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Oligoclonal IgM band patterns in multiple sclerosis: A two-center study.

Francesco Masi1, Sabrina Al Qudsi2, Davide Visigalli3

  • 1Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

Journal of Neuroimmunology
|April 27, 2025
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Summary

Cerebrospinal fluid (CSF) oligoclonal IgM bands (OCMBs) indicate poor prognosis in multiple sclerosis (MS). Both CSF-unique and serum-CSF identical OCMB patterns predict active MS disease and relapses, aiding treatment stratification.

Keywords:
BiomarkersIntrathecal IgM productionIsoelectric focusingPrognosisRelapsing-remitting multiple sclerosis

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Area of Science:

  • Neurology
  • Immunology
  • Biomarker Discovery

Background:

  • Cerebrospinal fluid (CSF) oligoclonal IgM bands (OCMBs) are potential prognostic markers in multiple sclerosis (MS).
  • The clinical significance of OCMBs detected in serum remains uncertain.

Purpose of the Study:

  • To determine the frequency and clinical relevance of all OCMB patterns in persons with MS (pwMS).
  • To evaluate OCMBs as predictors of active disease and relapses in MS.

Main Methods:

  • Retrospective analysis of 136 paired serum-CSF samples from pwMS across two centers.
  • OCMB detection using isoelectric focusing-immunoblotting.
  • Active disease defined by clinical or radiological relapse within a two-year follow-up period; statistical analysis via logistic regression and Kaplan-Meier curves.

Main Results:

  • OCMBs were detected in 6.6% of pwMS (pattern #2, CSF-unique) and 20.6% (pattern #4, serum-CSF identical).
  • Active disease was significantly more frequent in patients with pattern #2 (88.9%) and #4 (64.3%) compared to OCMB-negative individuals (33.3%).
  • Both pattern #2 (OR: 15.9) and #4 (OR: 3.3) independently predicted active disease, and both predicted radiological relapses.

Conclusions:

  • CSF OCMBs are confirmed indicators of poor prognosis in MS.
  • OCMB patterns #2 and #4 can help stratify pwMS for more aggressive treatment strategies.
  • Future stratification may utilize more standardized biomarkers like serum neurofilaments.