The enigma of oligoclonal immunoglobulin G in cerebrospinal fluid from multiple sclerosis patients.

The cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) contains immunoglobulin G (IgG) of restricted heterogeneity (oligoclonal IgG). Philip Paterson and Caroline Whitacre here review the core evidence that IgG in MS patients and normal subjects is synthezised intracerebrally and that most of it does- not have demonstrable antigenic specificity. They advance the view that the enigmatic oligoclonal IgG may be a product of B cells which are non-specifically activated by mitogenic stimuli originating within injured CNS tissue as a consequence of the MS process.