Myelin associated antibodies

Myelin proteins-myelin basic protein, proteolipid protein and myelin-associated glycoprotein-are trans-membrane proteins important for the normal myelination process exerted by oligodendrocytes and Schwann cells in the central and peripheral nervous systems, respectively. These myelin proteins have important roles associated with the compact myelin structure, nerve signaling through myelinated axons and integrity of the axon-myelin interactions. Antibodies to myelin proteins are associated with demyelinative diseases, such as multiple sclerosis and peripheral neuropathy. This chapter summarizes the current information related to antibodies to these myelin proteins, and the clinical and immunological significance of these antibodies in relation to human diseases from both the diagnostic and therapeutic aspects. Therapeutic reduction of anti-myelin-associated glycoprotein (MAG) IgM levels correlates with the improvement of the neuropathy using plasma exchange or immunosuppressive drugs. Patients with anti-MAG antibodies were also reported to respond to agents such as rituximab or fludarabine that lower IgM antibody concentration, but not to corticosteroids that primarily affect T-cells and are particularly effective in T-cell-induced neuropathies like CIDP.