Abstract
The aim of this study was to determine whether there were any differences in intrathecal synthesis of immunoglobulin G (IgG) (IgG index) and number of oligoclonal bands (OCB) among particular types of multiple sclerosis (MS). 120 cerebrospinal fluid (CSF) samples were examined from 29 clinically isolated syndrome (CIS) patients and 91 MS patients (77 patients with relapsing-remitting MS (RR), 6 patients with primary progressive course of the disease (PP) and 8 patients in secondary progression (SP)); mean age = 42 years (range = 18 to 70 years). Albumin and IgG in serum and CSF was evaluated using nephelometry; an albumin quotient (CSF albumin/serum albumin), an IgG quotient (CSF IgG/serum IgG) and an IgG index (IgG quotient / albumin quotient) were then calculated. OCB were assessed using isoelectric focusing (IEF) on agarose gel, followed by immunoblotting. All patients were evaluated using the Kurtzke Expanded Disability Status Scale (EDSS). No statistically significant differences between the IgG index and OC bands relative to particular types of MS were found. Further, there were no significant correlations between EDSS values and intrathecal synthesis (IgG index: QIgG / Qalbumin) and OC bands. No difference in intrathecal synthesis (IgG index) and the number of OCB between different types of MS was confirmed.
Highlights
GROUP AND METHODSMultiple sclerosis (MS) is an inflammatory autoimmune disease of the central nervous system (CNS), directed against the myelin sheath, leading to demyelination and axonal loss
72% of multiple sclerosis (MS) patients present with an elevated immunoglobulin G (IgG) index and 98% of MS patients have intrathecal oligoclonal bands (OCB), which are not found in serum[2,3]
We found no statistically significant differences between the IgG index and the number of OCB in particular MS types
Summary
Multiple sclerosis (MS) is an inflammatory autoimmune disease of the central nervous system (CNS), directed against the myelin sheath, leading to demyelination and axonal loss. The inflammatory reaction involves various components of the immune system: B and T cells, macrophages, cytokines, antibodies and the complement system[1]. Immunoglobulins produced by activated B-lymphocytes are capable of crossing the brain-blood barrier. An elevation of the CSF IgG and the IgG index, and the presence of oligoclonal bands in the CSF are characteristics of MS. ; these findings are not exclusive to MS. OCB can be found in other inflammatory and chronic infections of the CNS. 72% of MS patients present with an elevated IgG index and 98% of MS patients have intrathecal OCB, which are not found in serum[2,3]
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