School of Medicine

Multiple sclerosis (MS) is a chronic neurologic disease characterized by autoimmune destruction of myelin, a sheath-like material that insulates and protects nerve fibers. A significant portion of patients with MS experience severe chronic pain that is neuropathic in nature. Preclinical studies have recently demonstrated that a specific degradation product of myelin basic protein (MBP), one of the major targets of the autoimmune response in MS, is capable of producing neuropathic pain. In particular, MBP cryptic antigenic epitope, which is hidden in intact MBP, is exposed and released postnerve injury by the activity of matrix metalloproteinase 9 (MMP-9) and produces neuropathic pain. The purpose of our study is to determine if levels of the degradation product of MBP and antibodies against it correlate with the presence and severity of chronic neuropathic pain in patients with MS as well as to find out if levels of matrix metalloproteinase 9 in urine can be used as a marker of pain in MS patients.