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Oligoclonal bands in multiple sclerosis: clinical-pathologic correlation
Abstract:
Although oligoclonal banding is a characteristic feature of MS spinal fluid, some patients do not show this abnormality. Four of 18 consecutive patients with autopsy-proven MS had no oligoclonal bands (OB) in CSF during life or at postmortem. Patients with OB had numerous plasma cells in meninges and plaques (confirmed in sections stained for cytoplasmic immunoglobulin). The four patients without bands had few or no identifiable plasma cells. Therefore, lack of OB correlates with both inactivity of plaques and absence of plasma cells in plaques or meninges. This is another form of heterogeneity in MS.
Insights
Some multiple sclerosis (MS) patients lack oligoclonal bands (OB) in cerebrospinal fluid (CSF). This absence correlates with inactive plaques and fewer plasma cells, indicating MS heterogeneity.
Area of Science:
- Neurology
- Immunology
- Pathology
Background:
- Oligoclonal bands (OB) in cerebrospinal fluid (CSF) are a hallmark of multiple sclerosis (MS).
- However, a subset of MS patients do not exhibit this finding.
- Understanding this heterogeneity is crucial for accurate diagnosis and prognosis.
Observation:
- This study examined 18 autopsy-proven MS patients.
- Four patients lacked oligoclonal bands (OB) in CSF during life and postmortem.
- These patients also showed minimal or no plasma cell infiltration in meninges and plaques.
Findings:
- Patients with OB displayed numerous plasma cells in meninges and plaques.
- Conversely, patients without OB had significantly fewer plasma cells.
- Lack of OB correlates with plaque inactivity and reduced meningeal/plaque plasma cell presence.
Implications:
- The absence of OB may indicate a distinct, less active form of MS.
- This finding highlights the heterogeneity of MS pathology.
- Further research is needed to understand the clinical significance of OB-negative MS.