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Academia Mexicana de Neurología, A.C.

2005, Number 1

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Rev Mex Neuroci 2005; 6 (1)

Contribution of the detection of oligoclonal bands (OCB) in CSF for the confirmation of the diagnosis in multiple sclerosis (MS)

Robinson AMA, Guzmeli V, Martínez BM, Infante VE, Galvizo SRJ, Ochoa SM, Robinson AJE

Language: Spanish
References: 40
Page: 8-15
PDF size: 160.53 Kb.


ABSTRACT

Introduction: The presence of oligoclonal bands of IgG in the CSF continues being the immunologic alteration of greater usefulness for the diagnosis of the multiple sclerosis. The method that has shown greater sensitivity for its detection is the isoelectric focalization in agarosa followed by inmunofix with specific IgG. Objective: The work was directed to the assimilation and validation of the method for the detection of OCB in our laboratory. Patients and methods. Samples of CSF and serum of patients with the diagnosis of defined EM were evaluated according to Posser’s criteria and control subjects neurological and nonneurological, to determine the presence of OCB in these fluids. The method includes two stages: The assimilation of it and its validation (internal and external). The internal validation of the method contemplated the evaluation of sensitivity, specificity, precision and agreement tests. The external validation included an evaluation without information of control samples sent from a reference international laboratory for this system of diagnosis. Other analyses were directed to evaluate the contribution from this study’s to the confirmation of the clinical and immunological diagnosis. Results: The prevalence of OCB obtained in EMCD group was of 78.13%. The results showed a sensitivity of method of 78; 13% and a global effectiveness of 89,02%, a predictive value of 92,58% positivity, in accordance with reported by other groups. The test showed in addition a sensible contribution to the confirmation of the immunological diagnosis (40%) and clinical (10.12%), confirming its potentiality like diagnosis support in EM. Conclusion: Our results enhance that the detection of OCB continues being an element of great value in the confirmation of clinical diagnose in neurological diseases and particularly way in EM.


REFERENCES

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  2. Cabrera-Gómez JA, Santana Capote E, Echazábal-Santana N, Aguilera O, Gómez I, Ramos AM, et al. Esclerosis múltiple en Cuba. Estado actual y perspectiva. Rev Neurol 2000; 25 (Suppl. 3): S8.

  3. Datos analíticos. Frutos-Alegria MT, Beltrán Velazco I, Quilez-Iborra C, Moltó-Jordá J, Díaz-Marín C, Matias-Guiu Guia J. Epidemiología de la esclerosis múltiple en Alcoi. Rev Neurol 2002; 34: 813-16.

  4. Martino GR, Furtan PL, Poliani. El significado patogénico de la inflamación en la esclerosis múltiple. Rev Neurol 2000; 29: 1213-17.

  5. De la Maza M, García J, Bernal J, Fuentes M. Revisión de la epidemiología de la esclerosis múltiple en México. Rev Neurol 2000; 31: 494-5.

  6. Poser CM, Paty D W, Scheinberg L, McDonald W, Davis FA, Ebers GC, et al. New diagnostic criteria for multiple sclerosis guidelines for research protocols. Ann Neurol 1983; 13: 227-31.

  7. Burcet J, Zabay JM. Síntesis intratecal de IgG valorada mediante diferentes formulas: interés del análisis multivariante para el diagnóstico de esclerosis múltiple. Rev Neurol 2000; 31: 812-6.

  8. Reiber H. Cerebrospinal fluid–physiology, analysis and interpretation of protein patterns for diagnosis of neurological diseases. Multiple Sclerosis 1998; 4: 99-107.

  9. Anderson M, Alvarez-Cermeño J, Bernardi G, Cogato I. Cerebro spinal fluid in the diagnosis of multiple sclerosis: a concensus report. J Neurol Neurosurg Psychia 1994; 57: 897-902.

  10. Falip M, Tintoré M, Jardí R, Duran I, Link H, Montalbán X. Utilidad clínica de las bandas oligoclonales. Rev Neurol 2001; 32: 1120-24.

  11. Rand KH, Houck H, Denslow ND, Hielman KM. Molecular approach to find target (s) for oligoclonal bands in multiple sclerosis. J Neurol Neurosurg Psychiatry 1998; 65: 48-55.

  12. Krakauer M, Sclaldemose Nielsen J, Sellebjerg F. Intrathecal synthesis of the free immunoglobulins light chains in multiple sclerosis. Acta Neurol Scand 1998; 98: 161-5.

  13. Schipper HI, Kruse H, Reiber H. Silver staining of oligoclonal IgG subfractions in cerebrospinal fluid after isielectric focusig in thin-layer polyacrylamide gels. Science Tools.

  14. Poser CM. Diagnóstico de la esclerosis múltiple. Jornada de Actualización de Esclerosis Múltiple. 12 marzo de 1999; Montevideo, Uruguay.

  15. Ochoa R, Martinez JC, Estrada E, Garcia AM. Validación de inmunoensayos cualitativos usados para evaluar inmugenicidad de vacunas. Vaccine Monitor 2000; 9: 1-5.

  16. Reiber H. External quality assesment in clinical neurochemstry. Survey of analysis for cerebrospinal fluid (CSF) protein based on CSF /Serum quotients. Clin Chem Acta 1995, 41: 256-63.

  17. Uria DF. HLA y esclerosis múltiple. Estudios en la población española. Rev Neurol 2000; 31: 1066-70.

  18. Abers GC. Genetics and multiple sclerosis. An overview. Ann Neurol 1994; 36: 512-14.

  19. Yao SY, Stratton CW, Mitchell WM, Sriram S. CSF oligoclonal bands in MS include antibodies against chlamydophila antigens. Neurology 2001; 58: 1168-76.

  20. Fassas A, Passweg JR, Anagnoustopoulos A, Kaizs A, Kozak T, et al. Hematopoietic stem cell trasplantation for multiple sclerosis. A retrospective multicenter study. J Neurol 2002; 249: 1088-97.

  21. Brosnan CF, Raine CS. Mechanisms of immune injury in multiple sclerosis. Brain Pathol 1996; 6: 243-57.

  22. Cabrera-Gómez JA, Santana Capote E, Echazábal-Santana N, Aguilera O, Gómez I, Ramos AM, et al. Esclerosis múltiple en Cuba. Estado actual y perspectiva. Rev Neurol 2000; 25 (Suppl. 3): S8.

  23. Datos analíticos. Frutos-Alegria MT, Beltrán Velazco I, Quilez-Iborra C, Moltó-Jordá J, Díaz-Marín C, Matias-Guiu Guia J. Epidemiología de la esclerosis múltiple en Alcoi. Rev Neurol 2002; 34: 813-16.

  24. Martino GR, Furtan PL, Poliani. El significado patogénico de la inflamación en la esclerosis múltiple. Rev Neurol 2000; 29: 1213-17.

  25. De la Maza M, García J, Bernal J, Fuentes M. Revisión de la epidemiología de la esclerosis múltiple en México. Rev Neurol 2000; 31: 494-5.

  26. Poser CM, Paty D W, Scheinberg L, McDonald W, Davis FA, Ebers GC, et al. New diagnostic criteria for multiple sclerosis guidelines for research protocols. Ann Neurol 1983; 13: 227-31.

  27. Burcet J, Zabay JM. Síntesis intratecal de IgG valorada mediante diferentes formulas: interés del análisis multivariante para el diagnóstico de esclerosis múltiple. Rev Neurol 2000; 31: 812-6.

  28. Reiber H. Cerebrospinal fluid–physiology, analysis and interpretation of protein patterns for diagnosis of neurological diseases. Multiple Sclerosis 1998; 4: 99-107.

  29. Anderson M, Alvarez-Cermeño J, Bernardi G, Cogato I. Cerebro spinal fluid in the diagnosis of multiple sclerosis: a concensus report. J Neurol Neurosurg Psychia 1994; 57: 897-902.

  30. Falip M, Tintoré M, Jardí R, Duran I, Link H, Montalbán X. Utilidad clínica de las bandas oligoclonales. Rev Neurol 2001; 32: 1120-24.

  31. Rand KH, Houck H, Denslow ND, Hielman KM. Molecular approach to find target (s) for oligoclonal bands in multiple sclerosis. J Neurol Neurosurg Psychiatry 1998; 65: 48-55.

  32. Krakauer M, Sclaldemose Nielsen J, Sellebjerg F. Intrathecal synthesis of the free immunoglobulins light chains in multiple sclerosis. Acta Neurol Scand 1998; 98: 161-5.

  33. Schipper HI, Kruse H, Reiber H. Silver staining of oligoclonal IgG subfractions in cerebrospinal fluid after isielectric focusig in thin-layer polyacrylamide gels. Science Tools.

  34. Poser CM. Diagnóstico de la esclerosis múltiple. Jornada de Actualización de Esclerosis Múltiple. 12 marzo de 1999; Montevideo, Uruguay.

  35. Ochoa R, Martinez JC, Estrada E, Garcia AM. Validación de inmunoensayos cualitativos usados para evaluar inmugenicidad de vacunas. Vaccine Monitor 2000; 9: 1-5.

  36. Reiber H. External quality assesment in clinical neurochemstry. Survey of analysis for cerebrospinal fluid (CSF) protein based on CSF/Serum quotients. Clin Chem Acta 1995, 41: 256-63.

  37. Uria DF. HLA y esclerosis múltiple. Estudios en la población española. Rev Neurol 2000; 31: 1066-70.

  38. Abers GC. Genetics and multiple sclerosis. An overview. Ann Neurol 1994; 36: 512-14.

  39. Yao SY, Stratton CW, Mitchell WM, Sriram S. CSF oligoclonal bands in MS include antibodies against chlamydophila antigens. Neurology 2001; 58: 1168-76.

  40. Fassas A, Passweg JR, Anagnoustopoulos A, Kaizs A, Kozak T, et al. Hematopoietic stem cell trasplantation for multiple sclerosis. A retrospective multicenter study. J Neurol 2002; 249: 1088-97.




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