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Updated: Aug 30, 2025
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Oligoclonal M bands unveil occult inflammation in multiple sclerosis
Bonaventura Casanova1, Jessica Castillo1, Carlos Quintanilla-Bordás1
1Neuroimmunology Unit. València University and Polytechnic Hospital La Fe. València, Spain.
Introduction:
Recent works demonstrate that patients with multiple sclerosis (pwMS) and oligoclonal M bands (OCMB) in cerebrospinal fluid (CSF) are at higher risk of conversion to secondary progressive course, suggesting a distinct pathophysiology pathway in these patients.
Objectives:
To analyze the relationship of serum neurofilament light chain (s-NFL) in absence of inflammatory activity in people with multiple sclerosis (pwMS) according to the presence of OCMB versus healthy controls (HC), and the effect of aging.
Methods:
Two cohorts of HC were compared to a cohort of pwMS without clinical or radiological signs of acute inflammation. Lack of inflammation was defined as the absence of relapses or gadolinium-enhancing lesions (GEL) brain in an MRI performed within three months before and after s-NFL determination. S-NFL was measured with SIMOa technology. OCMB in the cerebrospinal fluid (CSF) were analyzed with isoelectric focusing and immunoblotting.
Results:
254 people were studied: 124 healthy voluntary controls and 130 pwMS. Despite the absence of inflammatory activity, pwMS and OCMB showed higher levels of s-NFL compared to those without OCMB and HC (11.4 pg/mL, 8.9 pg/mL and 9.0 pg/mL, respectively). A positive and exponential correlation between age and s-NFL was observed, with highest increases among pwMS and OCMB in the CSF.
Discussion:
In absence of overt inflammatory activity, pwMS and OCMB exhibit higher s-NFL levels, and a greater age-related increase. Thus, OCMB may portray an underlying inflammatory process not detected by conventional MRI studies and may explain the poorer prognosis of these patients.
Insights
Patients with multiple sclerosis (pwMS) and oligoclonal M bands (OCMB) show elevated serum neurofilament light chain (s-NFL) levels, even without active inflammation, suggesting OCMB indicate a distinct disease pathway.
Area of Science:
- Neurology
- Neuroimmunology
- Biomarker Research
Background:
- Multiple Sclerosis (MS) patients with oligoclonal M bands (OCMB) in cerebrospinal fluid (CSF) face a higher risk of progressing to a secondary progressive course.
- This suggests a unique pathophysiological pathway in these individuals.
Purpose of the Study:
- To investigate the relationship between serum neurofilament light chain (s-NFL) levels and the presence of OCMB in people with MS (pwMS).
- To analyze this relationship in the absence of inflammatory activity and assess the impact of aging.
- To compare s-NFL levels in pwMS with OCMB against those without OCMB and healthy controls (HC).
Main Methods:
- A study involving 130 pwMS and 124 HC, with pwMS selected for the absence of clinical or radiological signs of acute inflammation.
- Inflammation absence was confirmed by no relapses or gadolinium-enhancing lesions on MRI within three months of s-NFL measurement.
- s-NFL was quantified using SIMOa technology, and OCMB were analyzed in CSF via isoelectric focusing and immunoblotting.
Main Results:
- PwMS with OCMB exhibited significantly higher s-NFL levels (11.4 pg/mL) compared to pwMS without OCMB (8.9 pg/mL) and HC (9.0 pg/mL), despite the absence of overt inflammation.
- A positive, exponential correlation was observed between age and s-NFL levels.
- The most substantial age-related increases in s-NFL were noted in pwMS with OCMB in their CSF.
Conclusions:
- OCMB in pwMS are associated with elevated s-NFL levels, even without detectable inflammatory activity.
- These findings suggest OCMB may indicate an underlying inflammatory process not evident on standard MRI.
- The heightened s-NFL and accelerated age-related increase in pwMS with OCMB may explain their poorer prognosis.
