BACKGROUND: African Americans (AAs) experience greater disability from multiple sclerosis (MS) compared with Caucasian Americans (CAs). Interethnic immunologic differences in MS and their relationship to disease-related disability have not been described. OBJECTIVE: To compare measures of CSF humoral immunity between AAs and CAs with MS. METHODS: Using a case-control design, all AA MS patients with CSF immune studies at the Washington University MS center were compared with randomly selected CAs with MS. Two CA controls were selected for every AA case. Immunoglobulin G (IgG) index and synthesis rates, oligoclonal band positivity, white blood cell count, and CSF protein were compared between groups. Survival analysis was conducted to compare times to ambulatory assistance. RESULTS: Sixty-six AA cases and 132 CA controls were identified. Measures of CSF humoral activity were all higher in the AA group. The mean IgG index of AAs was 1.35 (SD 0.62), and that of CAs was 1.05 (SD 0.55), for a mean difference of 0.30 (p = 0.001). The median IgG synthesis rate was also higher among AAs (13.55 vs 8.20 mg/day), for a median difference of 5.35 mg/day (p = 0.010). Survival analysis confirmed previous reports of earlier ambulatory assistance requirement among AAs. Despite differences in both humoral immune response and times to ambulatory assistance, Cox proportional hazards modeling did not show IgG index as predictive of earlier ambulatory assistance. CONCLUSIONS: The CSF humoral immune response is more active among African Americans (AAs) than among Caucasian Americans (CAs) with multiple sclerosis. AAs also progress to ambulatory assistance earlier than CAs, but high immunoglobulin G index does not predict earlier progression to the disability endpoint.
BACKGROUND: African Americans (AAs) experience greater disability from multiple sclerosis (MS) compared with Caucasian Americans (CAs). Interethnic immunologic differences in MS and their relationship to disease-related disability have not been described. OBJECTIVE: To compare measures of CSF humoral immunity between AAs and CAs with MS. METHODS: Using a case-control design, all AA MS patients with CSF immune studies at the Washington University MS center were compared with randomly selected CAs with MS. Two CA controls were selected for every AA case. Immunoglobulin G (IgG) index and synthesis rates, oligoclonal band positivity, white blood cell count, and CSF protein were compared between groups. Survival analysis was conducted to compare times to ambulatory assistance. RESULTS: Sixty-six AA cases and 132 CA controls were identified. Measures of CSF humoral activity were all higher in the AA group. The mean IgG index of AAs was 1.35 (SD 0.62), and that of CAs was 1.05 (SD 0.55), for a mean difference of 0.30 (p = 0.001). The median IgG synthesis rate was also higher among AAs (13.55 vs 8.20 mg/day), for a median difference of 5.35 mg/day (p = 0.010). Survival analysis confirmed previous reports of earlier ambulatory assistance requirement among AAs. Despite differences in both humoral immune response and times to ambulatory assistance, Cox proportional hazards modeling did not show IgG index as predictive of earlier ambulatory assistance. CONCLUSIONS: The CSF humoral immune response is more active among African Americans (AAs) than among Caucasian Americans (CAs) with multiple sclerosis. AAs also progress to ambulatory assistance earlier than CAs, but high immunoglobulin G index does not predict earlier progression to the disability endpoint.
Authors: An Goris; Ine Pauwels; Marte W Gustavsen; Brechtje van Son; Kelly Hilven; Steffan D Bos; Elisabeth Gulowsen Celius; Pål Berg-Hansen; Jan Aarseth; Kjell-Morten Myhr; Sandra D'Alfonso; Nadia Barizzone; Maurizio A Leone; Filippo Martinelli Boneschi; Melissa Sorosina; Giuseppe Liberatore; Ingrid Kockum; Tomas Olsson; Jan Hillert; Lars Alfredsson; Sahl Khalid Bedri; Bernhard Hemmer; Dorothea Buck; Achim Berthele; Benjamin Knier; Viola Biberacher; Vincent van Pesch; Christian Sindic; Annette Bang Oturai; Helle Bach Søndergaard; Finn Sellebjerg; Poul Erik H Jensen; Manuel Comabella; Xavier Montalban; Jennifer Pérez-Boza; Sunny Malhotra; Jeannette Lechner-Scott; Simon Broadley; Mark Slee; Bruce Taylor; Allan G Kermode; Pierre-Antoine Gourraud; Stephen J Sawcer; Bettina Kullle Andreassen; Bénédicte Dubois; Hanne F Harbo Journal: Brain Date: 2015-01-22 Impact factor: 13.501
Authors: Natalia Gonzalez Caldito; Shiv Saidha; Elias S Sotirchos; Blake E Dewey; Norah J Cowley; Jeffrey Glaister; Kathryn C Fitzgerald; Omar Al-Louzi; James Nguyen; Alissa Rothman; Esther Ogbuokiri; Nicholas Fioravante; Sydney Feldman; Ohemaa Kwakyi; Hunter Risher; Dorlan Kimbrough; Teresa C Frohman; Elliot Frohman; Laura Balcer; Ciprian Crainiceanu; Peter C M Van Zijl; Ellen M Mowry; Daniel S Reich; Jiwon Oh; Dzung L Pham; Jerry Prince; Peter A Calabresi Journal: Brain Date: 2018-11-01 Impact factor: 13.501
Authors: Ganesh M Babulal; Yakeel T Quiroz; Benedict C Albensi; Eider Arenaza-Urquijo; Arlene J Astell; Claudio Babiloni; Alex Bahar-Fuchs; Joanne Bell; Gene L Bowman; Adam M Brickman; Gaël Chételat; Carrie Ciro; Ann D Cohen; Peggye Dilworth-Anderson; Hiroko H Dodge; Simone Dreux; Steven Edland; Anna Esbensen; Lisbeth Evered; Michael Ewers; Keith N Fargo; Juan Fortea; Hector Gonzalez; Deborah R Gustafson; Elizabeth Head; James A Hendrix; Scott M Hofer; Leigh A Johnson; Roos Jutten; Kerry Kilborn; Krista L Lanctôt; Jennifer J Manly; Ralph N Martins; Michelle M Mielke; Martha Clare Morris; Melissa E Murray; Esther S Oh; Mario A Parra; Robert A Rissman; Catherine M Roe; Octavio A Santos; Nikolaos Scarmeas; Lon S Schneider; Nicole Schupf; Sietske Sikkes; Heather M Snyder; Hamid R Sohrabi; Yaakov Stern; Andre Strydom; Yi Tang; Graciela Muniz Terrera; Charlotte Teunissen; Debora Melo van Lent; Michael Weinborn; Linda Wesselman; Donna M Wilcock; Henrik Zetterberg; Sid E O'Bryant Journal: Alzheimers Dement Date: 2018-12-13 Impact factor: 21.566
Authors: Dorlan J Kimbrough; Elias S Sotirchos; James A Wilson; Omar Al-Louzi; Amy Conger; Darrel Conger; Teresa C Frohman; Shiv Saidha; Ari J Green; Elliot M Frohman; Laura J Balcer; Peter A Calabresi Journal: Ann Neurol Date: 2015-01-13 Impact factor: 10.422
Authors: Hanne F Harbo; Noriko Isobe; Pål Berg-Hansen; Steffan D Bos; Stacy J Caillier; Marte W Gustavsen; Inger-Lise Mero; Elisabeth Gulowsen Celius; Stephen L Hauser; Jorge R Oksenberg; Pierre-Antoine Gourraud Journal: Mult Scler Date: 2013-10-07 Impact factor: 6.312
Authors: C E Teunissen; A Petzold; J L Bennett; F S Berven; L Brundin; M Comabella; D Franciotta; J L Frederiksen; J O Fleming; R Furlan; R Q Hintzen; S G Hughes; M H Johnson; E Krasulova; J Kuhle; M C Magnone; C Rajda; K Rejdak; H K Schmidt; V van Pesch; E Waubant; C Wolf; G Giovannoni; B Hemmer; H Tumani; F Deisenhammer Journal: Neurology Date: 2009-12-01 Impact factor: 9.910
Authors: Jonathan Howard; Marco Battaglini; James Scott Babb; Donatello Arienzo; Brigitte Holst; Mirza Omari; Nicola De Stefano; Joseph Herbert; Matilde Inglese Journal: PLoS One Date: 2012-08-10 Impact factor: 3.240