Abstract
Free and bound levels of myelin basic protein (MBP) and anti–myelin basic protein (anti‐MBP) antibodies were measured by radioimmunoassay in the cerebrospinal fluid of patients with multiple sclerosis who were experiencing acute exacerbations or progressing disease. In a cross‐sectional study, free levels of MBP correlated with those of free anti‐MBP, and bound MBP levels correlated with those of bound anti‐MBP in both groups of patients with active disease. However, acute exacerbations of multiple sclerosis were characterized by higher free MBP and anti‐MBP levels with lower levels of bound fractions. Conversely, patients with progressing disease had higher titers of bound than free fractions. Longitudinal studies of individual patients confirmed the association of higher titers of free anti‐MBP with acute exacerbations and higher levels of bound anti‐MBP with chronic progressing disease.