OBJECTIVE: To identify a biomarker distinguishing patients who, despite a primary progressive multiple sclerosis (PPMS) clinical course, may nonetheless benefit from immune therapy. METHODS: The presence or absence of both immunoglobulin (Ig) G and IgM oligoclonal bands (OCB) was blindly examined in paired cerebrospinal fluid (CSF) and serum samples from a large PPMS patient cohort, and related to clinical and imaging evidence of focal inflammatory disease activity. RESULTS: Using both cross-sectional samples and serial sampling in a subgroup of patients followed prospectively as part of the placebo-controlled OLYMPUS study of rituximab in PPMS, we found that the presence of CSF-restricted IgM OCB (but not of IgG OCB) is associated with an active inflammatory disease phenotype in PPMS patients. This finding was confirmed in an independent, multicenter validation cohort. INTERPRETATION: The presence of CSF IgM OCB may be a biomarker for a subset of PPMS patients with more active inflammatory disease, who may benefit from immune-directed treatments.
OBJECTIVE: To identify a biomarker distinguishing patients who, despite a primary progressive multiple sclerosis (PPMS) clinical course, may nonetheless benefit from immune therapy. METHODS: The presence or absence of both immunoglobulin (Ig) G and IgM oligoclonal bands (OCB) was blindly examined in paired cerebrospinal fluid (CSF) and serum samples from a large PPMS patient cohort, and related to clinical and imaging evidence of focal inflammatory disease activity. RESULTS: Using both cross-sectional samples and serial sampling in a subgroup of patients followed prospectively as part of the placebo-controlled OLYMPUS study of rituximab in PPMS, we found that the presence of CSF-restricted IgM OCB (but not of IgG OCB) is associated with an active inflammatory disease phenotype in PPMS patients. This finding was confirmed in an independent, multicenter validation cohort. INTERPRETATION: The presence of CSF IgM OCB may be a biomarker for a subset of PPMS patients with more active inflammatory disease, who may benefit from immune-directed treatments.
Authors: Bonaventura Casanova; Laura Lacruz; María Luisa Villar; José Andrés Domínguez; María Carcelén Gadea; Francisco Gascón; Javier Mallada; David Hervás; María Simó-Castelló; José Carlos Álvarez-Cermeño; Carmen Calles; Javier Olascoaga; Lluís Ramió-Torrentà; Carmen Alcalá; Angeles Cervelló; Isabel Boscá; Francisco Carlos Pérez-Mirallles; Francisco Coret Journal: Neurol Sci Date: 2018-06-07 Impact factor: 3.307
Authors: Kathrine E Attfield; Lise Torp Jensen; Max Kaufmann; Manuel A Friese; Lars Fugger Journal: Nat Rev Immunol Date: 2022-05-04 Impact factor: 53.106
Authors: Carmen Alcalá; F Gascón; F Pérez-Miralles; S Gil-Perotín; A Navarré; I Boscá; F Coret; B Casanova Journal: J Neurol Date: 2018-05-21 Impact factor: 6.682