Cerebrospinal fluid in multiple sclerosis

Rammohan, Kottil

doi:10.4103/0972-2327.58282

Cited by 29 publications

(20 citation statements)

References 47 publications

(52 reference statements)

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“…The key observation that led to the discovery of OCB dates to 1942, when Kabat described elevated gamma globulins in the CSF of MS patients. In 1959, Karcher, van Sande and Lowenthal reported that agar electrophoresis could differentiate CSF gamma-globulins from a patient with subacute sclerosing panencephalitis 4,5 . Since 1986, OCB detection in CSF has been routinely carried out using isoelectric focusing on agarose gel with immunoblotting.…”

Section: Discussionmentioning

confidence: 99%

Intrathecal synthesis in particular types of multiple sclerosis

Sládková¹,

Mares²,

Hluštı́k³

et al. 2014

BIOMED PAP

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Aim. 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). Methods. 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). Results. 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. Conclusion.No difference in intrathecal synthesis (IgG index) and the number of OCB between different types of MS was confirmed.

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Section: Discussionmentioning

confidence: 99%

Intrathecal synthesis in particular types of multiple sclerosis

Sládková¹,

Mares²,

Hluštı́k³

et al. 2014

BIOMED PAP

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“…Th e main source of case identifi cation were hospital medical fi les, with relevant medical data routinely collected by neurologists at the Neuroimmunology and Neurogenetics Unit, Clinical Department of Neurology, Sestre milosrdnice University Hospital Centre in Zagreb, Croatia, during hospitalization. Relevant registry data included the following: age and gender; family history of MS; data on previous immunization: vaccination for morbillivirus (measles virus), parotitis virus (mumps) and rubella virus, hepatitis B virus (HBV), and other nonspecifi c vaccination; MS disease course (primary progressive MS (PPMS), remitting relapsing MS (RRMS), or secondary progressive MS (SPMS); Expanded Disability Status Scale (EDSS) score; cerebral magnetic resonance imaging (MRI) T2/FLAIR lesion load quantifi cation: moderate lesion load (0-9), signifi cant lesion load (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and progressive lesion load (more than 20); cerebrospinal fl uid (CSF) examination: protein index for evaluation of intrathecal IgG synthesis, evaluation of the blood-brain-barrier permeability, presence of oligoclonal bands (OCBs); evaluation of polyspecifi c, intrathecal humoral immune response against viral agents including antibodies to measles, rubella and varicella zoster virus (MRZ) reaction (MRZR); and further CSF analysis for Borrelia burgdorferi, neurotropic viruses, and central nervous system (CNS) parasites. Lifestyle habits, smoking and alcohol consumption were also analyzed.…”

Section: Methodsmentioning

confidence: 99%

The First Hospital-Based Registry of Patients with Multiple Sclerosis in Croatia

Kes¹

2017

ACC

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The first hospital-based registry of patients with multiple sclerosis (MS) was established at the University Department of Neurology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia, in 2014. The aim of the registry was to continuously provide data on the number of hospital-managed MS patients, patterns of disease progression, predictors of disability progression, changes in lifespan and long-term outcomes. Relevant medical data included age and gender of MS patients, family history of MS, data on previous immunization, disease course, Expanded Disability Status Scale (EDSS) score, cerebral magnetic resonance imaging (MRI) lesion load quantification, and cerebrospinal fluid analysis. Lifestyle habits in MS patients including smoking and alcohol consumption were also analyzed. All data were obtained from primary medical records between January 1, 2014 and January 1, 2015, and entered into the database. Data were evaluated retrospectively according to age and gender differences. Results showed that the majority of patients enrolled in the registry had the remitting relapsing course of disease, with low EDSS score indicating no disability or minimal disability. Cerebrospinal fluid analysis showed that oligoclonal bands were present in the majority of MS patients, with affected blood-brain-barrier permeability. According to the remitting relapsing course of the disease, cerebral MRI quantitative analysis demonstrated a significant lesion load in the majority of patients. When stratified by lifestyle habits, smokers and alcohol consumers were more prevalent among male patients. Our hospital-based registry might be considered as a prototype for the national MS registry and should be improved for reliable statistical analysis.

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“…OCBs are bands of oligoclonal immunoglobulins, mainly immunoglobulin G (IgG), which are separated based on differences in isoelectric points (Rammohan, 2009). The existence of these bands within the CSF, but not within the serum, is a strong indicator of intrathecal antibody synthesis and, interestingly, is found in nearly all patients with clinically definitive MS (Zeman et al, 1996).…”

Section: B Cells and Antibodiesmentioning

confidence: 99%