Cellular Hypersensitivity to Basic Myelin (A1) Protein and Clinical Multiple Sclerosis

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Abstract
Cellular hypersensitivity to myelin basic (A1) protein in relation to clinical attacks of multiple sclerosis was investigated with the technic of macrophage-migration inhibition. Lymphocytes from 48 patients with multiple sclerosis and 24 normal controls were cultured in the presence of human central nervous system basic myelin protein and the culture supernatants assayed for migration-inhibition factor with normal guinea-pig peritoneal macrophages. The controls exhibited a mean (± S.D.) migration of 97 ± 9 per cent, and the patients one of 73.2 ± 16.5 per cent. Twelve patients suspected pected of having multiple sclerosis gave a mean of 73.8 ± 23 per cent. Thirteen with acute "probable" multiple sclerosis gave a mean migration of 61 ± 8.9 per cent, and 12 convalescent patients, one of 78.8 ± 8.3 per cent. Eleven chronic patients studied for six months or longer after their attacks gave a value of 90.9 ± 9 per cent. The results demonstrate a temporal relation between production of migration-inhibition factor (cellular hypersensitivity) to basic myelin protein and clinical attacks of illness in multiple sclerosis. (N Engl J Med 291:14–17, 1974)