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Experimental demyelination of nerve induced by serum of patients with neuropathy and an anti-MAG IgM M-protein

Departments of Pathology (Division of Neuropathology) (Drs. Hays and Takatsu), Neurology (Dr. Latov). and Medicine (Dr. Sherman), Columbia University, College of Physicians and Surgeons, New York, NY.

Demyelination of feline sciatic nerve was induced by intraneural injection of serum from three patients with neuropathy and an IgM M-protein that reacted with myelin-associated glycoprotein (MAG). Demyelimtion exceeded that induced by serum from 18 other individuals, including six IgM M-proteins unreactive with MAG. The myelholytic effect required active hurnan complement and was abolished by exposure of serum to homogenate o human peripheral nerve that removed 90% of the M-protein. Immunofluorescence studies demonstrated deposition of the injected M-protein and complement on the surface of myelin sheaths, implying that the M-protein reacted with epitopes of myelin exposed to the extracellular space.

Address correspondence and reprint requests to Dr. Hays, Division of Neuropathology. College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032.

Received October 23, 1985. Accepted for publication May 15, 1986.

Supported by a grant from the Muscular Dystrophy Association. Dr. Takatsu was a recipient of a fellowship from the Muscular Dystrophy Association.

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