Intrathecal oligoclonal bands synthesis in multiple sclerosis: is it always a prognostic factor?

J Neurol. 2018 Feb;265(2):424-430. doi: 10.1007/s00415-017-8716-4. Epub 2017 Dec 22.

Abstract

Background: Oligoclonal IgM (OCMB) and IgG (OCGB) bands were found to be associated with poor multiple sclerosis (MS) prognosis.

Objective: We aimed to evaluate the prognostic value of OCMB/OCGB in a cohort of Sardinian MS patients.

Materials and methods: We recruited patients from the University of Cagliari. They underwent lumbar puncture for diagnostic purposes. Demographic and the following clinical data were recorded: clinical course; time to reach EDSS 3 and 6; EDSS at last follow-up; and MS treatments. The influence of gender, clinical course, age at onset, treatments, and OCGB/OCMB on reaching EDSS 3 was analysed using Cox regression. Kaplan-Meier curves were used to study the time to reach EDSS 3 considering OCMB/OCGB and therapies.

Results: The enrolled number of subjects was 503. The variables influencing the achievement of EDSS 3.0 were: male gender (p = 0.005); progressive course (p = 0.001); age at onset (p < 0.001); and disease-modifying drugs (p < 0.001). The OCGB/OCMB status was not significant. Kaplan-Meier analysis showed no difference in time to reach EDSS 3 for patients with and without OCGB or OCMB in both treated and non-treated groups.

Conclusion: Our study did not confirm the poor prognostic value of OCMB/OCGB. These results may be influenced by the peculiar genetic background associated with the risk of MS in Sardinians.

Keywords: Intrathecal oligoclonal bands; MS disability; Multiple sclerosis; Prognostic factors; Sardinia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Cohort Studies
  • Disability Evaluation
  • Female
  • Humans
  • Immunoglobulin G / metabolism
  • Immunoglobulin M / metabolism
  • Italy / epidemiology
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / pathology*
  • Oligoclonal Bands / metabolism*
  • Spinal Cord / metabolism*
  • Young Adult

Substances

  • Immunoglobulin G
  • Immunoglobulin M
  • Oligoclonal Bands