Usefulness of antibody index assessment in cerebrospinal fluid from patients negative for total-IgG oligoclonal bands

Fluids and Barriers of the CNS

Manfred Wick¹  Brigitte Wildemann²  Peter Eichhorn¹  Sven Jarius² 

[1] Department of Clinical Chemistry, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany;Division of Molecular Neuroimmunology, Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany

关键词: MRZ reaction;    Multiple sclerosis;    Borrelia burgdorferi;    Rubella virus;    Measles virus;    Varicella zoster virus;    Cytomegalovirus;    Herpes simplex virus;    Oligoclonal bands;    Cerebrospinal fluid;    Antibody index;    Intrathecal IgG synthesis;   

Others  :  807216
DOI  :  10.1186/2045-8118-9-14

 received in 2012-04-14, accepted in 2012-07-11,  发布年份 2012

【 摘 要 】

Background

Testing for cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCB) by isoelectric focusing is used to detect intrathecally produced total IgG. By contrast, antibody indices (AI) are assessed to test for intrathecally produced antigen-specific IgG. A number of previous cases reports have suggested that AI testing might be more sensitive than OCB testing in detecting intrathecal IgG synthesis.

Findings

Here we report on 21 patients with positive AI for either herpes simplex virus, varicella zoster virus, cytomegalovirus, measles virus, rubella virus, or Borrelia burgdorferi in the absence of total-IgG OCB and, accordingly, in the presence of a normal total-IgG CSF/serum ratio.

Conclusion

Our findings indicate that AI testing should not generally be omitted in OCB-negative patients and provide a rationale for systematic and prospective studies on the comparative sensitivity and specificity of AI and total-IgG OCB testing in infectious and other diseases of the CNS.

【 授权许可】

   
2012 Jarius et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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