Comparison of Seven Formulae and Isoelectrofocusing for Determination of Intrathecally Produced IgG in Neurological Diseases

Ohman, S; Ernerudh, Jan; Forsberg, Pia; Henriksson, Annemarie; Schenck, H von; Vrethem, Magnus

doi:10.1177/000456329202900406

Cited by 52 publications

(21 citation statements)

References 17 publications

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“…In fact, the isolated finding of free light chain oligoclonal bands is a nonspecific finding and may argue against the diagnosis of MS. 23,25,26 Sensitivities for detecting oligoclonal banding using IEF with immunoblotting are in excess of 95% (Table 2). 11,[16][17][18][19] Although we do not yet understand the precise role of oligoclonal bands in MS, their presence is tightly coupled (Ͼ95%) with the disease and, thus, can provide a useful supplement to the diagnosis. The evidence for studies from approximately 3000 patients (Table 2) is presented from individual publications using IEF with immunofixation on more than 500 patients for sensitivity and for specificity using prospective studies with follow-up exceeding 2 years.…”

Section: Qualitative Methods In Csf Analysismentioning

confidence: 99%

Recommended Standard of Cerebrospinal Fluid Analysis in the Diagnosis of Multiple Sclerosis

Thompson²,

et al. 2005

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Section: Qualitative Methods In Csf Analysismentioning

confidence: 99%

Recommended Standard of Cerebrospinal Fluid Analysis in the Diagnosis of Multiple Sclerosis

Thompson²,

et al. 2005

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“…The most popular formulae, IgG index [167], IgG synthesis rate [168] (both are linear approaches) and IgG Loc [128] (a non-linear approach) are of similar clinical sensitivity in MS. Nevertheless, the use of a non-linear relation between the Ig quotient and the albumin quotient is recommended when there is BBB dysfunction, since a linear approach leads to a loss of sensitivity [1,84,128,198]. These bands of restricted heterogeneity were designated as oligoclonal in contrast to the normal electrophoretically heterogeneous polyclonal Ig pattern.…”

Section: S Evaluation Of Intrathecal Immunoglobulins Synthesismentioning

confidence: 99%

Oligoclonal bands and antibody responses in Multiple Sclerosis

Correale

Molinas²

2002

J Neurol

108

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Multiple Sclerosis (MS) is an inflammatory disease of the Central Nervous System with multifocal areas of demyelination. Although its etiology and pathogenesis remain controversial, several lines of evidence indicate that MS is mediated by a misdirected immune response against one or several myelin proteins. The involvement of diverse leukocyte subsets and their products in MS is still the subject of considerable debate. The emphasis on T cells has derived mainly from the detection of activated T cells in MS plaques and analogies with animal models of MS. Because of these observations cell-mediated immunity has dominated the research field of MS to this day. However, in recent years the role of B cells, plasma cells and immunoglobulins in MS have been re-examined, and current findings indicate that humoral immunity also plays a major role in disease pathogenesis. B cells and their products could exert several potential effects during the course of MS. Firstly, autoantibodies against specific myelin antigens could mediate damage to myelin membranes. Secondly, some studies suggest that natural autoantibodies could enhance remyelination. Thirdly, antibodies directed against myelin components can participate in anti-idiotypic networks, which may regulate the course of MS. Increased intrathecal immunoglobulin synthesis reflected by raised IgG indices and an oligoclonal pattern is the most common abnormality detected in MS patients. The introduction of more sensitive procedures for protein detection has allowed demonstrating oligoclonal bands (OCBs) in up to 95 % of patients with clinically definite MS. Although the presence of OCBs in CSF of MS patients is now well established as a sensitive laboratory test to support the clinical diagnosis, OCBs may be present in other disorders, including those not directly related to infection or abnormal immune response. Nevertheless, the pathogenesis of OCBs in MS is still obscure, and despite extensive research their antigenic target(s) have yet to be established. Therefore, a critical task is to identify the specificity of such target(s), thus providing significant clues about MS etiology. For this purpose, novel molecular immunologic strategies have been recently developed to offer alternative approaches to identify putative antigens recognized by antibodies present in MS patients. The elucidation of the mechanisms and target(s) responsible for the onset of MS has obvious implications for the further development of specific therapies.

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“…Selective increase in the C S F Ig G level has been observed consistendy in M S and it has become an impor tant laboratory test for confirmation o f the diagnosis (Poser et al, 1983). A selective C S F Ig G increase can be estab lished by using the Ig G Index (L in k and Tibbling, 1977), formulas for intrathecal produced Ig G (Reiber and Felgenhauer, 1987;Ohman et al, 1992) or by detection o f C S F restricted oligoclonal Ig G bands (W alk e r et al, 1983;Luxton et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

Cerebrospinal fluid free kappa light chains versus IgG findings in neurological disorders: qualitative and quantitative measurements

Lamers

Jong

Jongen

et al. 1995

Journal of Neuroimmunology

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In this study free kappa light chains in cerebrospinal fluid (C SF) were determined both by an affinity mediated capillary blotting technique after isoelectric focusing (IE F ) in agarose gel and by a quantitative enzyme linked immunosorbent assay (E L IS A ). The free kappa results were compared with the IgG findings in 4 neurological patient groups with a distinct C SF IgG pattern: (1) C SF without oligoclonal IgG bands, (2) C SF with serum derived IgG bands, (3) C SF restricted IgG bands and (4) C SF restricted and serum derived IgG bands. Oligoclonal free kappa bands are nearly absent in CSF of groups 1 + 2, and present in 88% of group 3 and 84% of group 4 patients. We could also establish free kappa indices from specimens in the 4 groups in analogy to IgG indices. Group 1 had a median free kappa index of 1.1, group 2: 1.0 and groups 3+ 4: 10.0. The correspondence between immunoblot and index findings for free kappa is better than for IgG. Free kappa index is more sensitive but somewhat less specific than IgG index for establishing intrathecal immune production.

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Comparison of Seven Formulae and Isoelectrofocusing for Determination of Intrathecally Produced IgG in Neurological Diseases

Cited by 52 publications

References 17 publications

Recommended Standard of Cerebrospinal Fluid Analysis in the Diagnosis of Multiple Sclerosis

Recommended Standard of Cerebrospinal Fluid Analysis in the Diagnosis of Multiple Sclerosis

Oligoclonal bands and antibody responses in Multiple Sclerosis

Cerebrospinal fluid free kappa light chains versus IgG findings in neurological disorders: qualitative and quantitative measurements

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