibitors, as well as many other aberrations. However, no consistent patterns have emerged that relate any of these findings to clinical variables such as exacerbations, during of disease, disability, or lesions in the central nervous system (CNS) detected at magnetic resonance imaging. In order to elucidate the relevance of these immunological abnormalities in the pathogenesis of MS, my colleagues and I studied patients with acute monosymptomatic optic neuritis (ON) and compared them with patients with clinically definite MS (CDMS). The patients have not been treated and have not received corticosteroids or interferon-β. When comparing these two groups, we were unable to identify any differences in any of the variables mentioned. Thus, very early MS, as represented by ON, shows the same full-blown pattern of immunological abnormalities seen in CDMS. Furthermore, a complete epitope spread affecting MBP, MOG, PLP, MAG and other myelin components is already present in ON. Whether any of these alterations play a pathogenetic role is still unsettled.     

Frequency of T cells specific for myelin basic protein and myelin proteolipid protein in blood and cerebrospinal fluid in multiple sclerosis

T cell sensitization to two myelin components, myelin basic protein (MBP) and myelin proteolipid protein (PLP), may be important to the pathogenesis of multiple sclerosis (MS). Using the limiting dilution assay, we demonstrated that the blood of MS patients had an increased frequency of MBP-reactive T cells compared with normal subjects and patients with other neurological diseases (OND) and rheumatoid arthritis. There was no difference in T cell frequency to a synthetic peptide, PLP139-151, or Herpes simplex virus. Within cerebrospinal fluid (CSF), 37% of IL-2/IL-4-reactive T cell isolates from MS patients responded either to MBP or PLP139-151 while only 5% of similar isolates from OND patients responded to these myelin antigens. The mean relative frequency of MBP-reactive T cells within CSF from MS patients was significantly higher than that of OND patients (22 x 10(-5) cells versus 1 x 10(-5) cells) and was similar to that of MBP reactive T cells within the central nervous system of rats with experimental autoimmune encephalomyelitis. These results lend new support to the hypothesis that myelin-reactive T cells mediate disease in MS.     

Binding properties of cerebrospinal fluid IgG in multiple sclerosis and other neurological diseases

A solid phase radioimmunoassay (RIA) was used to detect antibodies to myelin or myelin basic protein (MBP) in the cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) or other neurological diseases (OND). When measured at the same IgG concentration, MS samples had higher binding values than OND against myelin, but not against MBP. Using F(ab')2 fragments purified from pools of MS and OND CSF there was no difference in binding to myelin between MS and OND samples. These results indicate that anti-MBP antibodies are nt a feature of MS and binding of CSF IgG to myelin is not due to specific antibody, but is probably the result of non-specific binding to Fc receptors.     

Human muscle acetylcholine receptor reactive T and B lymphocytes in the peripheral blood of patients with myasthenia growth

The prevalence of T and B cells reactive with the acetylcholine receptor (AChR) of human skeletal muscle was studied in 33 patients with myasthenia gravis (MG), 18 patients with other neurological diseases (OND) or autoimmune disorders (AD) and 27 age- and sex-matched healthy controls. T cell stimulation was estimated by enumerating cells secreting interferon (IFN)-γ and interleukin (IL)-2 in response to the AChR, whereas B cell reactivity was estimated by enumerating cells secreting IgG antibodies binding to the AChR. AChR-reactive T cells were increased in the peripheral blood of patients with MG as compared to patients with OND, AD and healthy individuals. Of the patients with MG, 29/33 (87.7%) had numbers of IFN-γ secreting cells higher than the mean ± 2 SD of the mean of controls as compared to 4/18 (22.2%) of patients with OND or AD and 2/27 (7.4%) of the controls. The mean value of the numbers of AChR-reactive T cells in the patients with MG was 19.6/10⁵ PBMC, corresponding to 1/5100 PBMC. Comparable results were obtained also for IL-2-secreting cells. Anti-AChR IgG antibody-secreting cells were detected in the blood of 30/33 (91%) of the patients with MG, 3/18 (16.7%) of the patients with OND or AD and 2/25 (8%) of the controls. The mean value of the antibody-secreting cells in MG was 11.7 cells/10⁶ PBMC corresponding to 1/70400 PBMC in the patients with MG, compared to a mean value of antibody-secreting cells in the patients with OND or AD of 0.33 and controls of 0.16 cells/10⁶ PBMC.     

Immunoglobulin producing cells in bone marrow and blood of patients with multiple sclerosis and controls.

Multiple sclerosis (MS) is characterised by intrathecal synthesis of IgG, less frequently of IgA and IgM. Local production of antibodies to myelin basic protein (MBP) and other myelin components has also been reported, and autoimmune pathogenesis has been postulated. Whether MS is accompanied by a systemic B cell response is less clear. To elucidate this question, we examined bone marrow and peripheral blood from patients with MS and controls for cells secreting IgG, IgA and IgM, as well as anti-MBP antibodies of these three isotypes. Patients with MS without any signs of concurrent infections had higher numbers of IgG + IgA + IgM secreting cells both in bone marrow and peripheral blood compared with healthy controls. The same abnormalities were observed in patients with other inflammatory neurological diseases (OIND). When analysing individual isotypes, patients with MS and OIND had higher numbers of IgA secreting cells both in bone marrow and blood compared with healthy controls. Only one of 13 MS patients examined had anti-MBP antibody secreting cells in bone marrow and blood. The systemic B cell response registered in MS is also present in other inflammatory neurological diseases and its specificity and possible role in the pathogenesis of MS remains unknown.     

Humoral antibodies in immune mediated neuropathy

Immune mediated neuropathy includes acute inflammatory demyelinating polyneuropathy (AIDP), chronic inflammatory demyelinating neuropathy (CIDN), paraproteinemic polyneuropathy (PPN) and Crow-Fukase syndrome (CFS). Serum antibodies as humoral immunity in patients with immune mediated neuropathy were measured by the method of immunoblots and ELISA. P0 protein, P2 protein, 170K-Mr glycoprotein and ganglioside (GGD) of human peripheral nerve myelin and MBP, myelin associated glycoprotein (MAG) of human central nerve myelin were used as antigens. In AIDP anti P2 antibodies were elevated significantly. However, anti MBP antibodies were also elevated in parallel. In PPN anti MAG antibodies were detected in 4 patients with IgM-M proteinemia and demyelinating neuropathy. High titers of anti MAG antibodies were also detected in the same 4 patients. Characteristic pathological findings of biopsied sural nerve were segmental demyelination with widening of the intraperiod line of the outer myelin lamella in all 4 patients. Positive rate of anti myelin antibodies were 23% in 23 cases with PPN. Anti 170K-Mr glycoprotein was detected only in one patient with IgM-M proteinemia, polyneuropathy and incurable dermatitis. Anti GGD antibodies were not detected in PPN or CFS. A few patients with GBS or CIDN have anti GGD antibodies in ELISA. It is well known that various antibodies to peripheral nerve myelin are detected in neuropathy, especially demyelinating state. The most important antigen established in this study in the pathogenesis of neuropathy is MAG. IgM monoclonal protein including anti MAG antibodies was absorbed by purified MAG completely. Anti 170K Mr glycoprotein was also absorbed by purified 170K-Mr glycoprotein. Role of humoral antibody to peripheral nerve myelin specific 170K-Mr glycoprotein remains to be solved.     

CSF antibodies to myelin basic protein and to myelin-associated glycoprotein in multiple sclerosis. Evidence of the intrathecal production of antibodies

Cerebrospinal fluid (CSF) from 40 multiple sclerosis (MS) patients was tested by solid-phase radioimmunoassay (RIA) for ability to bind 2 common structural components of myelin and oligodendroglia, i.e., to bind myelin basic protein (MBP) and myelin-associated glycoprotein (MAG). To prevent the effect of differences in CSF IgG concentration on binding activity, the CSF samples were tested at equal IgG concentration 1 mg/ml. The mean binding activity to MBP and MAG was significantly higher than in control neurotics, respectively P less than or equal to 0.05 and P less than or equal to 0.001. In 33% of MS cases, CSF antibody against both antigens was found. Indirect data were obtained that autoantibodies whose antigens are associated with myelin-oligodendrocyte unit are produced locally within the central nervous system (CNS). Anti-MAG and anti-MBP CSF antibody activity was significantly higher, P less than or equal to 0.01 for both antibody specificity, in MS cases characterized by high IgG Index, greater than or equal to 0.70 = means + SD in the neurotic group, versus MS cases characterized by normal IgG Index (less than or equal to 0.70). Correlation coefficient between antibody activity and IgG Index values was 0.785 for anti-MBP antibody, and 0.400 for anti-MAG antibody. The importance of intrathecally produced antibody to MBP and MAG lies in the fact that it indicates an active humoral autoimmune process against a myelin-oligodendrocyte unit in which more than one autoantigen is involved.