Different clinical response to interferon beta and glatiramer acetate related to the presence of oligoclonal IgM bands in CSF in multiple sclerosis patients

Casanova, Bonaventura; Lacruz, Laura; Villar, M; Domínguez, José Andrés; Gadea, María Carcelén; Gascón, Francisco; Mallada, Javier; Hervás, David; Simó-Castelló, María; Álvarez‐Cermeño, José C.; Calles, Carmen; Olascoaga, Javier; Ramió-Torrentà, Lluı́s; Alcalá, Carmen; Cervelló, Ángeles; Boscá, Isabel; Pérez-Mirallles, Francisco Carlos; Coret, Francisco

doi:10.1007/s10072-018-3442-y

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…36,37 OCBs as well as the presence of intrathecal IgM synthesis have some prognostic value in MS at the time of diagnosis. [38][39][40][41][42] Some OCB antibodies recognize conformational epitopes of ubiquitous intracellular proteins, indicating that part of the OCB response may occur secondary to tissue damage. 43 OCB production and expanded intrathecal plasmablast clones can be observed even at the earliest prodromal stages of MS, as revealed in MS-discordant monozygotic twin pairs, where the clinically unaffected cotwin may show CSF changes of "subclinical neuroinflammation."…”

Section: B-cell Trafficking In the Cnsmentioning

confidence: 99%

Role of B Cells in Multiple Sclerosis and Related Disorders

Comı¹,

Bar‐Or

Lassmann³

et al. 2020

Annals of Neurology

156

106

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The success of clinical trials of selective B‐cell depletion in patients with relapsing multiple sclerosis (MS) and primary progressive MS has led to a conceptual shift in the understanding of MS pathogenesis, away from the classical model in which T cells were the sole central actors and toward a more complex paradigm with B cells having an essential role in both the inflammatory and neurodegenerative components of the disease process. The role of B cells in MS was selected as the topic of the 27th Annual Meeting of the European Charcot Foundation. Results of the meeting are presented in this concise review, which recaps current concepts underlying the biology and therapeutic rationale behind B‐cell–directed therapeutics in MS, and proposes strategies to optimize the use of existing anti–B‐cell treatments and provide future directions for research in this area. ANN NEUROL 2021;89:13–23

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Section: B-cell Trafficking In the Cnsmentioning

confidence: 99%

Role of B Cells in Multiple Sclerosis and Related Disorders

Comı¹,

Bar‐Or

Lassmann³

et al. 2020

Annals of Neurology

156

106

View full text Add to dashboard Cite

show abstract

“…However, studies that directly compared ITGS with ITMS with regards to prediction of disease severity have shown that ITMS is more reliable ( 12 , 20 ). Over the years, various methods to quantify the presence of ITMS have been developed ( 5 ), including the linear IgM-index, the intrathecal fraction of IgM (IgM IF ) according to Reiber’s formula ( 10 , 12 , 17 ), and qualitative detection of oligoclonal IgM bands (OCMB) ( 18 , 21 ), as well as lipid-specific OCMB ( 11 , 22 ). However, it remains to be determined which of these methods most reliably estimates ITMS.…”

Section: Introductionmentioning

confidence: 99%

Increased intrathecal neurofilament light and immunoglobulin M predict severe disability in relapsing-remitting multiple sclerosis

et al. 2022

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BackgroundEmerging evidence supports that determination of intrathecal immunoglobulin M (IgM) synthesis (ITMS) and neurofilament light (NfL) concentration in cerebrospinal fluid (CSF) may be clinically useful as disease severity biomarkers in relapsing-remitting multiple sclerosis (RRMS).MethodsMonocentric observational longitudinal cohort study in which prospectively collected data were retrospectively retrieved. Included were patients with RRMS (n=457) who had a diagnostic investigation including analysis of ITMS and CSF neurofilament light (cNfL). ITMS was calculated with the linear index formula, the intrathecal fraction of IgM according to Reiber (IgMIF), and by qualitative determination of oligoclonal IgM bands (OCMB). Univariable and multivariable models were performed to predict Evidence of Disease Activity-3 (EDA-3) status within 24 months from onset, and the risk of Expanded Disability Status Score (EDSS) ≥3 and ≥6.ResultsAll investigated methods to calculate ITMS significantly predicted evidence of disease activity (EDA-3) within 24 months. IgMIF>0% showed the strongest association with EDA-3 status (adjusted hazard ratio [aHR] 3.7, 95%CI 2.7-5, p<0.001). Combining IgM-index>0.1 or OCMB with increased cNfL were strong predictors of EDSS≥3 (for cNfL+/IgM-index+: aHR 4.6, 95%CI 2.6-8.2, p<0.001) and EDSS≥6 (aHR 8.2, 95%CI 2.3-30, p<0.001).ConclusionsIn a real-world setting, ITMS was a useful biomarker in early RRMS to predict disabling MS and its prognostic value was even stronger in combination with cNfL. Our data suggest that determination of ITMS and cNfL should be included in the diagnostic work-up of RRMS for prognostic purposes and in decisions of disease-modifying therapy.

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