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Immunoglobulin M oligoclonal bands: Biomarker of targetable inflammation in primary progressive multiple sclerosis
Author(s) -
Villar Luisa M.,
Casanova Bonaventura,
Ouamara Nadia,
Comabella Manuel,
Jalili Farzaneh,
Leppert David,
de Andrés Clara,
Izquierdo Guillermo,
Arroyo Rafael,
Avşar Timuçin,
Lapin Sergey V.,
Johnson Trina,
Montalbán Xavier,
Fernández Oscar,
ÁlvarezLafuente Roberto,
Masterman Donna,
GarcíaSánchez María I.,
Coret Francisco,
Siva Aksel,
Evdoshenko Evgeniy,
ÁlvarezCermeño José C.,
BarOr Amit
Publication year - 2014
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.24190
Subject(s) - multiple sclerosis , biomarker , antibody , inflammation , immunology , medicine , immunoglobulin g , biology , genetics
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. Ann Neurol 2014;76:231–240