Detection of oligoclonal bands as a part of the diagnosis of multiple sclerosis – case studies

2021 ◽  
Vol 57 (2) ◽  
pp. 1-8
Author(s):  
Jolanta Stacherzak-Pawlik ◽  
Paulina Boćko ◽  
Ewa Zagocka
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Autoimmune Diseases ◽  
Oligoclonal Bands ◽  
Multiple Sclerosis Case ◽  
Limit Values ◽  
Igg Synthesis ◽  
Intrathecal Igg Synthesis ◽  
Specific Antigens

Introduction: Oligoclonal bands are the result of the synthesis of antibodies of limited heterogeneity, that is, directed against one or more specific antigens. Their detection is an important element in the diagnosis of autoimmune diseases. In multiple sclerosis, the diagnostic sensitivity of the determination of oligoclonal bands is high. Aim: The aim of this study is to answer the question whether the detection of oligoclonal bands a more valuable study is than the Tibbling-Link index and reibergram analysis in the context of the diagnosis of multiple sclerosis. Material and methods: Oligoclonal bands were tested in the cerebrospinal fluid and serum from 9 patients suspected of multiple sclerosis using the Sebia HYDRAGEL 3 CSF ISOFOCUSING kit. Results: In 7 out of 9 patients the Tibbling-Link index, reibergram analysis and oligoclonal bands detection clearly indicated intrathecal IgG synthesis. In 2 of 9 patients, detection of oligoclonal bands indicated intrathecal IgG synthesis and the value of Tibbling-Link index and reibergram analysis did not indicated intrathecal IgG production or these tests indicated limit values. Conclusions: The detection of oligoclonal bands in many cases allows for faster diagnosis and introduction of therapy. This test should be an integral part of SM diagnostics.

scholarly journals Cytokines and intrathecal IgG synthesis in multiple sclerosis patients during clinical remission

2005 ◽  
Vol 63 (4) ◽  
pp. 914-919 ◽  
Author(s):  
Carlos Otávio Brandão ◽  
Heloísa Helena Ruocco ◽  
Alessandro dos Santos Farias ◽  
Celina Oliveira ◽  
Dannie Eiko Maeda Hallal-Longo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Proinflammatory Cytokines ◽  
Clinical Remission ◽  
Cytokine Production ◽  
Inflammatory Activity ◽  
Oligoclonal Bands ◽  
Igg Synthesis ◽  
Intrathecal Igg Synthesis ◽  
Multiple Sclerosis Patients

Cytokines and intrathecal IgG synthesis were determined in the cerebrospinal fluid (CSF) and sera to evaluate inflammatory activity in multiple sclerosis (MS) patients during clinical remission. Although the disease was stable, there had been a significant increase of proinflammatory cytokines such as TNFalpha and IFNgamma in the CSF and serum, with no significant changes of IL12 and IL10 production. The changes in the cytokine production patterns were associated with an increase of leukocytes in the CSF, as well as the presence of oligoclonal bands suggesting intrathecal IgG synthesis. These results suggest that even when the disease is clinically silent, one can observe inflammatory activity in these MS patients.

scholarly journals The cerebrospinal fluid in multiple sclerosis: far beyond the bands

2017 ◽  
Vol 15 (1) ◽  
pp. 100-104 ◽  
Author(s):  
Renan Barros Domingues ◽  
Gustavo Bruniera Peres Fernandes ◽  
Fernando Brunale Vilela de Moura Leite ◽  
Charles Peter Tilbery ◽  
Rodrigo Barbosa Thomaz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Oligoclonal Bands ◽  
Fluid Analysis ◽  
Cerebrospinal Fluid Biomarkers ◽  
Therapeutic Decisions ◽  
Neuroimaging Data ◽  
Chemokine Ligand ◽  
New Biomarkers

ABSTRACT The cerebrospinal fluid analysis has been employed for supporting multiple sclerosis diagnosis and ruling out the differential diagnoses. The most classical findings reflect the inflammatory nature of the disease, including mild pleocytosis, mild protein increase, intrathecal synthesis of immunoglobulin G, and, most typically, the presence of oligoclonal bands. In recent years, new biomarkers have emerged in the context of multiple sclerosis. The search for new biomarkers reflect the need of a better evaluation of disease activity, disease progression, and treatment efficiency. A more refined evaluation of disease and therapy status can contribute to better therapeutic choices, particularly in escalation of therapies. This is very relevant taking into account the availability of a greater number of drugs for multiple sclerosis treatment in recent years. In this review, we critically evaluate the current literature regarding the most important cerebrospinal fluid biomarkers in multiple sclerosis. The determination of biomarkers levels, such as chemokine ligand 13, fetuin A, and mainly light neurofilament has shown promising results in the evaluation of this disease, providing information that along with clinical and neuroimaging data may contribute to better therapeutic decisions.

scholarly journals Comparative characteristic of laboratory indicators for encephalitis, disseminated encephalomyelitis and multiple sclerosis in children

2018 ◽  
Vol 13 (3) ◽  
pp. 25-35
Author(s):  
E. Y. Skripchenko ◽  
L. A. Alekseeva ◽  
N. V. Skripchenko ◽  
T. V. Bessonova
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Immunoglobulin G ◽  
Clinical Manifestations ◽  
Comparative Characteristic ◽  
Control Group ◽  
Humoral Immune ◽  
Igg Synthesis ◽  
Intrathecal Igg Synthesis ◽  
Subsequent Calculation

Background. The similarity of the clinical manifestations of encephalitis (E), disseminated encephalomyelitis (DEM) and multiple sclerosis (MS) in children, the complexity of predicting the nature of the course and outcome of diseases determines the search for additional diagnostic and prognosis criteria.Objective: a comparative characteristic of laboratory indicators for E, DEM and RS in children to assess their diagnostic and prognostic value.Materials and methods. Fifty six children (14 children with E, 14 – with DEM, 28 – with MS) and 16 children of the control group (with acute respiratory virus infection) at the age from 10 to 17 years were examined. Laboratory methods included standard studies of cerebrospinal fluid (protein, cytosis), determination of concentrations of albumin and immunoglobulin G (IgG) in cerebrospinal fluid and serum with subsequent calculation of protein indices (albumin, immunoglobulin, intrathecal immunoglobulin G indexes).Results. With all nosological forms in the serum there were no significant differences between albumin and IgG from the control group, whereas in the cerebrospinal fluid an excess of the concentration of IgG was detected at a normal level of albumin. An increase in the albumin index was found only in E, whereas the immunoglobulin index was significantly higher than the norm in all groups of patients. A significant spread of the intrathecal IgG index (from 0.1 to 11.9) was found, which determined the analysis of clinical and laboratory parameters by subgroups, depending on its magnitude. The maximum incidence of increased intrathecal IgG synthesis was detected in children with MS (with exacerbation of MS – 74 %, in remission – 67 %), whereas in E and DEM, an increase was observed in about half of the patients surveyed and associated with a more favorable course of the disease.Conclusion. The data obtained make it possible to assert that, despite the commonness of some pathogenetic mechanisms, there are differences in the degree of impaired permeability of the blood brain barrier, the intensity of the systemic and intrathecal humoral immune response in E, DEM and RS, which may determine the features of their course and the outcome of the disease, including the transformation of the DEM in the RS.

Relative value of three laboratory methods in the diagnosis of multiple sclerosis.

1981 ◽  
Vol 27 (12) ◽  
pp. 2011-2013 ◽  
Author(s):  
L C Bloomer ◽  
P F Bray
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Laboratory Data ◽  
Oligoclonal Bands ◽  
Serum Samples ◽  
Relative Value ◽  
Definite Multiple Sclerosis ◽  
Multiple Sclerosis Patients ◽  
Positive Results

Abstract We compared three methods of analysis for IgG in cerebrospinal fluid, using samples from 158 patients with clinically suspected multiple sclerosis and from 200 neurological controls. The tests were: search for oligoclonal bands, calculation of rate of synthesis of IgG in the cerebrospinal fluid, and determination of the IgG/albumin ratio. Paired cerebrospinal fluid and serum samples were collected and their IgG and albumin concentrations measured. Oligoclonal bands were detected by electrophoresis on agarose. Positive results were obtained in 94, 75, and 67% of patients with probable or definite multiple sclerosis by the three respective methods. In contrast, for patients for whom the clinical diagnosis of multiple sclerosis was considered possible, positive results were obtained in 10, 43, and 13%, respectively. Evidently, detection of oligoclonal bands remains the best single test for the presence of abnormal IgG in suspected multiple sclerosis patients. A combination of the first two tests is most sensitive for both probable and definite multiple sclerosis (97%) and possible multiple sclerosis (50%). Some infectious or immunologic disorders can also produce these IgG abnormalities, but they can usually be distinguished from multiple sclerosis by other clinical and laboratory data.

Cerebrospinal fluid measures of disease activity in patients with multiple sclerosis

1998 ◽  
Vol 4 (6) ◽  
pp. 475-479 ◽  
Author(s):  
Finn Sellebjerg ◽  
Michael Christiansen ◽  
Peter Michael Nielsen ◽  
Jette L Frederiksen
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Disease Activity ◽  
Surrogate Marker ◽  
Albumin Concentration ◽  
Fluid Analysis ◽  
Acute Optic Neuritis ◽  
Igg Synthesis ◽  
Acute Exacerbations ◽  
Intrathecal Igg Synthesis

The potential of magnetic resonance imaging to serve as a surrogate marker of disease activity in patients with multiple sclerosis (MS) is increasingly recognised. In contrast, the use of cerebrospinal fluid analysis has received less attention. We analysed the correlation between clinical data and cerebrospinal fluid parameters in 75 patients with acute optic neuritis (ON) as a possible first symptom of MS, as a symptom of clinically definite MS, and in patients with an attack of MS other than ON. The samples were obtained within 30 days from the onset of an exacerbation. The concentration of myelin basic protein (MBP) in cerebrospinal fluid was significantly correlated with the visual acuity in patients with ON and the Kurtzke EDSS score in patients with MS. The concentration of MBP in CSF also correlated positively with the CSF leukocyte count, intrathecal IgG synthesis, and the CSF-serum albumin concentration quotient. The concentration of MBP in CSF correlated negatively with intrathecal IgA synthesis. The results support the use of the concentration of MBP in CSF as a surrogate marker of disease activity during acute exacerbations of MS; the data also link the presence of MBP in CSF to neuroimmunological parameters.

Tau protein level in cerebrospinal fluid is increased in patients with early multiple sclerosis

2005 ◽  
Vol 11 (3) ◽  
pp. 261-265 ◽  
Author(s):  
J Brettschneider ◽  
M Maier ◽  
S Arda ◽  
A Claus ◽  
S D Süssmuth ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Tau Protein ◽  
Protein A ◽  
Surrogate Marker ◽  
Axonal Damage ◽  
Igg Synthesis ◽  
Significant Difference ◽  
Intrathecal Igg Synthesis ◽  
Normal Controls

Axonal damage has been proposed as the major substrate of permanent clinical disability in multiple sclerosis. Tau protein, a microtubule-associated protein localised in neuronal axons, may serve as a biochemical surrogate marker to evaluate axonal damage in vivo.We intended to determine the extent of axonal damage in different stages and clinical subtypes of MS by investigating cerebrospinal fluid tau concentrations. Tau was measured using an immunoassay in 35 patients with relapsing—remitting MS, eight patients with secondary progressive MS, nine patients with primary progressive MS, 50 patients with clinically isolated syndrome suggestive of early MS and 46 normal controls. Cerebrospinal fluid tau was significantly elevated in MS compared with normal controls (median 206.0 pg/mL versus152.0 pg/mL;P=0.002). No significant difference among different subtypes of MS could be detected, although highest levels were found in very early disease stages. There was a significant elevation of CSF tau among patients with gadolinium-enhancing brain lesions in magnetic resonance imaging (P=0.02) and a tendency towards higher CSF tau levels in patients with pronounced intrathecal IgG synthesis, supporting the notion that axonal damage is influenced by inflammatory activity.

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