<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article article-type="research-article" dtd-version="2.3" xml:lang="EN" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Chem.</journal-id>
<journal-title>Frontiers in Chemistry</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Chem.</abbrev-journal-title>
<issn pub-type="epub">2296-2646</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">885180</article-id>
<article-id pub-id-type="doi">10.3389/fchem.2022.885180</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Chemistry</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Role of Helical Structure in MBP Immunodominant Peptides for Efficient IgM Antibody Recognition in Multiple Sclerosis</article-title>
<alt-title alt-title-type="left-running-head">Sta&#x15b;kiewicz et al.</alt-title>
<alt-title alt-title-type="right-running-head">MBP Peptides for Antibody Recognition</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Sta&#x15b;kiewicz</surname>
<given-names>Agnieszka</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1251610/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Quagliata</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Real-Fernandez</surname>
<given-names>Feliciana</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1489035/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Nuti</surname>
<given-names>Francesca</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1694653/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lanzillo</surname>
<given-names>Roberta</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/865890/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Brescia-Morra</surname>
<given-names>Vincenzo</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rusche</surname>
<given-names>Hendrik</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jewginski</surname>
<given-names>Michal</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/651722/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Carotenuto</surname>
<given-names>Alfonso</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Brancaccio</surname>
<given-names>Diego</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Aharoni</surname>
<given-names>Rina</given-names>
</name>
<xref ref-type="aff" rid="aff7">
<sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Arnon</surname>
<given-names>Ruth</given-names>
</name>
<xref ref-type="aff" rid="aff7">
<sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rovero</surname>
<given-names>Paolo</given-names>
</name>
<xref ref-type="aff" rid="aff8">
<sup>8</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/136663/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Latajka</surname>
<given-names>Rafal</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/679437/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Papini</surname>
<given-names>Anna Maria</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/140768/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology</institution>, <institution>Department of Chemistry &#x201c;Ugo Schiff&#x201d;</institution>, <institution>University of Florence</institution>, <addr-line>Sesto Fiorentino</addr-line>, <country>Italy</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Bioorganic Chemistry</institution>, <institution>Faculty of Chemistry</institution>, <institution>Wroclaw University of Science and Technology</institution>, <addr-line>Wroclaw</addr-line>, <country>Poland</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Multiple Sclerosis Clinical Care and Research Centre</institution>, <institution>Department of Neurosciences</institution>, <institution>Reproductive Sciences and Odontostomatology</institution>, <institution>University of Naples &#x201c;Federico II&#x201d;</institution>, <addr-line>Naples</addr-line>, <country>Italy</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Fischer Analytics GmbH</institution>, <addr-line>Weiler</addr-line>, <country>Germany</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>CY PeptLab Platform of Peptide and Protein Chemistry and Biology and UMR 8076 CNRS-BioCIS</institution>, <institution>CNRS</institution>, <institution>CY Cergy Paris Universit&#xe9;</institution>, <addr-line>Neuville sur Oise</addr-line>, <country>France</country>
</aff>
<aff id="aff6">
<sup>6</sup>
<institution>Department of Pharmacy</institution>, <institution>University of Naples &#x201c;Federico II&#x201d;</institution>, <addr-line>Naples</addr-line>, <country>Italy</country>
</aff>
<aff id="aff7">
<sup>7</sup>
<institution>Department of Immunology</institution>, <institution>The Weizmann Institute of Science</institution>, <addr-line>Rehovot</addr-line>, <country>Israel</country>
</aff>
<aff id="aff8">
<sup>8</sup>
<institution>Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology</institution>, <institution>Department of NeuroFarBa</institution>, <institution>University of Florence</institution>, <addr-line>Sesto Fiorentino</addr-line>, <country>Italy</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/22879/overview">John D. Wade</ext-link>, University of Melbourne, Australia</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/608215/overview">Mark Del Borgo</ext-link>, Monash University, Australia</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1013419/overview">Michele Saviano</ext-link>, Institute of Crystallography, National Research Council (IC-CNR), Italy</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Anna Maria Papini, <email>annamaria.papini@unifi.it</email>
</corresp>
<fn fn-type="other">
<p>This article was submitted to Chemical Biology, a section of the journal Frontiers in Chemistry</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>20</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>10</volume>
<elocation-id>885180</elocation-id>
<history>
<date date-type="received">
<day>27</day>
<month>02</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>26</day>
<month>05</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2022 Sta&#x15b;kiewicz, Quagliata, Real-Fernandez, Nuti, Lanzillo, Brescia-Morra, Rusche, Jewginski, Carotenuto, Brancaccio, Aharoni, Arnon, Rovero, Latajka and Papini.</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Sta&#x15b;kiewicz, Quagliata, Real-Fernandez, Nuti, Lanzillo, Brescia-Morra, Rusche, Jewginski, Carotenuto, Brancaccio, Aharoni, Arnon, Rovero, Latajka and Papini</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>The involvement of Myelin Basic Protein (MBP) in Multiple Sclerosis (MS) has been widely discussed in the literature. This intrinsically disordered protein has an interesting &#x3b1;-helix motif, which can be considered as a conformational epitope. In this work we investigate the importance of the helical structure in antibody recognition by MBP peptides of different lengths. Firstly, we synthesized the peptide MBP (81&#x2013;106) (1) and observed that its elongation at both N- and C-termini, to obtain the peptide MBP (76&#x2013;116) (2) improves IgM antibody recognition in SP-ELISA, but destabilizes the helical structure. Conversely, in competitive ELISA, MBP (81&#x2013;106) (1) is recognized more efficiently by IgM antibodies than MBP (76&#x2013;116) (2), possibly thanks to its more stable helical structure observed in CD and NMR conformational experiments. These results are discussed in terms of different performances of peptide antigens in the two ELISA formats tested.</p>
</abstract>
<kwd-group>
<kwd>multiple sclerosis</kwd>
<kwd>circular dichroism</kwd>
<kwd>immune response</kwd>
<kwd>synthetic helical peptides</kwd>
<kwd>myelin basic protein antigen</kwd>
<kwd>peptide-antigen based ELISA</kwd>
<kwd>NMR</kwd>
</kwd-group>
<contract-num rid="cn001">2017/R/5</contract-num>
<contract-num rid="cn002">2019</contract-num>
<contract-sponsor id="cn001">Fondazione Italiana Sclerosi Multipla<named-content content-type="fundref-id">10.13039/100007366</named-content>
</contract-sponsor>
<contract-sponsor id="cn002">Council for Higher Education<named-content content-type="fundref-id">10.13039/501100005385</named-content>
</contract-sponsor>
</article-meta>
</front>
<body>
<sec id="s1">
<title>1 Introduction</title>
<p>Multiple Sclerosis (MS) is a demyelinating disease of the central nervous system (CNS). Genetic and environmental factors, such as bacterial or viral infections, are involved in its multifactorial etiology. Among the viral agent putatively associated with the disease, Epstein-Barr virus (EBV) has been repeatedly reported (<xref ref-type="bibr" rid="B30">Meier et al., 2021</xref>; <xref ref-type="bibr" rid="B46">Robinson and Steinman, 2022</xref>), and the <italic>Haemophilus influenzae</italic> has been described as possible bacterial triggering agent in MS (<xref ref-type="bibr" rid="B57">Walvoort et al., 2016</xref>). Although MS etiology and pathogenesis are not fully clarified, it is widely accepted that a T-cell-mediated inflammatory process directed against myelin and other related proteins plays a crucial role, jointly with a possible role of B cells (<xref ref-type="bibr" rid="B52">Steinman, 1996</xref>; <xref ref-type="bibr" rid="B43">Rahmanzadeh et al., 2018</xref>; <xref ref-type="bibr" rid="B11">D&#xed;az et al., 2019</xref>). Recent discoveries suggest that B lymphocytes substantially contribute to its initiation and chronic propagation. The fulminant clinical success of anti-CD20 antibodies in the treatment of MS, raised awareness that besides T-cells, B cells play a decisive role in MS. Synergic interaction of B and T-cell mechanisms were recently implicated as possible causes of MS (<xref ref-type="bibr" rid="B55">van Langelaar et al., 2020</xref>).</p>
<p>Due to its heterogeneity, no fully specific MS biomarkers are available, thus hampering both diagnosis and patient stratification. Considering that recent studies on B cells demonstrated the critical role of antibodies in MS pathology, identification of the antigenic targets recognized by specific antibodies in MS patient sera may help in the patient stratification process.</p>
<p>One of the most deeply studied myelin antigens related to MS is the myelin basic protein (MBP), a 170 amino-acid protein, which is the second most abundant component of the myelin sheath and plays an essential role in the myelination process (<xref ref-type="bibr" rid="B32">Moscarello, 1997</xref>; <xref ref-type="bibr" rid="B24">Lolli et al., 2006</xref>). Moreover, MBP is involved in the adhesion of the cytosolic surfaces of multilayered compact myelin, interacting with several polyanionic proteins, including actin, tubulin, Ca<sup>2&#x2b;</sup>-calmodulin, and clathrin, and with negatively charged lipids, thus changing its structure upon binding to them (<xref ref-type="bibr" rid="B5">Boggs, 2006</xref>).</p>
<p>Although MBP has not been demonstrated to be the main autoantigen in MS, MBP-specific autoreactive T-cells have been found in blood of MS patients at a higher rate than in healthy individuals (<xref ref-type="bibr" rid="B53">Tejada-Simon et al., 2003</xref>). Moreover, immunization of susceptible mouse strains with MBP induces a T-cell response that causes experimental autoimmune encephalomyelitis (EAE), considered a valuable mouse model of human MS (<xref ref-type="bibr" rid="B62">Zamvil and Steinman, 1990</xref>). These evidences suggest that MBP may be a candidate autoantigen in MS. In fact, it has been reported that autoantibodies from MS patient sera recognize MBP and recruit inflammatory cells to focal areas, thereby targeting CNS myelin components and affecting their stability (<xref ref-type="bibr" rid="B47">Rozenblum et al., 2014</xref>). In this context, investigations of anti-MBP antibodies in MS have been largely described, reporting controversial results ranging from 0 to 100% of seropositivity (<xref ref-type="bibr" rid="B10">Cruz et al., 1987</xref>; <xref ref-type="bibr" rid="B22">Link, 1997</xref>). In particular, relapsing-remitting MS patients have been described to be seropositive to anti-MBP (84&#x2013;100) antibodies (<xref ref-type="bibr" rid="B23">Lolli et al., 2005</xref>). Anti-MBP antibodies have been detected not only in sera, but also in the cerebrospinal fluid (CSF) (<xref ref-type="bibr" rid="B59">Warren et al., 1995</xref>; <xref ref-type="bibr" rid="B48">Sellebjerg et al., 2000</xref>) in 85% relapsing-remitting MS patients and 45% MS patients, respectively, compared to 2% in non-MS controls. In any case, anti-MBP antibodies and their pathogenic role have been a matter of debate for many years, while the role of myelin-reactive autoantibodies appears more defined (<xref ref-type="bibr" rid="B28">Martinsen and Kursula, 2021</xref>).</p>
<p>This discussion may be triggered by several factors, sometimes involving unclear changes at the molecular level in the composition and structure of MBP isoforms, as well as in compact myelin, during the pathogenesis of MS (<xref ref-type="bibr" rid="B3">Beniac et al., 1999</xref>; <xref ref-type="bibr" rid="B6">Boggs et al., 1999</xref>). The hypothesis of an abnormal isoform composition of MBP, leading to weakened membrane interactions and loosening the rigid myelin structure, could lead to the observed anti-MBP immune-reactivity, as well as to the presence of MBP in the CSF. Then, structural changes in the MBP sequences used in immunosorbent assays could explain, at least in part, not only the controversial results reported about anti-MBP antibody recognition in sera samples, but also their described low affinity. In fact, cells secreting high-affinity anti-myelin antibodies have been described in CSF from MS patients, particularly when compared to circulating anti-MBP antibodies, which showed low affinity (<xref ref-type="bibr" rid="B49">Sellebjerg et al., 1995</xref>; <xref ref-type="bibr" rid="B36">O&#x2019;Connor et al., 2003</xref>). In any case, the association of anti-MBP antibodies with earlier and more frequent disease relapses (<xref ref-type="bibr" rid="B4">Berger et al., 2003</xref>) highlights their interesting role in MS.</p>
<p>With all these considerations in mind, we focused our research on a further investigation of the factors involved in antibody recognition of MBP peptide antigens by MS patients. Herein, we present a study on the role of the sequence and structure of synthetic MBP peptides that have been used to identify specific antibodies in Multiple Sclerosis patient sera.</p>
</sec>
<sec id="s2">
<title>2 Materials and Methods</title>
<sec id="s2-1">
<title>2.1 Reagents</title>
<p>All Fmoc-protected amino acids, <italic>N</italic>,<italic>N</italic>&#x2032;-diisopropylcarbodiimide (DIC), OxymaPure&#x00AE; (ethyl-2-cyano-2-(hydroxyimino)acetate), and Fmoc-Lys(Boc)-Wang Tentagel<sup>&#xae;</sup> resin were purchased from Iris Biotech GmbH (Marktredwitz, Germany). Tentagel<sup>&#xae;</sup> S RAM was purchased from Rapp Polymere (Tuebingen, Germany). Peptide-synthesis grade <italic>N</italic>,<italic>N&#x2032;</italic>-dimethylformamide (DMF) and acetonitrile (ACN) were purchased from Carlo Erba (Milan, Italy). Dichloromethane (DCM), trifluoroacetic acid (TFA), triisopropylsilane (TIS), and piperidine were purchased from Sigma-Aldrich (Milan, Italy). 2,2,2-trifluoroethanol (TFE) was purchased from Alfa Aesar (Kandel, Germany). Myelin Basic Protein (MBP) was purchased from Merck (Milan, Italy).</p>
</sec>
<sec id="s2-2">
<title>2.2 Microwave-Assisted Solid Phase Peptide Synthesis</title>
<p>Peptides 1-6 were synthesized in solid-phase using a microwave-assisted protocol (MW-SPPS) on a Liberty Blue&#x2122; automated peptide synthesizer (CEM Corporation, Matthews, NC, United States), following the Fmoc/tBu strategy as previously described (<xref ref-type="bibr" rid="B45">Rizzolo et al., 2011</xref>; <xref ref-type="bibr" rid="B38">Pandey et al., 2013</xref>; <xref ref-type="bibr" rid="B34">Nuti et al., 2020</xref>). Tentagel&#xae; S RAM resin (loading 0.23&#xa0;mmol/g) was used for the synthesis of peptides 1, 5, and 6. Fmoc-Lys(Boc)-Wang Tentagel&#xae; resin (loading 0.23&#xa0;mmol/g) was used for the synthesis of peptides 2, 3, and 4. Fmoc-deprotections were performed with a solution of 20% (v/v) piperidine in DMF (2&#xa0;M). Peptide assembly was performed by repeating the standard MW-SPPS coupling cycle for each amino acid, using Fmoc-protected amino acids (2.5&#xa0;equiv, 0.4&#xa0;M in DMF), OxymaPure&#x00AE; (2.5&#xa0;equiv, 1&#xa0;M in DMF), and DIC (2.5&#xa0;equiv, 3&#xa0;M in DMF). Uncertain peptide coupling steps were checked by the ninhydrin test described by Kaiser (<xref ref-type="bibr" rid="B63">Kaiser et al., 1970</xref>), or micro-cleavages performed with a microwave apparatus CEM Discover&#x2122; single-mode MW reactor (CEM Corporation, Matthews, NC, United States). Resins with peptides 2-4 were N-terminal acetylated before cleavage, using twice Ac<sub>2</sub>O in a DMF solution for 10&#xa0;min at room temperature. Final cleavage and side-chain deprotections were performed using a mixture of TFA/TIS/H<sub>2</sub>O (95:2.5:2.5, v/v/v) at room temperature. After 2.5&#xa0;h each resin was filtered off and the solution was concentrated flushing with N<sub>2</sub>. Each peptide was precipitated from cold Et<sub>2</sub>O, centrifuged, and lyophilized.</p>
<p>The crude peptides were purified by Reverse-Phase Flash Liquid Chromatography (RP-HPLC) on an Isolera One Flash Chromatography (Biotage, Uppsala, Sweden) using a SNAP Ultra C18 column (25&#xa0;g) at 20&#xa0;ml/min. Eluent systems: 0.1% (v/v) TFA in H<sub>2</sub>O (A), 0.1% (v/v) TFA in ACN (B) (elution gradient reported in <xref ref-type="sec" rid="s11">Supplementary Table S1</xref>). The second step of purification of the peptides was performed by semipreparative RP-HPLC on a Waters instrument (Separation Module 2695, detector diode array 2996) using a Sepax Bio-C18 column (Sepax Technologies, Newark, United States) (5&#xa0;&#x3bc;M, 250&#xa0;mm &#xd7; 10&#xa0;mm), at 4&#xa0;ml/min using the solvent systems A (0.1% TFA in H<sub>2</sub>O) and B (0.1% TFA in ACN). Characterization of the peptides was performed by analytical HPLC using a Waters ACQUITY HPLC coupled to a single quadrupole ESI-MS (Waters&#xae; ZQ Detector, Waters Milford, MA, United States) supplied with a BEH C18 column (1.7&#xa0;&#x3bc;m, 2.1&#xa0;mm &#xd7; 50&#xa0;mm) at 35&#xb0;C, 0.6&#xa0;ml/min with the solvent systems A (0.1% TFA in H<sub>2</sub>O) and B (0.1% TFA in ACN). Gradient elution was performed with a flow of 0.6&#xa0;ml/min and started at 10% B, with a linear increase to 90% B in 5&#xa0;min. The analytical data are reported in the Supplementary Material (<xref ref-type="sec" rid="s11">Supplementary Table S1</xref> and <xref ref-type="sec" rid="s11">Supplementary Figures S1&#x2013;S6</xref>).</p>
</sec>
<sec id="s2-3">
<title>2.3 Immunoassays</title>
<sec id="s2-3-1">
<title>2.3.1 Sample Sera Collection</title>
<p>Fifteen Multiple Sclerosis (MS) patients were recruited in the Multiple Sclerosis Clinical Care and Research Centre, Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University (Naples, Italy). The relapsing-remitting MS (RR-MS) patients were previously diagnosed after a lumbar puncture, cerebrospinal fluid analysis, and MRI examination and fulfilled the established international diagnostic criteria (<xref ref-type="bibr" rid="B42">Polman et al., 2011</xref>; <xref ref-type="bibr" rid="B54">Thompson et al., 2018</xref>). The present study was conducted in accordance with the Declaration of Helsinki. The performed experimental protocols were approved by the Ethics Committee 2006 (protocol n. 120/06) and 2017 (protocol n. 160/17). Blood samplings were performed during the routine follow-up of patients, while the healthy control samplings were carried out during routine health checks or blood donations. Sera samples were obtained for diagnostic purposes from patients and healthy controls who had given their informed consent. Blood samples were centrifuged at 4,000&#xa0;rpm for 10&#xa0;min and sera supernatant was stored at -20&#xb0;C until use.</p>
</sec>
<sec id="s2-3-2">
<title>2.3.2 Inhibition ELISA</title>
<p>Nunc-Immuno MicroWell 96 well polystyrene ELISA plates (NUNC Maxisorb, product code M9410, Merck, Milan, Italy) were coated with a solution 10&#xa0;&#x3bc;g/ml of the peptide antigens in pure carbonate buffer 0.05&#xa0;M (pH 9.6) adding 100&#xa0;&#x3bc;L/well, and microplates were incubated at 4&#xb0;C overnight. Wells were washed (5&#xd7;) with washing buffer (0.9% NaCl, 0.05% Tween 20) using an automatic Hydroflex microplate washer (Tecan Italia, Milan, Italy). Nonspecific binding sites were blocked with 100&#xa0;&#x3bc;L/well of fetal bovine serum (FBS) buffer solution (10% in washing buffer) at room temperature for 1&#xa0;h. Antibody affinity was measured following the competitive ELISA previously reported (<xref ref-type="bibr" rid="B44">Real-Fern&#xe1;ndez et al., 2015</xref>). Semi-saturating sera dilution was previously calculated in preliminary titration curves (absorbance 0.7). Seven different concentrations of each synthetic antigenic peptide probe were used as inhibitors. Then, sera samples at the selected dilution were incubated in parallel with increasing concentrations of antigens (range 1 &#xd7; 10<sup>&#x2013;10</sup> to 1 &#xd7; 10<sup>&#x2013;4</sup>&#xa0;M) for 1&#xa0;h at room temperature. All competitive experiments were performed in triplicate. After washes (3&#xd7;), uninhibited antibodies were identified by adding 100&#xa0;&#x3bc;L/well of alkaline phosphatase-conjugated to anti-human immunoglobulin G or M (IgG and IgM, Merck, Milano, Italy) diluted 1:3,000 (IgG) and 1:200 (IgM) in FBS buffer. The microplates were then incubated 3&#xa0;h at room temperature and, after washes (3&#xd7;), 100&#xa0;&#x3bc;L of substrate solution consisting of 1&#xa0;mg/ml p-nitrophenyl phosphate pNPP (Merck, Milan, Italy) and MgCl<sub>2</sub> 0.01&#xa0;M in carbonate buffer (pH 9.6) were added. After approximately 30&#xa0;min, the reaction was stopped with 1&#xa0;M NaOH solution (50&#xa0;&#x3bc;L/well), and the absorbance was read in a multichannel ELISA reader (Tecan Sunrise, M&#xe4;nnedorf, Switzerland) at 405&#xa0;nm. Antibody titer values were calculated as (mean Abs of serum triplicate)&#x2014;(mean Abs of blank triplicate) representing graphically the absorbance inhibition percentage. One positive and one negative serum, as references, were included in each plate for further normalization. Each experiment was performed at least twice in different days. Within-assays and between-assays coefficients of variations were below 10%. Calculated half maximal inhibitory concentrations (IC<sub>50</sub>) are reported for each antigen.</p>
</sec>
<sec id="s2-3-3">
<title>2.3.3 Solid-Phase ELISA (SP-ELISA)</title>
<p>Immunoassays were performed to evaluate IgM or IgG antibodies in sera by SP-ELISA. At this purpose, the synthetic antigens were coated on 96-well plates (NUNC Maxisorb, product code M9410, Merck, Milan, Italy). Coating conditions were set-up independently for each peptide and results are reported in the <bold>Supplementary Material</bold>. Polystyrene 96-well ELISA plates were coated with 100&#xa0;&#x3bc;L/well of a 10&#xa0;&#x3bc;g/ml solution of synthetic peptide antigens 1-6 diluted in pure carbonate buffer 0.05&#xa0;M (pH 9.6), independently. After overnight incubation at 4&#xb0;C, plates were washed (3&#xd7;) using washing buffer. Nonspecific binding sites were blocked with 100&#xa0;&#x3bc;L/well of fetal bovine serum buffer (10% FBS in washing buffer) at room temperature for 1&#xa0;h. FBS buffer was removed, and plates were incubated overnight at 4&#xb0;C with sera (diluted 1:100 in FBS buffer, 100&#xa0;&#x3bc;L/well). After three washes, plates were treated with 100 &#x3bc;L/well of anti-human IgG or IgM alkaline phosphatase-conjugated specific antibodies diluted in FBS buffer 1:3,000 (IgG) and 1:200 (IgM) for all tested antigens. After 3&#xa0;h of incubation at room temperature and washes (3&#xd7;), 100&#xa0;&#x3bc;L of substrate buffer (1&#xa0;mg/ml <italic>p</italic>NPP, MgCl<sub>2</sub> 0.01&#xa0;M in carbonate buffer, pH 9.6) was added to each well. Colorimetric reaction was carried out adding 100&#xa0;&#x3bc;l of substrate reaction solution (1&#xa0;mg/ml <italic>p</italic>NPP, MgCl<sub>2</sub> 0.01&#xa0;M in carbonate buffer, pH 9.6) to each well and plates were read at 405&#xa0;nm using a TECAN plate reader. After 30&#xa0;min, the reaction was stopped with 1&#xa0;M NaOH solution (50&#xa0;&#x3bc;L/well) and the absorbance was read in a multichannel ELISA reader (Tecan Sunrise, M&#xe4;nnedorf, Switzerland) at 405&#xa0;nm. Antibody titer values were calculated as (mean Abs of serum triplicate)&#x2014;(mean Abs of blank triplicate) representing graphically the calculated mean values. One positive and one negative serum, as references, were included in each plate for further normalization. Each experiment was performed at least twice in different days. Within-assays and between-assays coefficients of variations were below 10%.</p>
</sec>
</sec>
<sec id="s2-4">
<title>2.4 Circular Dichroism</title>
<p>CD spectra were recorded on JASCO J-815 with increasing temperature from 10 to 60&#xb0;C in increments of 5&#xb0;C between <italic>&#x3bb;</italic> &#x3d; 270 and 185&#xa0;nm. The CD measurements were carried out in H<sub>2</sub>O, a mixture of H<sub>2</sub>O:TFE (50:50, v:v) and PBS (phosphate buffered saline, pH 7.4, containing: sodium chloride, potassium chloride, sodium phosphate dibasic, potassium phosphate monobasic). The spectra were registered with the following parameters: 0.2&#xa0;nm resolution, 1.0&#xa0;nm bandwidth, 20 mdeg sensitivity, 0.25&#xa0;s response, 100&#xa0;nm&#xa0;min<sup>&#x2212;1</sup> scanning speed, 5 scans, and 0.02&#xa0;cm cuvette path length. The CD spectra of solvents were recorded and subtracted from the raw data. The spectra were corrected by a baseline that was measured with the identical solvent in the same cell. The CD intensity is given as mean residue molar ellipticity (&#x3b8;) [deg &#x00D7; cm<sup>2</sup> &#x00D7; dmol<sup>&#x2212;1</sup>].</p>
</sec>
<sec id="s2-5">
<title>2.5 NMR</title>
<p>The samples for NMR spectroscopy were prepared by dissolving the appropriate amount of peptide in 50&#xa0;mM potassium phosphate buffer (pH 6.5), 10% D<sub>2</sub>O, and 100&#xa0;mM DPC-d<sub>38</sub>. NMR spectra were recorded on a Varian INOVA 600&#xa0;MHz spectrometer equipped with a z-gradient 5&#xa0;mm triple-resonance probe head. Spectra were recorded at a temperature of 25&#xb0;C. The spectra were calibrated relative to TSP (0.00&#xa0;ppm) as internal standard. One-dimensional (1D) NMR spectra were recorded in the Fourier mode with quadrature detection. The water signal was suppressed by gradient echo (<xref ref-type="bibr" rid="B16">Hwang and Shaka, 1995</xref>). 2D DQF-COSY (<xref ref-type="bibr" rid="B41">Piantini et al., 1982</xref>; <xref ref-type="bibr" rid="B26">Marion and W&#xfc;thrich, 1983</xref>), TOCSY (<xref ref-type="bibr" rid="B8">Braunschweiler and Ernst, 1983</xref>), and NOESY (<xref ref-type="bibr" rid="B18">Jenner et al., 1979</xref>) spectra were recorded in the phase-sensitive mode. Data block sizes were 2048 addresses in T2 and 512 equidistant T1 values. Before Fourier transformation, the time domain data matrices were multiplied by shifted sin2 functions in both dimensions. A mixing time of 70&#xa0;ms was used for the TOCSY experiments. NOESY experiments were run with mixing time of 100&#xa0;ms.</p>
</sec>
</sec>
<sec sec-type="results|discussion" id="s3">
<title>3 Results and Discussion</title>
<sec id="s3-1">
<title>3.1 Design of the Synthetic Myelin Basic Protein Peptides</title>
<p>Many publications indicate the presence of an immunodominant sequence in a specific region of MBP. One report described the sequence MBP (83&#x2013;101) as a potential immunodominant T-cell epitope restricted to HLA-DR2b (DRB1&#x2a;15:01) in MS (<xref ref-type="bibr" rid="B37">Ota et al., 1990</xref>), while others reported that MBP (89&#x2013;101) peptide has two registers for binding to DR2a and DR2b (<xref ref-type="bibr" rid="B20">Kim et al., 2014</xref>). Other authors identified MBP (87&#x2013;106) (<xref ref-type="bibr" rid="B27">Martin et al., 1990</xref>), MBP (83&#x2013;101) (<xref ref-type="bibr" rid="B15">Hansen et al., 2007</xref>), and other overlapping sequences as T-cell epitopes inside the MBP protein. Importantly, these MBP regions match with B-cell epitopes previously described (<xref ref-type="bibr" rid="B23">Lolli et al., 2005</xref>; <xref ref-type="bibr" rid="B58">Warren et al., 2006</xref>; <xref ref-type="bibr" rid="B25">Mameli et al., 2014</xref>).</p>
<p>With the idea in mind to cover the whole immunodominant region of MBP, we synthesized and tested the peptide MBP (81&#x2013;106) (1). Moreover, considering that the sensitivity of the peptide-based ELISA might be limited when short antigen sequences are used, we designed the elongated sequence MBP (76&#x2013;116) (2), in order to achieve better antigen exposition in the solid-phase conditions of the ELISA (<xref ref-type="bibr" rid="B34">Nuti et al., 2020</xref>). With the aim of clarifying the amino-acid residues specifically involved in the B-cell epitope recognition, we divided the whole sequence of MBP (76&#x2013;116) (2) into two fragments: MBP (76&#x2013;96) (3) and MBP (97&#x2013;116) (4). Amino- and carboxy-termini of peptides were acetylated and amidated, respectively, in order to remove free terminal charges, which are not present in the native protein sequence and may interfere with antibody recognition (<xref ref-type="bibr" rid="B56">Van Regenmortel, 2001</xref>). Finally, we also synthesized the shorter sequences MBP (81&#x2013;92) (5) and MBP (99&#x2013;106) (6), to be tested in competitive ELISA.</p>
</sec>
<sec id="s3-2">
<title>3.2 Biological Activity</title>
<sec id="s3-2-1">
<title>3.2.1 Solid-phase ELISA</title>
<p>Fifteen sera from MS patients were screened using the synthetic peptides 1&#x2013;6 as antigens in solid-phase ELISA. To this purpose, preliminary tests were performed to set-up the optimal conditions for the coating of the different peptide antigens onto the ELISA plates. Accordingly, we evaluated IgG and IgM antibody titres to each relevant peptide (<xref ref-type="fig" rid="F1">Figure 1</xref>), observing a nonspecific IgG antibody reactivity against peptide MBP (99&#x2013;106) (6). To a lesser extent, also against peptide MBP (81&#x2013;106) (1). A deeper analysis of these data indicated that peptide 6 is too short to be efficiently coated and/or exposed on the ELISA plate, favouring the nonspecific signals observed (<xref ref-type="sec" rid="s11">Supplementary Figure S13</xref>). At variance, peptides 2-5 did not detect IgG-type antibodies. On the other hand, IgM antibodies were detected in one representative patient serum with peptide MBP (76&#x2013;116) (2) and, to a lesser way, with peptide MBP (81&#x2013;106) (1) [1 out of 15 patients (7%)] (<xref ref-type="fig" rid="F1">Figure 1B</xref>). Interestingly, whereas the intensity of IgMs signal is clear for peptide MBP (76&#x2013;116) (2), the peptide MBP (81&#x2013;106) (1) slightly recognized IgGs and IgMs. This finding can be explained by the longer peptide MBP (76&#x2013;116) (2), which may contain an extended epitope, or features an optimal exposition on the ELISA plate, not obtained by the shorter peptide MBP (81&#x2013;106) (1), but important to capture pentameric IgM antibodies. This interesting result let us to hypothesize that the structures of peptide 1 may reproduce the correct antigen presentation, i.e., the one observed in the whole protein, thus enabling optimal antibody recognition of IgM antibodies. In fact, we already reported that, generally speaking, IgG antibodies can be more easily identified in ELISA using synthetic peptides as antigens, as compared to IgMs, possibly due to the pentameric spatial orientation of the latter. Previously, we overcome this problem using multivalent peptides to exploit IgMs higher avidity (<xref ref-type="bibr" rid="B34">Nuti et al., 2020</xref>; <xref ref-type="bibr" rid="B29">Mazzoleni et al., 2021</xref>). Interestingly, we herein observed that the monomeric, linear peptide MBP (76&#x2013;116) (2) is able to detect a high, stable, and reproducible IgM antibody titer.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Mean antibody titers to MBP peptide antigens for IgGs <bold>(A)</bold> and IgMs <bold>(B)</bold> of MS patient sera. IgM antibody responses of the MS serum to the coated peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;106) (2) are plotted in red.</p>
</caption>
<graphic xlink:href="fchem-10-885180-g001.tif"/>
</fig>
<p>An additional explanation for the low reactivity generally observed for both IgGs and IgMs with most of the tested samples stems from the observation that a high percentage of patients are under immunosuppressive treatment, and they are not in the initial stage of the disease. In fact, it has been previously reported that anti-MBP IgM antibodies decrease in patients with a longer disease duration (<xref ref-type="bibr" rid="B12">Egg et al., 2001</xref>). Moreover, it should be noted that the recognized representative patient is not following any immunosuppressive treatment.</p>
</sec>
<sec id="s3-2-2">
<title>3.2.2 Inhibition ELISA</title>
<p>We focused our attention on the IgM antibody response to peptide MBP (76&#x2013;116) (2), with the aim of verifying the specificity of the observed signals in a competitive solid-phase ELISA. To this purpose, MBP (76&#x2013;116) (2) was coated on the plate and all the synthesized MBP sequences, including MBP (76&#x2013;116) (2) itself, were individually tested at different concentrations as inhibitors of IgM antibody binding in the representative serum. The results showed in <xref ref-type="fig" rid="F2">Figure 2A</xref> indicate that peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;116) (2) were able to inhibit IgM antibody binding to peptide 2 in the tested MS serum, showing an IC<sub>50</sub> of 2.2&#x2219;10<sup>&#x2013;7</sup> and 8.4&#x2219;10<sup>&#x2013;7</sup>, respectively (<xref ref-type="table" rid="T2">Table 2</xref>). These results confirm that IgM antibody response to peptide MBP (76&#x2013;116) (2) is concentration-dependent and assess the specificity of the IgM recognition, previously observed in SP-ELISA. Moreover, we performed the inhibition experiments coating the MBP protein and using peptides MBP (81&#x2013;106) (1), MBP (76&#x2013;116) (2), MBP (97&#x2013;116) (4), and the MBP protein as inhibitors (<xref ref-type="fig" rid="F2">Figure 2B</xref>). Results showed the cross-reactivity between peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;116) (2) and the whole MBP protein, and peptides were able to inhibit IgM antibody binding to MBP protein in the tested MS serum with comparable IC<sub>50</sub> (<xref ref-type="table" rid="T2">Table 2</xref>). The greater affinity observed in the competitive experiment with peptide MBP (81&#x2013;106) (1) indicates that, while the elongation of the sequence featured by peptide MBP (76&#x2013;116) (2) is fundamental for antibody recognition in solid-phase ELISA, the shortened sequence MBP (81&#x2013;106) (1) is recognized more efficiently by antibodies in the solution conditions of the competitive experiments. In light of these results, we decided to study the secondary structure of peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;116) (2) by circular dichroism.</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Competitive ELISA obtained coating the peptide antigen MBP (76&#x2013;116) (2) <bold>(A)</bold> or the MBP protein <bold>(B)</bold>. Inhibition curve of IgMs using peptides and protein as inhibitors at different concentrations. Results show the inhibition activity % (ordinate axis) of the reference MS serum for IgMs vs. antigen concentrations on a logarithmic scale (abscissas axis). Antibody titer values were calculated as (mean Abs of serum triplicate)&#x2014;(mean Abs of blank triplicate) representing graphically the calculated mean values &#xb1; the standard deviation.</p>
</caption>
<graphic xlink:href="fchem-10-885180-g002.tif"/>
</fig>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Synthesized MBP peptides.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Peptide</th>
<th align="center">Fragment</th>
<th align="center">Sequence</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">
<bold>1</bold>
</td>
<td>MBP (81&#x2013;106)</td>
<td align="left">-----TQDENPVVHFFKNIVTPRTPPPSQGK----------</td>
</tr>
<tr>
<td align="left">
<bold>2</bold>
</td>
<td>MBP (76&#x2013;116)<xref ref-type="table-fn" rid="Tfn1">
<sup>a</sup>
</xref>
</td>
<td align="left">SQHGRTQDENPVVHFFKNIVTPRTPPPSQGKGRGLSLSRFS</td>
</tr>
<tr>
<td align="left">
<bold>3</bold>
</td>
<td>MBP (76&#x2013;96)<xref ref-type="table-fn" rid="Tfn1">
<sup>a</sup>
</xref>
</td>
<td align="left">SQHGRTQDENPVVHFFKNIVT--------------------</td>
</tr>
<tr>
<td align="left">
<bold>4</bold>
</td>
<td>MBP (97&#x2013;116)<xref ref-type="table-fn" rid="Tfn1">
<sup>a</sup>
</xref>
</td>
<td align="left">---------------------PRTPPPSQGKGRGLSLSRFS</td>
</tr>
<tr>
<td align="left">
<bold>5</bold>
</td>
<td>MBP (81&#x2013;92)</td>
<td align="left">-----TQDENPVVHFFK------------------------</td>
</tr>
<tr>
<td align="left">
<bold>6</bold>
</td>
<td>MBP (99&#x2013;106)</td>
<td align="left">-----------------------TPPPSQGK----------</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="Tfn1">
<label>a</label>
<p>N-terminal acetylated and C-terminal amide.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>Calculated IC<sub>50</sub> values of anti-MBP (76&#x2013;116) or anti-MBP protein IgM antibodies of MS serum to MBP (76&#x2013;116) (2) and MBP (81&#x2013;106) (1). Values are reported as 95% confidence interval for the calculated mean IC<sub>50</sub> &#xb1; the standard error (SEM).</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Coated antigen</th>
<th align="center">Inhibitor</th>
<th align="center">IC<sub>50</sub> (IgM)</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="left">MBP (76&#x2013;116) (2)</td>
<td align="char" char="( (">MBP (81&#x2013;106) (1)</td>
<td align="char" char="plusmn">(2.2 &#xb1; 0.18)&#x2219;10<sup>&#x2013;7</sup>
</td>
</tr>
<tr>
<td align="char" char="( (">MBP (76&#x2013;116) (2)</td>
<td align="char" char="plusmn">(8.4 &#xb1; 0.24)&#x2219;10<sup>&#x2013;7</sup>
</td>
</tr>
<tr>
<td rowspan="3" align="left">MBP protein</td>
<td align="char" char="( (">MBP (81&#x2013;106) (1)</td>
<td align="char" char="plusmn">(5.5 &#xb1; 0.31)&#x2219;10<sup>&#x2013;7</sup>
</td>
</tr>
<tr>
<td align="char" char="( (">MBP (76&#x2013;116) (2)</td>
<td align="char" char="plusmn">(2.3 &#xb1; 0.07)&#x2219;10<sup>&#x2013;7</sup>
</td>
</tr>
<tr>
<td align="left">MBP protein</td>
<td align="char" char="plusmn">(7.9 &#xb1; 0.34)&#x2219;10<sup>&#x2013;7</sup>
</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
</sec>
<sec id="s3-3">
<title>3.3 Circular Dichroism</title>
<p>A preliminary screening of the conformational preferences of peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;116) (2) indicate that these peptides appear randomly structured in water solution (<xref ref-type="fig" rid="F3">Figure 3A</xref>; <xref ref-type="sec" rid="s11">Supplementary Figure S14</xref>). We subsequently studied the conformational behavior of these peptides in H<sub>2</sub>O:TFE (50:50, v:v), a solvent mixture known to act as stabilizing agent (<xref ref-type="bibr" rid="B9">Campagna et al., 1998</xref>). Moreover, the use of fluoroalcohol provides additional stability by removing the water molecules from the surroundings of the peptides (<xref ref-type="bibr" rid="B19">Khandelwal et al., 1999</xref>). The spectra obtained in the solvent mixture displayed two negative bands at 222 and 208&#xa0;nm (n&#x2192;&#x3c0;&#x2a; and &#x3c0;&#x2192;&#x3c0;&#x2a; transitions) and one positive band at 190&#xa0;nm (&#x3c0;&#x2192;&#x3c0;&#x2a; transition) (<xref ref-type="fig" rid="F3">Figure 3B</xref>), characteristic for helical structures according to the literature (<xref ref-type="bibr" rid="B7">Bradley et al., 1990</xref>; <xref ref-type="bibr" rid="B2">Bates et al., 2004</xref>; <xref ref-type="bibr" rid="B1">Ahmed et al., 2012</xref>; <xref ref-type="bibr" rid="B31">Miles et al., 2022</xref>). Indeed, predictions based on amino acid composition of these peptides indicate that they show a tendency to form helical structures (<xref ref-type="bibr" rid="B61">Yang et al., 1997</xref>; <xref ref-type="bibr" rid="B2">Bates et al., 2004</xref>; <xref ref-type="bibr" rid="B1">Ahmed et al., 2012</xref>). Moreover, it may be assumed that there were no spectral differences of secondary peptide structure at various temperatures (<xref ref-type="sec" rid="s11">Supplementary Figure S14, S15</xref>). Interestingly, the shorter peptide MBP (81&#x2013;106) (1) displays higher tendency to adopt an helical conformation, as compared to the longer analogue MBP (76&#x2013;116) (2) (% helix 14 <italic>vs</italic>. 3) (<xref ref-type="fig" rid="F3">Figure 3B</xref>) (<xref ref-type="bibr" rid="B51">Sommese et al., 2010</xref>). Apparently, the elongation at N- and C-termini of the peptide causes the disability in forming the helix. Furthermore, a different agent stabilizing the helix motif in the structure of MBP (81&#x2013;106) (1) is the presence at the C- and N-termini of positively and negatively charged amino acids able to form salt bridges (<xref ref-type="bibr" rid="B13">Forood et al., 1993</xref>). At variance, the longer peptide MBP (76&#x2013;116) (2) includes many positively charged residues, i.e., arginine residues that produce a destabilized effect on helix conformation by electrostatic repulsion (<xref ref-type="bibr" rid="B50">Sitkoff et al., 1994</xref>).</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>CD spectra of peptides MBP (81&#x2013;106) (1) (blue line) and MBP (76&#x2013;116) (2) (red line) measured in water <bold>(A)</bold> and mixture of H<sub>2</sub>O:TFE (50:50, v:v) <bold>(B)</bold> at 25&#xb0;C.</p>
</caption>
<graphic xlink:href="fchem-10-885180-g003.tif"/>
</fig>
<p>We subsequently studied the conformational preferences of peptides MBP(81&#x2013;106) (1) and MBP (76&#x2013;116) (2) in PBS, which is the most frequently used solvent to maintain physiological pH (<xref ref-type="bibr" rid="B60">White, 2002</xref>). These data indicate that the peptides present random coil structures (<xref ref-type="fig" rid="F4">Figure 4</xref>). In fact, the obtained spectra displayed a single band with negative ellipticity at approximately 200&#xa0;nm characteristic for unordered peptides. However, peptide MBP (81&#x2013;106) (1) presents a more ordered structure, as can be inferred by the small but significant shift at higher wavelength of the minimum of MBP (81&#x2013;106) (1) compared to MBP (76&#x2013;116) (2) (<xref ref-type="bibr" rid="B33">Muruganandam et al., 2013</xref>; <xref ref-type="bibr" rid="B21">Lanthier et al., 2014</xref>). Moreover, we can assume there were no differences of secondary structure at various temperatures for MBP(81&#x2013;106) (1) (<xref ref-type="fig" rid="F5">Figure 5</xref>). In contrast, increasing the temperature of MBP (76&#x2013;116) (2) led to a shift of the minimum to lower wavelength and a strong decrease of the signal intensity (<xref ref-type="fig" rid="F6">Figure 6</xref>). This result can derive from a temperature-induced peptide self-aggregation, likely in beta structures (minimum at about 205&#xa0;nm). The partial aggregation can account for the reduced ability of MBP (76&#x2013;116) (2) to interact with the IgM antibody.</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>CD spectra of peptides MBP (81&#x2013;106) (1) (blue line) and MBP (76&#x2013;116) (2) (red line) in PBS at 25&#xb0;C.</p>
</caption>
<graphic xlink:href="fchem-10-885180-g004.tif"/>
</fig>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>CD spectra of peptide MBP (81&#x2013;106) (1) in PBS at various temperatures.</p>
</caption>
<graphic xlink:href="fchem-10-885180-g005.tif"/>
</fig>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>CD spectra of peptide MBP (76&#x2013;116) (2) in PBS at various temperatures.</p>
</caption>
<graphic xlink:href="fchem-10-885180-g006.tif"/>
</fig>
</sec>
<sec id="s3-4">
<title>3.4 NMR</title>
<p>Conformational behavior of peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;116) (2) was studied in DPC micelle (100&#xa0;mm) by solution NMR spectroscopy. Almost complete <sup>1</sup>H NMR assignments were not was obtained for peptide 1 while some residues of 2 could not be assigned due to strong signals overlapping (<xref ref-type="sec" rid="s11">Supplementary Tables S2, S3</xref>). From chemical shift and NOE interaction patterns (<xref ref-type="sec" rid="s11">Supplementary Tables S2, S3</xref>; <xref ref-type="sec" rid="s11">Supplementary Figure S16</xref>), the two peptides have stable helical structure along residues 87&#x2013;96, while the remaining regions did not show diagnostic parameters of any secondary structure. They are henceforth in random coil conformation. These results are in agreement with those reported in the literature (<xref ref-type="bibr" rid="B1">Ahmed et al., 2012</xref>) about a 36-residue peptide fragment of murine MBP corresponding to residues 76&#x2013;111. Comparing the chemical shift values peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;116) (2), which are not significantly different, the helical structure turns out to have the same stability regardless of the sequence length. Superposition of chosen regions of the NOESY spectra of the two peptides (<xref ref-type="sec" rid="s11">Supplementary Figure S16</xref>) gives a visual confirmation of this result.</p>
</sec>
</sec>
<sec id="s4">
<title>4 Conclusion</title>
<p>In MS the myelin sheath is severely damaged by the autoimmune response, including autoreactive antibodies, therefore the characterization of antigens, particularly those expressed by proteins in the CNS, is highly relevant. In this study, we investigated the MBP protein, an important constituent of the myelin membrane. New insights in the anti-MBP antibodies and their pathogenicity can contribute to clarify their role, debated in the literature for many years. To this aim, we synthesized peptides covering the MBP (76&#x2013;116) (2) fragment, including the immunodominant B-cell epitope MBP (84&#x2013;104), and tested them both in solid-phase and competitive ELISA with MS patient sera. We focused our attention on IgM antibodies, observed in one representative serum using the peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;116) (2), while the other tested sequences showed in general low reactivity, for both IgGs and IgMs. The reactivity of peptides 1 and 2 is particularly relevant since frequency of serum anti-MBP IgMs is lower in patients with a long-term disease duration. Competitive ELISA experiments confirmed the specificity of the interaction and perhaps high antibody affinity to these peptide sequences.</p>
<p>NMR conformational analysis in DPC indicates that the two peptides MBP (81&#x2013;106) (1) and MBP (76&#x2013;116) (2) display a stable helical conformation along residues 87&#x2013;96, while the remaining regions display unordered conformation. CD experiments in H<sub>2</sub>O:TFE mixture showed that the shorter peptide MBP (81&#x2013;106) (1) displays a slightly higher tendency to adopt an helical conformation, which may be considered the bioactive conformation of the epitope recognized by IgMs, since the competitive ELISA experiments show a 4-fold greater affinity of IgMs for this peptide, as compared to the longer analogue. However, the longer peptide MBP (76&#x2013;116) (2) appears to be much more suitable to be efficiently coated on the plate, correctly exposing the helical epitope to capture IgMs in solid-phase. At variance, the correct epitope exposition is hampered by the flanking flexible N- and C-terminal regions, when the longer peptide is tested in solution.</p>
<p>In conclusion, the efficacy of the experimental approach based on the use of designed peptide sequences as synthetic antigenic probes to characterize antibodies in patient sera is greatly enhanced by the optimisation of the procedure to synthesize specifically modified and unique molecules (<xref ref-type="bibr" rid="B35">Nuti et al., 2010</xref>). Moreover, we demonstrated the possible positive role of chain elongation in solid-phase ELISA, enabling the detection of antibodies that cannot be identified by shorter sequences, even if they contain an epitope. These facts explain how minor changes in the MBP sequence and structure may contribute to the controversial results reported about its antibody reactivity. The selection of the methodology with the correct and well-exposed structures, is fundamental to improve antibody identification. Further studies based on a larger cohort of recently diagnosed and untreated MS patients could contribute to clarify the role of MBP in Multiple Sclerosis.</p>
</sec>
</body>
<back>
<sec id="s5">
<title>Data Availability Statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.</p>
</sec>
<sec id="s6">
<title>Ethics Statement</title>
<p>The studies involving human participants were reviewed and approved by the protocols n. 120/06 and n. 160/17. Comitato etico per le attivit&#x00E0; biomediche, Dipartimento di Medicina Pubblica e della Sicurezza Sociale, Facolt&#x00E0; di Medicina e Chirurgia, Universit&#x00E0; degli Studi di Napoli &#x201C;Federico II,&#x201D; Via S. Pansini 5, 80131 Napoli (Italy). The patients/participants provided their written informed consent to participate in this study.</p>
</sec>
<sec id="s7">
<title>Author Contributions</title>
<p>AS, MQ, and FN synthesized the peptide antigens. AS, MJ, and RaL at performed and interpreted the CD spectra. AC and DB performed and interpreted the NMR spectra. RuA and RiA participated to the conceptual discussions. MQ and FR-F performed the immunoassays and interpreted immunoassays data analyses. RL and VB-M recruited patients and analyzed the clinical data. AMP and PR developed the project, designed the experiments, interpreted the data. All authors contributed to write the manuscript.</p>
</sec>
<sec id="s8">
<title>Funding</title>
<p>This work was partly supported by the Rita Levi Montalcini Prize for scientific cooperation between Italy (University of Florence) and Israel (Weizmann Institute of Science, Hebrew University, and Bar Ilan University) to AMP (Israel Council for Higher Education grant 2018, attributed in 2019). Authors gratefully acknowledge the Italian Multiple Sclerosis Foundation (FISM) (grant n. 2017/R/5). AS is a participant of BioTechNan project&#x2014;Interdisciplinary Environmental Doctoral Studies KNOW in the field of Biotechnology and Nanotechnology, co-financed by the European Union. The PhD of AS was performed in the context of a Cotutorate between the PhD Schools in Chemical Sciences of the University of Florence (XXXV Ciclo) and of the Wroclaw University of Science and Technology. The PhD scholarship of MQ is funded by the &#x201C;Progetto Ministeriale Dipartimenti di Eccellenza 2018-2022&#x201D; (58503_DIPECC-C.U.P. B96C17000200008).</p>
</sec>
<sec sec-type="COI-statement" id="s9">
<title>Conflict of Interest</title>
<p>Author HR is employed by Fischer Analytics GmbH.</p>
<p>The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s10">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="s11">
<title>Supplementary Material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fchem.2022.885180/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fchem.2022.885180/full&#x23;supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="DataSheet1.pdf" id="SM1" mimetype="application/pdf" xmlns:xlink="http://www.w3.org/1999/xlink"/>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ahmed</surname>
<given-names>M. A. M.</given-names>
</name>
<name>
<surname>De Avila</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Polverini</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Bessonov</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Bamm</surname>
<given-names>V. V.</given-names>
</name>
<name>
<surname>Harauz</surname>
<given-names>G.</given-names>
</name>
</person-group> (<year>2012</year>). <article-title>Solution Nuclear Magnetic Resonance Structure and Molecular Dynamics Simulations of a Murine 18.5 kDa Myelin Basic Protein Segment (S72-S107) in Association with Dodecylphosphocholine Micelles</article-title>. <source>Biochemistry</source> <volume>51</volume>, <fpage>7475</fpage>&#x2013;<lpage>7487</lpage>. <pub-id pub-id-type="doi">10.1021/bi300998x</pub-id> </citation>
</ref>
<ref id="B2">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bates</surname>
<given-names>I. R.</given-names>
</name>
<name>
<surname>Feix</surname>
<given-names>J. B.</given-names>
</name>
<name>
<surname>Boggs</surname>
<given-names>J. M.</given-names>
</name>
<name>
<surname>Harauz</surname>
<given-names>G.</given-names>
</name>
</person-group> (<year>2004</year>). <article-title>An Immunodominant Epitope of Myelin Basic Protein Is an Amphipathic &#x3b1;-Helix</article-title>. <source>J. Biol. Chem.</source> <volume>279</volume>, <fpage>5757</fpage>&#x2013;<lpage>5764</lpage>. <pub-id pub-id-type="doi">10.1074/jbc.M311504200</pub-id> </citation>
</ref>
<ref id="B3">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Beniac</surname>
<given-names>D. R.</given-names>
</name>
<name>
<surname>Wood</surname>
<given-names>D. D.</given-names>
</name>
<name>
<surname>Palaniyar</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Ottensmeyer</surname>
<given-names>F. P.</given-names>
</name>
<name>
<surname>Moscarello</surname>
<given-names>M. A.</given-names>
</name>
<name>
<surname>Harauz</surname>
<given-names>G.</given-names>
</name>
</person-group> (<year>1999</year>). <article-title>Marburg&#x27;s Variant of Multiple Sclerosis Correlates with a Less Compact Structure of Myelin Basic Protein</article-title>. <source>Mol. Cell Biol. Res. Commun.</source> <volume>1</volume>, <fpage>48</fpage>&#x2013;<lpage>51</lpage>. <pub-id pub-id-type="doi">10.1006/mcbr.1999.0111</pub-id> </citation>
</ref>
<ref id="B4">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Berger</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Rubner</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Schautzer</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Egg</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Ulmer</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Mayringer</surname>
<given-names>I.</given-names>
</name>
<etal/>
</person-group> (<year>2003</year>). <article-title>Antimyelin Antibodies as a Predictor of Clinically Definite Multiple Sclerosis after a First Demyelinating Event</article-title>. <source>N. Engl. J. Med.</source> <volume>349</volume>, <fpage>139</fpage>&#x2013;<lpage>145</lpage>. <pub-id pub-id-type="doi">10.1056/NEJMoa022328</pub-id> </citation>
</ref>
<ref id="B5">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Boggs</surname>
<given-names>J. M.</given-names>
</name>
</person-group> (<year>2006</year>). <article-title>Myelin Basic Protein: a Multifunctional Protein</article-title>. <source>Cell. Mol. Life Sci.</source> <volume>63</volume>, <fpage>1945</fpage>&#x2013;<lpage>1961</lpage>. <pub-id pub-id-type="doi">10.1007/s00018-006-6094-7</pub-id> </citation>
</ref>
<ref id="B6">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Boggs</surname>
<given-names>J. M.</given-names>
</name>
<name>
<surname>Rangaraj</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Koshy</surname>
<given-names>K. M.</given-names>
</name>
<name>
<surname>Ackerley</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Wood</surname>
<given-names>D. D.</given-names>
</name>
<name>
<surname>Moscarello</surname>
<given-names>M. A.</given-names>
</name>
</person-group> (<year>1999</year>). <article-title>Highly Deiminated Isoform of Myelin Basic Protein from Multiple Sclerosis Brain Causes Fragmentation of Lipid Vesicles</article-title>. <source>J. Neurosci. Res.</source> <volume>57</volume>, <fpage>529</fpage>&#x2013;<lpage>535</lpage>. <pub-id pub-id-type="doi">10.1002/(SICI)1097-4547(19990815)57:4&#x3c;529::AID-JNR12&#x3e;3.0.CO;2-0</pub-id> </citation>
</ref>
<ref id="B7">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bradley</surname>
<given-names>E. K.</given-names>
</name>
<name>
<surname>Thomason</surname>
<given-names>J. F.</given-names>
</name>
<name>
<surname>Cohen</surname>
<given-names>F. E.</given-names>
</name>
<name>
<surname>Kosen</surname>
<given-names>P. A.</given-names>
</name>
<name>
<surname>Kuntz</surname>
<given-names>I. D.</given-names>
</name>
</person-group> (<year>1990</year>). <article-title>Studies of Synthetic Helical Peptides Using Circular Dichroism and Nuclear Magnetic Resonance</article-title>. <source>J. Mol. Biol.</source> <volume>215</volume>, <fpage>607</fpage>&#x2013;<lpage>622</lpage>. <pub-id pub-id-type="doi">10.1016/S0022-2836(05)80172-X</pub-id> </citation>
</ref>
<ref id="B8">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Braunschweiler</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Ernst</surname>
<given-names>R. R.</given-names>
</name>
</person-group> (<year>1983</year>). <article-title>Coherence Transfer by Isotropic Mixing: Application to Proton Correlation Spectroscopy</article-title>. <source>J. Magnetic Reson. (1969)</source> <volume>53</volume>, <fpage>521</fpage>&#x2013;<lpage>528</lpage>. <pub-id pub-id-type="doi">10.1016/0022-2364(83)90226-3</pub-id> </citation>
</ref>
<ref id="B9">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Campagna</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Vitoux</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Humbert</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Girardet</surname>
<given-names>J. M.</given-names>
</name>
<name>
<surname>Linden</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Haertle</surname>
<given-names>T.</given-names>
</name>
<etal/>
</person-group> (<year>1998</year>). <article-title>Conformational Studies of a Synthetic Peptide from the Putative Lipid-Binding Domain of Bovine Milk Component PP3</article-title>. <source>J. Dairy Sci.</source> <volume>81</volume>, <fpage>3139</fpage>&#x2013;<lpage>3148</lpage>. <pub-id pub-id-type="doi">10.3168/jds.S0022-0302(98)75879-5</pub-id> </citation>
</ref>
<ref id="B10">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cruz</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Olsson</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Ernerudh</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>H&#xf6;jeberg</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Link</surname>
<given-names>H.</given-names>
</name>
</person-group> (<year>1987</year>). <article-title>Immunoblot Detection of Oligoclonal Anti-myelin Basic Protein IgG Antibodies in Cerebrospinal Fluid in Multiple Sclerosis</article-title>. <source>Neurology</source> <volume>37</volume>, <fpage>1515</fpage>. <pub-id pub-id-type="doi">10.1212/wnl.37.9.1515</pub-id> </citation>
</ref>
<ref id="B11">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>D&#xed;az</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Zarco</surname>
<given-names>L. A.</given-names>
</name>
<name>
<surname>Rivera</surname>
<given-names>D. M.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Highly Active Multiple Sclerosis: An Update</article-title>. <source>Multiple Scler. Relat. Disord.</source> <volume>30</volume>, <fpage>215</fpage>&#x2013;<lpage>224</lpage>. <pub-id pub-id-type="doi">10.1016/j.msard.2019.01.039</pub-id> </citation>
</ref>
<ref id="B12">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Egg</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Reindl</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Deisenhammer</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Linington</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Berger</surname>
<given-names>T.</given-names>
</name>
</person-group> (<year>2001</year>). <article-title>Anti-MOG and Anti-MBP Antibody Subclasses in Multiple Sclerosis</article-title>. <source>Mult. Scler.</source> <volume>7</volume>, <fpage>285</fpage>&#x2013;<lpage>289</lpage>. <pub-id pub-id-type="doi">10.1177/135245850100700503</pub-id> </citation>
</ref>
<ref id="B13">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Forood</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Feliciano</surname>
<given-names>E. J.</given-names>
</name>
<name>
<surname>Nambiar</surname>
<given-names>K. P.</given-names>
</name>
</person-group> (<year>1993</year>). <article-title>Stabilization of Alpha-Helical Structures in Short Peptides via End Capping</article-title>. <source>Proc. Natl. Acad. Sci. U.S.A.</source> <volume>90</volume>, <fpage>838</fpage>&#x2013;<lpage>842</lpage>. <pub-id pub-id-type="doi">10.1073/pnas.90.3.838</pub-id> </citation>
</ref>
<ref id="B15">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hansen</surname>
<given-names>B. E.</given-names>
</name>
<name>
<surname>Rasmussen</surname>
<given-names>A. H.</given-names>
</name>
<name>
<surname>Jakobsen</surname>
<given-names>B. K.</given-names>
</name>
<name>
<surname>Ryder</surname>
<given-names>L. P.</given-names>
</name>
<name>
<surname>Svejgaard</surname>
<given-names>A.</given-names>
</name>
</person-group> (<year>2007</year>). <article-title>Extraordinary Cross-Reactivity of an Autoimmune T-Cell Receptor Recognizing Specific Peptides Both on Autologous and on Allogeneic HLA Class II Molecules</article-title>. <source>Tissue Antigens</source> <volume>70</volume>, <fpage>42</fpage>&#x2013;<lpage>52</lpage>. <pub-id pub-id-type="doi">10.1111/j.1399-0039.2007.00849.x</pub-id> </citation>
</ref>
<ref id="B16">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hwang</surname>
<given-names>T. L.</given-names>
</name>
<name>
<surname>Shaka</surname>
<given-names>A. J.</given-names>
</name>
</person-group> (<year>1995</year>). <article-title>Water Suppression that Works. Excitation Sculpting Using Arbitrary Wave-Forms and Pulsed-Field Gradients</article-title>. <source>J. Magnetic Reson. Ser. A</source> <volume>112</volume>, <fpage>275</fpage>&#x2013;<lpage>279</lpage>. <pub-id pub-id-type="doi">10.1006/jmra.1995.1047</pub-id> </citation>
</ref>
<ref id="B18">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jeener</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Meier</surname>
<given-names>B. H.</given-names>
</name>
<name>
<surname>Bachmann</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Ernst</surname>
<given-names>R. R.</given-names>
</name>
</person-group> (<year>1979</year>). <article-title>Investigation of Exchange Processes by Two&#x2010;dimensional NMR Spectroscopy</article-title>. <source>J. Chem. Phys.</source> <volume>71</volume>, <fpage>4546</fpage>&#x2013;<lpage>4553</lpage>. <pub-id pub-id-type="doi">10.1063/1.438208</pub-id> </citation>
</ref>
<ref id="B63">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kaiser</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Colescott</surname>
<given-names>R. L.</given-names>
</name>
<name>
<surname>Bossinger</surname>
<given-names>C. D.</given-names>
</name>
<name>
<surname>Cook</surname>
<given-names>P. I.</given-names>
</name>
</person-group> (<year>1970</year>). <article-title>Color Test for Detection of Free Terminal Amino Groups in the Solid-Phase Synthesis of Peptides</article-title>. <source>Anal. Biochem.</source> <volume>34 (2)</volume>, <fpage>595</fpage>&#x2013;<lpage>598</lpage>. <pub-id pub-id-type="doi">10.1016/0003-2697(70)90146-6</pub-id> </citation>
</ref>
<ref id="B19">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Khandelwal</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Seth</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>V. Hosur</surname>
<given-names>R.</given-names>
</name>
</person-group> (<year>1999</year>). <article-title>CD and NMR Investigations on Trifluoroethanol-Induced Step-wise Folding of Helical Segment from Scorpion Neurotoxin</article-title>. <source>Eur. J. Biochem.</source> <volume>264</volume>, <fpage>468</fpage>&#x2013;<lpage>478</lpage>. <pub-id pub-id-type="doi">10.1046/j.1432-1327.1999.00641.x</pub-id> </citation>
</ref>
<ref id="B20">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kim</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Hartman</surname>
<given-names>I. Z.</given-names>
</name>
<name>
<surname>Poore</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Boronina</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Cole</surname>
<given-names>R. N.</given-names>
</name>
<name>
<surname>Song</surname>
<given-names>N.</given-names>
</name>
<etal/>
</person-group> (<year>2014</year>). <article-title>Divergent Paths for the Selection of Immunodominant Epitopes from Distinct Antigenic Sources</article-title>. <source>Nat. Commun.</source> <volume>5</volume>, <fpage>5369</fpage>. <pub-id pub-id-type="doi">10.1038/ncomms6369</pub-id> </citation>
</ref>
<ref id="B21">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lanthier</surname>
<given-names>D. K.</given-names>
</name>
<name>
<surname>Vassall</surname>
<given-names>K. A.</given-names>
</name>
<name>
<surname>Harauz</surname>
<given-names>G.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Biophysical Characterization of 21.5-kDa Myelin Basic Protein (MBP) and the Effects of Zinc on its Structure</article-title>. <source>Surgery</source> <volume>7</volume>, <fpage>30</fpage>&#x2013;<lpage>41</lpage>. <pub-id pub-id-type="doi">10.21083/surg.v7i3.2958</pub-id> </citation>
</ref>
<ref id="B22">
<citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname>Link</surname>
<given-names>H.</given-names>
</name>
</person-group> (<year>1997</year>). &#x201c;<article-title>B Cells and Autoimmunity</article-title>,&#x201d; in <source>Molecular Biology of Multiple Sclerosis</source>. Editor <person-group person-group-type="editor">
<name>
<surname>Russell</surname>
<given-names>WC.</given-names>
</name>
</person-group> (<publisher-loc>Chichester, UK</publisher-loc>: <publisher-name>John Wiley &#x26; Sons</publisher-name>), <fpage>161</fpage>&#x2013;<lpage>191</lpage>. </citation>
</ref>
<ref id="B23">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lolli</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Mulinacci</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Carotenuto</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Bonetti</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Sabatino</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Mazzanti</surname>
<given-names>B.</given-names>
</name>
<etal/>
</person-group> (<year>2005</year>). <article-title>An N-Glucosylated Peptide Detecting Disease-specific Autoantibodies, Biomarkers of Multiple Sclerosis</article-title>. <source>Proc. Natl. Acad. Sci. U.S.A.</source> <volume>102</volume>, <fpage>10273</fpage>&#x2013;<lpage>10278</lpage>. <pub-id pub-id-type="doi">10.1073/pnas.0503178102</pub-id> </citation>
</ref>
<ref id="B24">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lolli</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Rovero</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Chelli</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Papini</surname>
<given-names>A. M.</given-names>
</name>
</person-group> (<year>2006</year>). <article-title>Toward Biomarkers in Multiple Sclerosis: New Advances</article-title>. <source>Expert Rev. Neurother.</source> <volume>6</volume>, <fpage>781</fpage>&#x2013;<lpage>794</lpage>. <pub-id pub-id-type="doi">10.1586/14737175.6.5.781</pub-id> </citation>
</ref>
<ref id="B25">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mameli</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Cossu</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Cocco</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Masala</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Frau</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Marrosu</surname>
<given-names>M. G.</given-names>
</name>
<etal/>
</person-group> (<year>2014</year>). <article-title>Epstein-Barr Virus and <italic>Mycobacterium avium</italic> Subsp. Paratuberculosis Peptides Are Cross Recognized by Anti-myelin Basic Protein Antibodies in Multiple Sclerosis Patients</article-title>. <source>J. Neuroimmunol.</source> <volume>270</volume>, <fpage>51</fpage>&#x2013;<lpage>55</lpage>. <pub-id pub-id-type="doi">10.1016/j.jneuroim.2014.02.013</pub-id> </citation>
</ref>
<ref id="B26">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Marion</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>W&#xfc;thrich</surname>
<given-names>K.</given-names>
</name>
</person-group> (<year>1983</year>). <article-title>Application of Phase Sensitive Two-Dimensional Correlated Spectroscopy (COSY) for Measurements of 1H-1H Spin-Spin Coupling Constants in Proteins</article-title>. <source>Biochem. Biophysical Res. Commun.</source> <volume>113</volume>, <fpage>967</fpage>&#x2013;<lpage>974</lpage>. <pub-id pub-id-type="doi">10.1016/0006-291X(83)91093-8</pub-id> </citation>
</ref>
<ref id="B27">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Martin</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Jaraquemada</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Flerlage</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Richert</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Whitaker</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Long</surname>
<given-names>E. O.</given-names>
</name>
<etal/>
</person-group> (<year>1990</year>). <article-title>Fine Specificity and HLA Restriction of Myelin Basic Protein-specific Cytotoxic T Cell Lines from Multiple Sclerosis Patients and Healthy Individuals</article-title>. <source>J. Immunol.</source> <volume>145</volume>, <fpage>540</fpage>&#x2013;<lpage>548</lpage>. </citation>
</ref>
<ref id="B28">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Martinsen</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Kursula</surname>
<given-names>P.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>Multiple Sclerosis and Myelin Basic Protein: Insights into Protein Disorder and Disease</article-title>. <source>Amino Acids</source> <volume>54</volume>, <fpage>99</fpage>&#x2013;<lpage>109</lpage>. <pub-id pub-id-type="doi">10.1007/s00726-021-03111-7</pub-id> </citation>
</ref>
<ref id="B29">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mazzoleni</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Real&#x2010;Fernandez</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Nuti</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Lanzillo</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Brescia Morra</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Dambruoso</surname>
<given-names>P.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>Selective Capture of Anti&#x2010; N &#x2010;glucosylated NTHi Adhesin Peptide Antibodies by a Multivalent Dextran Conjugate</article-title>. <source>Chembiochem</source> <volume>23</volume>. <pub-id pub-id-type="doi">10.1002/cbic.202100515</pub-id> </citation>
</ref>
<ref id="B30">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Meier</surname>
<given-names>U.-C.</given-names>
</name>
<name>
<surname>Cipian</surname>
<given-names>R. C.</given-names>
</name>
<name>
<surname>Karimi</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Ramasamy</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Middeldorp</surname>
<given-names>J. M.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>Cumulative Roles for Epstein-Barr Virus, Human Endogenous Retroviruses, and Human Herpes Virus-6 in Driving an Inflammatory Cascade Underlying MS Pathogenesis</article-title>. <source>Front. Immunol.</source> <volume>12</volume>, <fpage>757302</fpage>. <pub-id pub-id-type="doi">10.3389/fimmu.2021.757302</pub-id> </citation>
</ref>
<ref id="B31">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Miles</surname>
<given-names>A. J.</given-names>
</name>
<name>
<surname>Ramalli</surname>
<given-names>S. G.</given-names>
</name>
<name>
<surname>Wallace</surname>
<given-names>B. A.</given-names>
</name>
</person-group> (<year>2022</year>). <article-title>DichroWeb, a Website for Calculating Protein Secondary Structure from Circular Dichroism Spectroscopic Data</article-title>. <source>Protein Sci.</source> <volume>31</volume>, <fpage>37</fpage>&#x2013;<lpage>46</lpage>. <pub-id pub-id-type="doi">10.1002/pro.4153</pub-id> </citation>
</ref>
<ref id="B32">
<citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname>Moscarello</surname>
<given-names>M. A.</given-names>
</name>
</person-group> (<year>1997</year>). &#x201c;<article-title>Myelin Basic Protein, the "Executive" Molecule of the Myelin Membrane</article-title>,&#x201d; in <source>Cell Biology and Pathology of Myelin: Evolving Biological Concepts and Therapeutic Approaches (Juurlink B.H.J.</source> Editors <person-group person-group-type="editor">
<name>
<surname>Devon</surname>
<given-names>R.M.</given-names>
</name>
<name>
<surname>Doucette</surname>
<given-names>J.R.</given-names>
</name>
<name>
<surname>Nazarali</surname>
<given-names>A.J.</given-names>
</name>
<name>
<surname>Schreyer</surname>
<given-names>D.J.</given-names>
</name>
<name>
<surname>Verge</surname>
<given-names>V.M.K.</given-names>
</name>
</person-group> (<publisher-loc>New York</publisher-loc>: <publisher-name>Plenum</publisher-name>), <fpage>13</fpage>&#x2013;<lpage>25</lpage>. <pub-id pub-id-type="doi">10.1007/978-1-4615-5949-8_2</pub-id> </citation>
</ref>
<ref id="B33">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Muruganandam</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>B&#xfc;rck</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Ulrich</surname>
<given-names>A. S.</given-names>
</name>
<name>
<surname>Kursula</surname>
<given-names>I.</given-names>
</name>
<name>
<surname>Kursula</surname>
<given-names>P.</given-names>
</name>
</person-group> (<year>2013</year>). <article-title>Lipid Membrane Association of Myelin Proteins and Peptide Segments Studied by Oriented and Synchrotron Radiation Circular Dichroism Spectroscopy</article-title>. <source>J. Phys. Chem. B</source> <volume>117</volume>, <fpage>14983</fpage>&#x2013;<lpage>14993</lpage>. <pub-id pub-id-type="doi">10.1021/jp4098588</pub-id> </citation>
</ref>
<ref id="B34">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Nuti</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Fernandez</surname>
<given-names>F. R.</given-names>
</name>
<name>
<surname>Sabatino</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Peroni</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Mulinacci</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Paolini</surname>
<given-names>I.</given-names>
</name>
<etal/>
</person-group> (<year>2020</year>). <article-title>A Multiple N-Glucosylated Peptide Epitope Efficiently Detecting Antibodies in Multiple Sclerosis</article-title>. <source>Brain Sci.</source> <volume>10</volume>, <fpage>453</fpage>. <pub-id pub-id-type="doi">10.3390/brainsci10070453</pub-id> </citation>
</ref>
<ref id="B35">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Nuti</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Peroni</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Real-Fern&#xe1;ndez</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Bonache</surname>
<given-names>M. A.</given-names>
</name>
<name>
<surname>Le Chevalier-Isaad</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Chelli</surname>
<given-names>M.</given-names>
</name>
<etal/>
</person-group> (<year>2010</year>). <article-title>Posttranslationally Modified Peptides Efficiently Mimicking Neoantigens: A Challenge for Theragnostics of Autoimmune Diseases</article-title>. <source>Biopolymers</source> <volume>94</volume>, <fpage>791</fpage>&#x2013;<lpage>799</lpage>. <pub-id pub-id-type="doi">10.1002/bip.21456</pub-id> </citation>
</ref>
<ref id="B36">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>O&#x27;Connor</surname>
<given-names>K. C.</given-names>
</name>
<name>
<surname>Chitnis</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Griffin</surname>
<given-names>D. E.</given-names>
</name>
<name>
<surname>Piyasirisilp</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Bar-Or</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Khoury</surname>
<given-names>S.</given-names>
</name>
<etal/>
</person-group> (<year>2003</year>). <article-title>Myelin Basic Protein-Reactive Autoantibodies in the Serum and Cerebrospinal Fluid of Multiple Sclerosis Patients Are Characterized by Low-Affinity Interactions</article-title>. <source>J. Neuroimmunol.</source> <volume>136</volume>, <fpage>140</fpage>&#x2013;<lpage>148</lpage>. <pub-id pub-id-type="doi">10.1016/s0165-5728(03)00002-x</pub-id> </citation>
</ref>
<ref id="B37">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ota</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Matsui</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Milford</surname>
<given-names>E. L.</given-names>
</name>
<name>
<surname>Mackin</surname>
<given-names>G. A.</given-names>
</name>
<name>
<surname>Weiner</surname>
<given-names>H. L.</given-names>
</name>
<name>
<surname>Hafler</surname>
<given-names>D. A.</given-names>
</name>
</person-group> (<year>1990</year>). <article-title>T-cell Recognition of an Immuno-Dominant Myelin Basic Protein Epitope in Multiple Sclerosis</article-title>. <source>Nature</source> <volume>346</volume>, <fpage>183</fpage>&#x2013;<lpage>187</lpage>. <pub-id pub-id-type="doi">10.1038/346183a0</pub-id> </citation>
</ref>
<ref id="B38">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Pandey</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Alcaro</surname>
<given-names>M. C.</given-names>
</name>
<name>
<surname>Scrima</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Peroni</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Paolini</surname>
<given-names>I.</given-names>
</name>
<name>
<surname>Di Marino</surname>
<given-names>S.</given-names>
</name>
<etal/>
</person-group> (<year>2012</year>). <article-title>Designed Glucopeptides Mimetics of Myelin Protein Epitopes as Synthetic Probes for the Detection of Autoantibodies, Biomarkers of Multiple Sclerosis</article-title>. <source>J. Med. Chem.</source> <volume>55</volume> (<issue>23</issue>), <fpage>10437</fpage>&#x2013;<lpage>10447</lpage>. <pub-id pub-id-type="doi">10.1021/jm301031r</pub-id> </citation>
</ref>
<ref id="B41">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Piantini</surname>
<given-names>U.</given-names>
</name>
<name>
<surname>Sorensen</surname>
<given-names>O. W.</given-names>
</name>
<name>
<surname>Ernst</surname>
<given-names>R. R.</given-names>
</name>
</person-group> (<year>1982</year>). <article-title>Multiple Quantum Filters for Elucidating NMR Coupling Networks</article-title>. <source>J. Am. Chem. Soc.</source> <volume>104</volume>, <fpage>6800</fpage>&#x2013;<lpage>6801</lpage>. <pub-id pub-id-type="doi">10.1021/ja00388a062</pub-id> </citation>
</ref>
<ref id="B42">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Polman</surname>
<given-names>C. H.</given-names>
</name>
<name>
<surname>Reingold</surname>
<given-names>S. C.</given-names>
</name>
<name>
<surname>Banwell</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Clanet</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Cohen</surname>
<given-names>J. A.</given-names>
</name>
<name>
<surname>Filippi</surname>
<given-names>M.</given-names>
</name>
<etal/>
</person-group> (<year>2011</year>). <article-title>Diagnostic Criteria for Multiple Sclerosis: 2010 Revisions to the McDonald Criteria</article-title>. <source>Ann. Neurol.</source> <volume>69</volume>, <fpage>292</fpage>&#x2013;<lpage>302</lpage>. <pub-id pub-id-type="doi">10.1002/ana.22366</pub-id> </citation>
</ref>
<ref id="B43">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rahmanzadeh</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Br&#xfc;ck</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Minagar</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Sahraian</surname>
<given-names>M. A.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Multiple Sclerosis Pathogenesis: Missing Pieces of an Old Puzzle</article-title>. <source>Rev. Neurosci.</source> <volume>30</volume>, <fpage>67</fpage>&#x2013;<lpage>83</lpage>. <pub-id pub-id-type="doi">10.1515/revneuro-2018-0002</pub-id> </citation>
</ref>
<ref id="B44">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Real Fern&#xe1;ndez</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Di Pisa</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Rossi</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Auberger</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Lequin</surname>
<given-names>O.</given-names>
</name>
<name>
<surname>Larregola</surname>
<given-names>M.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Antibody Recognition in Multiple Sclerosis and Rett Syndrome Using a Collection of Linear and cyclicN-Glucosylated Antigenic Probes</article-title>. <source>Biopolymers</source> <volume>104</volume>, <fpage>560</fpage>&#x2013;<lpage>576</lpage>. <pub-id pub-id-type="doi">10.1002/bip.22677</pub-id> </citation>
</ref>
<ref id="B45">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rizzolo</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Testa</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Lambardi</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Chorev</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Chelli</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Rovero</surname>
<given-names>P.</given-names>
</name>
<etal/>
</person-group> (<year>2011</year>). <article-title>Conventional and Microwave-Assisted SPPS Approach: a Comparative Synthesis of PTHrP(1-34)NH2</article-title>. <source>J. Pept. Sci.</source> <volume>17</volume>, <fpage>708</fpage>&#x2013;<lpage>714</lpage>. <pub-id pub-id-type="doi">10.1002/psc.1395</pub-id> </citation>
</ref>
<ref id="B46">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Robinson</surname>
<given-names>W. H.</given-names>
</name>
<name>
<surname>Steinman</surname>
<given-names>L.</given-names>
</name>
</person-group> (<year>2022</year>). <article-title>Epstein-Barr Virus and Multiple Sclerosis</article-title>. <source>Science</source> <volume>375</volume>, <fpage>264</fpage>&#x2013;<lpage>265</lpage>. <pub-id pub-id-type="doi">10.1126/science.abm7930</pub-id> </citation>
</ref>
<ref id="B47">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Rozenblum</surname>
<given-names>G. T.</given-names>
</name>
<name>
<surname>Kaufman</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Vitullo</surname>
<given-names>A. D.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Myelin Basic Protein and a Multiple Sclerosis-Related MBP-Peptide Bind to Oligonucleotides</article-title>. <source>Mol. Ther. - Nucleic Acids</source> <volume>3</volume>, <fpage>e192</fpage>. <pub-id pub-id-type="doi">10.1038/mtna.2014.43</pub-id> </citation>
</ref>
<ref id="B48">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sellebjerg</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Jensen</surname>
<given-names>C. V.</given-names>
</name>
<name>
<surname>Christiansen</surname>
<given-names>M.</given-names>
</name>
</person-group> (<year>2000</year>). <article-title>Intrathecal IgG Synthesis and Autoantibody-Secreting Cells in Multiple Sclerosis</article-title>. <source>J. Neuroimmunol.</source> <volume>108</volume>, <fpage>207</fpage>&#x2013;<lpage>215</lpage>. <pub-id pub-id-type="doi">10.1016/s0165-5728(00)00292-7</pub-id> </citation>
</ref>
<ref id="B49">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sellebjerg</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Madsen</surname>
<given-names>H. O.</given-names>
</name>
<name>
<surname>Frederiksen</surname>
<given-names>J. L.</given-names>
</name>
<name>
<surname>Ryder</surname>
<given-names>L. P.</given-names>
</name>
<name>
<surname>Svejgaard</surname>
<given-names>A.</given-names>
</name>
</person-group> (<year>1995</year>). <article-title>Acute Optic Neuritis: Myelin Basic Protein and Proteolipid Protein Antibodies, Affinity, and the HLA System</article-title>. <source>Ann. Neurol.</source> <volume>38</volume>, <fpage>943</fpage>&#x2013;<lpage>950</lpage>. <pub-id pub-id-type="doi">10.1002/ana.410380616</pub-id> </citation>
</ref>
<ref id="B50">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sitkoff</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Lockhart</surname>
<given-names>D. J.</given-names>
</name>
<name>
<surname>Sharp</surname>
<given-names>K. A.</given-names>
</name>
<name>
<surname>Honig</surname>
<given-names>B.</given-names>
</name>
</person-group> (<year>1994</year>). <article-title>Calculation of Electrostatic Effects at the Amino Terminus of an Alpha Helix</article-title>. <source>Biophysical J.</source> <volume>67</volume>, <fpage>2251</fpage>&#x2013;<lpage>2260</lpage>. <pub-id pub-id-type="doi">10.1016/S0006-3495(94)80709-X</pub-id> </citation>
</ref>
<ref id="B51">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sommese</surname>
<given-names>R. F.</given-names>
</name>
<name>
<surname>Sivaramakrishnan</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Baldwin</surname>
<given-names>R. L.</given-names>
</name>
<name>
<surname>Spudich</surname>
<given-names>J. A.</given-names>
</name>
</person-group> (<year>2010</year>). <article-title>Helicity of Short E-R/K Peptides</article-title>. <source>Protein Sci.</source> <volume>19</volume>, <fpage>2001</fpage>&#x2013;<lpage>2005</lpage>. <pub-id pub-id-type="doi">10.1002/pro.469</pub-id> </citation>
</ref>
<ref id="B52">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Steinman, M.D</surname>
<given-names>L.</given-names>
</name>
</person-group> (<year>1996</year>). <article-title>Multiple Sclerosis: a Coordinated Immunological Attack against Myelin in the Central Nervous System</article-title>. <source>Cell</source> <volume>85</volume>, <fpage>299</fpage>&#x2013;<lpage>302</lpage>. <pub-id pub-id-type="doi">10.1016/s0092-8674(00)81107-1</pub-id> </citation>
</ref>
<ref id="B53">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tejada-Simon</surname>
<given-names>M. V.</given-names>
</name>
<name>
<surname>Zang</surname>
<given-names>Y. C. Q.</given-names>
</name>
<name>
<surname>Hong</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Rivera</surname>
<given-names>V. M.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>J. Z.</given-names>
</name>
</person-group> (<year>2003</year>). <article-title>Cross-reactivity with Myelin Basic Protein and Human Herpesvirus-6 in Multiple Sclerosis</article-title>. <source>Ann. Neurol.</source> <volume>53</volume>, <fpage>189</fpage>&#x2013;<lpage>197</lpage>. <pub-id pub-id-type="doi">10.1002/ana.10425</pub-id> </citation>
</ref>
<ref id="B54">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Thompson</surname>
<given-names>A. J.</given-names>
</name>
<name>
<surname>Banwell</surname>
<given-names>B. L.</given-names>
</name>
<name>
<surname>Barkhof</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Carroll</surname>
<given-names>W. M.</given-names>
</name>
<name>
<surname>Coetzee</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Comi</surname>
<given-names>G.</given-names>
</name>
<etal/>
</person-group> (<year>2018</year>). <article-title>Diagnosis of Multiple Sclerosis: 2017 Revisions of the McDonald Criteria</article-title>. <source>Lancet Neurology</source> <volume>17</volume>, <fpage>162</fpage>&#x2013;<lpage>173</lpage>. <pub-id pub-id-type="doi">10.1016/S1474-4422(17)30470-2</pub-id> </citation>
</ref>
<ref id="B55">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>van Langelaar</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Rijvers</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Smolders</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>van Luijn</surname>
<given-names>M. M.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>B and T Cells Driving Multiple Sclerosis: Identity, Mechanisms and Potential Triggers</article-title>. <source>Front. Immunol.</source> <volume>11</volume>, <fpage>760</fpage>. <pub-id pub-id-type="doi">10.3389/fimmu.2020.00760</pub-id> </citation>
</ref>
<ref id="B56">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Van Regenmortel</surname>
<given-names>M. H. V.</given-names>
</name>
</person-group> (<year>2001</year>). <article-title>Antigenicity and Immunogenicity of Synthetic Peptides</article-title>. <source>Biologicals</source> <volume>29</volume> (<issue>3-4</issue>), <fpage>209</fpage>&#x2013;<lpage>213</lpage>. <pub-id pub-id-type="doi">10.1006/biol.2001.0308</pub-id> </citation>
</ref>
<ref id="B57">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Walvoort</surname>
<given-names>M. T. C.</given-names>
</name>
<name>
<surname>Testa</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Eilam</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Aharoni</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Nuti</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Rossi</surname>
<given-names>G.</given-names>
</name>
<etal/>
</person-group> (<year>2016</year>). <article-title>Antibodies from Multiple Sclerosis Patients Preferentially Recognize Hyperglucosylated Adhesin of Non-typeable Haemophilus Influenzae</article-title>. <source>Sci. Rep.</source> <volume>6</volume>, <fpage>39430</fpage>. <pub-id pub-id-type="doi">10.1038/srep39430</pub-id> </citation>
</ref>
<ref id="B58">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Warren</surname>
<given-names>K. G.</given-names>
</name>
<name>
<surname>Catz</surname>
<given-names>I.</given-names>
</name>
<name>
<surname>Ferenczi</surname>
<given-names>L. Z.</given-names>
</name>
<name>
<surname>Krantz</surname>
<given-names>M. J.</given-names>
</name>
</person-group> (<year>2006</year>). <article-title>Intravenous Synthetic Peptide MBP8298 Delayed Disease Progression in an HLA Class II-Defined Cohort of Patients with Progressive Multiple Sclerosis: Results of a 24-month Double-Blind Placebo-Controlled Clinical Trial and 5 Years of Follow-Up Treatment</article-title>. <source>Eur. J. Neurol.</source> <volume>13</volume>, <fpage>887</fpage>&#x2013;<lpage>895</lpage>. <pub-id pub-id-type="doi">10.1111/j.1468-1331.2006.01533.x</pub-id> </citation>
</ref>
<ref id="B59">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Warren</surname>
<given-names>K. G.</given-names>
</name>
<name>
<surname>Catz</surname>
<given-names>I.</given-names>
</name>
<name>
<surname>Steinman</surname>
<given-names>L.</given-names>
</name>
</person-group> (<year>1995</year>). <article-title>Fine Specificity of the Antibody Response to Myelin Basic Protein in the Central Nervous System in Multiple Sclerosis: the Minimal B-Cell Epitope and a Model of its Features</article-title>. <source>Proc. Natl. Acad. Sci. U.S.A.</source> <volume>92</volume>, <fpage>11061</fpage>&#x2013;<lpage>11065</lpage>. <pub-id pub-id-type="doi">10.1073/pnas.92.24.11061</pub-id> </citation>
</ref>
<ref id="B60">
<citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname>White</surname>
<given-names>D. C.</given-names>
</name>
</person-group> (<year>2002</year>). <source>Proteins, Peptides, and Amino Acids SourceBook</source>. <publisher-name>New York, NY: Springer</publisher-name>. </citation>
</ref>
<ref id="B61">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yang</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Spek</surname>
<given-names>E. J.</given-names>
</name>
<name>
<surname>Gong</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Kallenbach</surname>
<given-names>N. R.</given-names>
</name>
</person-group> (<year>1997</year>). <article-title>The Role of Context on &#x3b1;-helix Stabilization: Host-Guest Analysis in a Mixed Background Peptide Model</article-title>. <source>Protein Sci.</source> <volume>6</volume>, <fpage>1264</fpage>&#x2013;<lpage>1272</lpage>. <pub-id pub-id-type="doi">10.1002/pro.5560060614</pub-id> </citation>
</ref>
<ref id="B62">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zamvil</surname>
<given-names>S. S.</given-names>
</name>
<name>
<surname>Steinman</surname>
<given-names>L.</given-names>
</name>
</person-group> (<year>1990</year>). <article-title>The T Lymphocyte in Experimental Allergic Encephalomyelitis</article-title>. <source>Annu. Rev. Immunol.</source> <volume>8</volume>, <fpage>579</fpage>&#x2013;<lpage>621</lpage>. <pub-id pub-id-type="doi">10.1146/annurev.iy.08.040190.003051</pub-id> </citation>
</ref>
</ref-list>
</back>
</article>